CHOLERA Edited by Sivakumar Joghi Thatha Gowder Cholera Edited by Sivakumar Joghi Thatha Gowder Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Sandra Bakic Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published March, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Cholera, Edited by Sivakumar Joghi Thatha Gowder p. cm. ISBN 978-953-51-0415-5 Contents Preface IX Part 1 Epidemiology 1 Chapter 1 Cholera and Spatial Epidemiology 3 Frank B Osei, Alfred A Duker and Alfred Stein Chapter 2 Evaluating Spatial and Space-Time Clustering of Cholera in Ashanti-Region-Ghana 19 Frank B Osei, Alfred A Duker and Alfred Stein Chapter 3 Cholera in Lao P. D. R.: Past and Present 33 Satoshi Nakamura, Yutaka Midorikawa, Masami Nakatsu, Toru Watanabe, Rattanaphone Phethsouvanh, Phengta Vongphrachanh, Kongsap Akkhavong and Paul Brey Part 2 Biology of Vibrio Cholera 57 Chapter 4 Vibrio cholerae Flagellar Synthesis and Virulence 59 Anastasia R. Rugel and Karl E. Klose Chapter 5 Genetic Analysis of CTX Prophage and Antibiotic Resistance Determinants in Vibrio cholerae O1 Belonging to the Atypical El Tor Biotype from Kelantan, Malaysia 75 Choo Yee Yu, Geik Yong Ang and Chan Yean Yean Chapter 6 Integration of Global Regulatory Mechanisms Controlling Vibrio Cholerae Behavior 91 Jorge A. Benitez and Anisia J. Silva Part 3 Cholera Toxin and Antagonists 127 Chapter 7 The Cholera Toxin as a Biotechnological Tool 129 Olivera Noelia, Maia Cédola and Ricardo M Gómez VI Contents Chapter 8 Brefeldin A and Exo1 Completely Releave the Block of Cholera Toxin Action by a Dipeptide Metalloendoprotease Substrate 153 Davy Vanden Broeck and Marc J.S. De Wolf Chapter 9 Structure Based Design of Cholera Toxin Antagonists 177 Črtomir Podlipnik and Jose J. Reina Part 4 Treatment 201 Chapter 10 Evidence Based Treatment of Cholera: A review of Existing Literature 203 Marzia Lazzerini Preface On 21 October, 2010 Haitian public health authorities confirmed an outbreak of cholera. Ten months later the toll of this outbreak tallied 386,429 cases, including 5,885 deaths, with the outbreak spreading to the neighboring Dominican Republic and Florida, United States. Cholera is a world problem. One of the most basic lessons, which was so elegantly restated in an editorial in the New England Journal of Medicine, is that no one should lack access to clean water and sanitation. If we are to control and ultimately eradicate the deadly threat of cholera, the approach must include healthcare workers, scientists, and general public. The book Cholera focuses on various aspects of this disease with information significant for all people, from scientist and educators to general public. This book is comprised of four parts: Epidemiology, Biology of Vibrio cholerae, Cholera Toxin, and Antagonists and Treatment. First two parts describe the history of cholera, its geographical distribution, mode of transmission, and structural and functional activities of V. cholerae. The third part deals with cholera toxin in a study of antagonist drugs used to treat cholera. The author's detailed discussion of the structural and functional aspects of cholera toxin paves the way for future drug discovery to both prevent and cure cholera. In addition to W.H.O. and other regulatory treatment regimens, the fourth part adds to an overall understanding of current methods and potential areas for enhancement of outcomes for the welfare of individuals and society. Some key points of interest in Cholera include: the emergence of an epidemiologically dominant new strain of V. cholerae, the importance of the bacterial flagellum, biotechnological utilities of cholera toxin and methods to design cholera drugs, and the spatial epidemiologic tools applied in cholera studies. This book is a significant resource not only for cholera researchers but also for scientists, physicians, healthcare professionals, faculty and students, local administrators, and general public and it is my privilege to present this book. I extend my gratitude to my mother, my late father and my brothers for introducing me to higher education. My thanks to higher authorities, and colleagues of Qassim University for their motivation to carry out this project. I am indebted to my wife Anitha for her encouragement and technical support for this project. I also acknowledge the interest and commitment from the Publishing Process Manager at InTech, Ms. Irena Voric, whose patience and focus were an immense support in this X Preface project. Finally, I express deep and sincere gratitude to all the authors for their valuable contributions and scholarly cooperation for timely completion of this book. Dr. Sivakumar Joghi Thatha Gowder Department of Pharmacology & Biochemistry, Al-Qassim University, College of Pharmacy, Buraidah, Saudi Arabia . CHOLERA Edited by Sivakumar Joghi Thatha Gowder Cholera Edited by Sivakumar Joghi Thatha Gowder Published by InTech. copies can be obtained from orders@intechopen.com Cholera, Edited by Sivakumar Joghi Thatha Gowder p. cm. ISBN 978-953-51-0415-5