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A comparison of purging and multiple rectal swabs in the detection of inapparent cholera infections
Abstract:
The relative effectiveness of daily rectal-swab cultures and cultures of purged stools in detecting inapparent infections of Vibrio cholerae were compared in family contacts of cholera patients. In one study of 187 contacts, a combination of purging by various methods plus 5 daily swabs detected 50 infections. Only 27 (54%) were detected by the purge alone, while 47 (94%) were detected by 5 daily rectal-swab cultures. In a second study of two groups of family contacts, purging on the first day did not appear to influence significantly the number of positive rectal-swab cultures obtained during the 4 subsequent days. The relative inefficiency of purging in detecting the inapparent infections among cholera contacts, as compared with its reported efficacy in the chronic convalescent carrier, probably reflects a basic difference in the pathogenesis and site of infection in these different conditions.
Insights
Daily rectal-swab cultures are more effective than purging for detecting Vibrio cholerae inapparent infections among cholera patient contacts. Rectal swabs identified 94% of infections, while purging alone detected only 54%.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Vibrio cholerae causes cholera, a significant global health concern.
- Detecting inapparent infections in contacts is crucial for cholera control.
- The efficacy of different diagnostic methods for asymptomatic carriers is not well-established.
Purpose of the Study:
- To compare the effectiveness of daily rectal-swab cultures versus purged stool cultures in identifying Vibrio cholerae in family contacts.
- To evaluate the role of purging in detecting asymptomatic cholera infections.
Main Methods:
- Two studies were conducted involving family contacts of cholera patients.
- Rectal-swab cultures were performed daily for five days.
- Stool samples were collected after purging, and their cultures were analyzed.
- Comparison of infection detection rates between the two methods.
Main Results:
- Daily rectal-swab cultures detected 94% of Vibrio cholerae infections in contacts.
- Purged stool cultures alone identified only 54% of infections.
- Purging on the first day did not significantly increase the yield of subsequent rectal-swab cultures.
Conclusions:
- Daily rectal-swab cultures are a more sensitive method for detecting inapparent Vibrio cholerae infections in cholera contacts.
- Purging is relatively ineffective for identifying asymptomatic infections in this population.
- Differences in diagnostic yield may reflect distinct infection sites or pathogenesis in asymptomatic contacts versus chronic carriers.
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