System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Preprint Epublish

PubMed: 40766146 DOI: 10.1101/2025.07.30.25332375

Clinical and environmental wastewater-based bacteriophage surveillance for high-impact diarrheal diseases, including cholera, in Bangladesh.

medRxiv

Authors: Marjahan Akhtar, Md Ariful Amin, Subah Nuzhat Hussain, Nazia Nazrul Nafsi, Nasrin Parvin, Farhana Khanam, Md Taufiqul Islam, Md Amirul Islam Bhuiyan, Rahima Afroz, Md Golam Firoj, Fahima Chowdhury, Ashraful Islam Khan, Mohammad Jubair, Edward T Ryan, B Jesse Shapiro, Nicholas R Thomson, Eric J Nelson, Md Mustafizur Rahman, Yasmin Ara Begum, Taufiqur Rahman Bhuiyan, Firdausi Qadri

Affiliations

  • Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
  • Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.
  • Department of Medicine, Harvard Medical School, Boston, MA, USA.
  • Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Department of Microbiology and Immunology, McGill University, Montreal, Canada.
  • Parasites and Microbes, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridgeshire, UK.
  • Department of Pathogen Molecular Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London.
  • Departments of Pediatrics and Environmental and Global Health, University of Florida, USA.

Abstract

Bacteriophages (phages) likely play a critical role in modulating transmission dynamics of diarrheal pathogens. This study investigated the role of phages in modulating the prevalence and seasonal patterns of major diarrheal pathogens, Vibrio cholerae O1 (VCO1), enterotoxigenic Escherichia coli (ETEC), Shigella spp., and Salmonella spp. in diarrheal patients and environmental wastewater specimens collected from six different sites in Dhaka, Bangladesh, in 2024. VCO1, ETEC, Shigella, and Salmonella were detected in 10.1%, 7.8%, 1.7%, and 2.4% of diarrheal specimens, respectively. In contrast, phages targeting these pathogens were more frequently isolated, with detection rates of 20% for VCO1, 30% for ETEC, 57% for Shigella, and 9.2% for Salmonella-specific phages. Adults showed a significantly higher burden of VCO1 and corresponding phages compared to children <5 years (P<0.001). Seasonal analysis revealed significant correlations between VCO1 (37.3%) and corresponding phages (57.6%) peaking in late September in both clinical (R = 0.53, P< 0.0001) and environmental wastewater specimens (R = 0.65, P<0.001). The highest correlation (R=0.68) was found between the increased rate of wastewater phages in the preceding week and a rise in cholera cases in the following week. ETEC and ETEC phages isolated from wastewater also showed strong correlations (R = 0.65, P<0.001). Cross-specificity analysis demonstrated that VCO1 phages were highly specific to their targets, whereas ETEC and Shigella phages exhibited broader host ranges, with some Shigella phages capable of infecting ETEC and Salmonella spp. Overall, these findings underscore the potential of bacteriophages as an alternate or adjunctive tool for cholera surveillance.

MeSH

Bacteriophages, Cholera