Serotype cycles in cholera dynamics

Katia Koelle, Mercedes Pascual, Md Yunus

Research output: Contribution to journalArticlepeer-review


Interest in understanding strain diversity and its impact on disease dynamics has grown over the past decade. Theoretical disease models of several co-circulating strains indicate that incomplete cross-immunity generates conditions for strain-cycling behaviour at the population level. However, there have been no quantitative analyses of disease time-series that are clear examples of theoretically expected strain cycling. Here, we analyse a 40-year (1966-2005) cholera time-series from Bangladesh to determine whether patterns evident in these data are compatible with serotype-cycling behaviour. A mathematical two-serotype model is capable of explaining the oscillations in case patterns when cross-immunity between the two serotypes, Inaba and Ogawa, is high. Further support that cholera's serotype-cycling arises from population-level immunity patterns is provided by calculations of time-varying effective reproductive rates. These results shed light on historically observed serotype dominance shifts and have important implications for cholera early warning systems.

Original languageEnglish (US)
Pages (from-to)2879-2886
Number of pages8
JournalProceedings of the Royal Society B: Biological Sciences
Issue number1603
StatePublished - Nov 22 2006


  • Cholera serotypes
  • Cholera two-strain model
  • Cross-immunity
  • Disease time series
  • Strain cycling

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology
  • General Immunology and Microbiology
  • General Environmental Science
  • General Agricultural and Biological Sciences


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