PT  - JOURNAL ARTICLE
AU  - Sadie J. Ryan
AU  - Anna M. Stewart Ibarra
AU  - Eunice Ordóñez
AU  - Winnie Chu
AU  - Julia L. Finkelstein
AU  - Christine A. King
AU  - Luis E. Escobar
AU  - Christina Lupone
AU  - Froilan Heras
AU  - Erica Tauzer
AU  - Egan Waggoner
AU  - Tyler G. James
AU  - Washington B. Cárdenas
AU  - Mark Polhemus
TI  - Spatial and seasonal dynamics of cholera (<em>Vibrio cholerae</em>) in an estuary in southern coastal Ecuador
AID  - 10.1101/110189
DP  - 2017 Jan 01
TA  - bioRxiv
PG  - 110189
4099  - http://biorxiv.org/content/early/2017/09/22/110189.short
4100  - http://biorxiv.org/content/early/2017/09/22/110189.full
AB  - Cholera emergence is strongly linked to local environmental and ecological context. The 1991-2004 pandemic emerged in Perú and spread north into Ecuador’s El Oro province, making this a key site for potential re-emergence. Machala, El Oro, is a port city of 250,000, near the Peruvian border. Many livelihoods depend on the estuarine system, from fishing for subsistence and trade, to domestic water use. In 2014, we conducted biweekly sampling for 10 months in five estuarine locations, across a gradient of human use, and ranging from inland to ocean. We measured water characteristics implicated in V. cholerae growth and persistence: pH, temperature, salinity, and algal concentration, and evaluated samples in five months for pathogenic and non-pathogenic Vibrio cholerae, by polymerase chain reaction (PCR). We found environmental persistence of strains O1 and O139, but no evidence for toxigene presence. V. cholerae presence was coupled to algal and salinity concentration, and sites exhibited considerable seasonal and spatial heterogeneity. This study indicates that environmental conditions in Machala are optimal for human cholera re-emergence, with risk peaking during September, and higher risk near urban periphery low-income communities. This highlights a need for surveillance of this coupled cholera– estuarine system to anticipate potential future outbreaks.