Genomic insights into the 2022–2023 Vibrio cholerae outbreak in Malawi

Chrispin Chaguza, Innocent Chibwe, David Chaima, Patrick Musicha, Latif Ndeketa, Watipaso Kasambara, Chimwemwe Mhango, Upendo Mseka, Joseph Bitilinyu-Bangoh, Bernard Mvula, Wakisa Kipandula, Patrick Bonongwe, Richard J. Munthali, Selemani Ngwira, Chikondi Mwendera, Akuzike Kalizang’oma, Kondwani Jambo, Dzinkambani Kambalame, Arox W. Kamng’ona, A. Duncan SteeleAnnie Chauma-Mwale, Daniel Hungerford, Matthew Kagoli, Martin M. Nyaga, Queen Dube, Neil French, Chisomo L. Msefula, Nigel A. Cunliffe, Khuzwayo C. Jere

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

Malawi experienced its deadliest Vibrio cholerae (Vc) outbreak following devastating cyclones, with >58,000 cases and >1700 deaths reported between March 2022 and May 2023. Here, we use population genomics to investigate the attributes and origin of the Malawi 2022–2023 Vc outbreak isolates. Our results demonstrate the predominance of ST69 clone, also known as the seventh cholera pandemic El Tor (7PET) lineage, expressing O1 Ogawa (~ 80%) serotype followed by Inaba (~ 16%) and sporadic non-O1/non-7PET serogroups (~ 4%). Phylogenetic reconstruction revealed that the Malawi outbreak strains correspond to a recent importation from Asia into Africa (sublineage AFR15). These isolates harboured known antimicrobial resistance and virulence elements, notably the ICEGEN/ICEVchHai1/ICEVchind5 SXT/R391-like integrative conjugative elements and a CTXφ prophage with the ctxB7 genotype compared to historical Malawian Vc isolates. These data suggest that the devastating cyclones coupled with the recent importation of 7PET serogroup O1 strains, may explain the magnitude of the 2022–2023 cholera outbreak in Malawi.

Original languageEnglish
Article number6291
Pages (from-to)e6291
JournalNature Communications
Volume15
Issue number1
Early online date26 Jul 2024
DOIs
Publication statusPublished - 26 Jul 2024

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