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Chapter 7 : Vibrio cholerae O139 Bengal
Beginning in October 1992, cases of cholera-like disease associated with a Vibrio cholerae strain that did not agglutinate with O1 antisera were noted in Madras, India. The emergence of V. cholerae O139 demonstrates that the O1 antigen is not an exclusive marker for epidemic potential and underscores the need to better understand the interplay of genetic and epidemiologic factors that allow strains to spread rapidly through populations. V. cholerae O139 Bengal does not agglutinate with monoclonal or polyclonal antisera directed against the O1 antigen. DNA sequences of 16S rRNA (positions 330 to 615) from these isolates are typical for V. cholerae O1 strains. V. cholerae O139 carries the gene for and expresses cholera toxin. Monoclonal and polyclonal antisera directed against the O139 antigen are available on a limited, experimental basis; such antisera should be available commercially in the near future. As with V. cholerae O1, the mainstay of therapy for diarrheal disease is oral rehydration. Since resistance to antimicrobial agents is in most instances plasmid mediated, it may be only a matter of time before tetracycline resistance is acquired by O139 strains.