Environmental reservoirs of Vibrio cholerae

The environmental reservoir of Vibrio cholerae, the causative agent of cholera, has been a topic of scientific investigation ever since the discovery of the bacterium itself. While the bacteria can be isolated from both clinical and environmental sources during epidemics, it evades isolation by conventional culture techniques during the period between successive epidemics. The problem is identifying the location and mode of survival and multiplication of V. cholerae during this inter-epidemic period. This information is crucial not only for epidemiological reasons, but also because the seasonality of cholera epidemics is plausibly mediated by the climate-regulated activity of the reservoir. This article focuses on the epidemiological importance of the environmental reservoir of V. cholerae, considering several investigations made on different types of aquatic fauna (zooplanktons, crustaceans, etc.) and flora (macrophytes and microphytes). After evaluating different lines of evidence, we make the case that certain species of cyanobacteria (Anabaena variabilis, Microcystis aeruginosa) can act as inter-epidemic reservoirs of V. cholerae. Physiological and functional aspects of this association are also discussed. We then present a hypothesis, expanding upon a previously published conceptual model, of how the climate-regulated seasonality of cholera epidemics is mediated by the effect of climatic factors on algal bloom and other local abiotic variables in the water, using Bangladesh as a model. Finally, another aspect of the climate-dependence of disease patterns is briefly explored: large-scale environmental signatures associated with cholera, and recent modelling efforts to predict cholera outbreaks based on coastal phytoplankton. The review, therefore, serves not only as a study of the identity of the inter-epidemic reservoir of V. cholerae, but also explores different ways in which the reservoir and the pathogen behaviour is affected by the climate, and the possible consequences it may have on disease pattern.