Journal
SCIENCE
Volume 358, Issue 6364, Pages 785-+Publisher
AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/science.aad5901
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Funding
- Institut Pasteur
- Institut Pasteur International Network
- Institut de Veille Sanitaire
- French government's Investissement d'Avenir program
- Fondation Le Roch-Les Mousquetaires
- Wellcome Trust [098051]
- Indian Council of Medical Research, New Delhi, India
- Specific Technologies, Mountain View, California
- Laboratoire d'Excellence Integrative Biology of Emerging Infectious Diseases [ANR-10-LABX-62-IBEID]
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The seventh cholera pandemic has heavily affected Africa, although the origin and continental spread of the disease remain undefined. We used genomic data from 1070 Vibrio cholerae O1 isolates, across 45 African countries and over a 49-year period, to show that past epidemics were attributable to a single expanded lineage. This lineage was introduced at least 11 times since 1970, into two main regions, West Africa and East/ Southern Africa, causing epidemics that lasted up to 28 years. The last five introductions into Africa, all from Asia, involved multidrug-resistant sublineages that replaced antibiotic-susceptible sublineages after 2000. This phylogenetic framework describes the periodicity of lineage introduction and the stable routes of cholera spread, which should inform the rational design of control measures for cholera in Africa.
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