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Background  Household contacts of cholera patients are at a 100 times higher risk of developing cholera than the general population. The objective of this study was to examine the incidence of  V .  cholerae  infections among household contacts of cholera patients in a rural setting in Bangladesh, to identify risk factors for  V .  cholerae  infections among this population, and to investigate transmission pathways of  V .  cholerae  using multilocus variable-number tandem-repeat analysis (MLVA).    Methodology/Principal findings  Stool from household contacts, source water and stored water samples were collected from cholera patient households on Day 1, 3, 5, and 7 after the presentation of the index patient at a health facility. Two hundred thirty clinical and water  V. cholerae  isolates were analyzed by MLVA. Thirty seven percent of households had at least one household contact with a  V .  cholerae  infection. Thirteen percent of households had  V .  cholerae  in their water source, and 27% had  V .  cholerae  in stored household drinking water. Household contacts with  V .  cholerae  in their water source had a significantly higher odds of symptomatic cholera (Odds Ratio (OR): 5.49, 95% Confidence Interval (CI): 1.07, 28.08). Contacts consuming street vended food had a significantly higher odds of a  V .  cholerae  infection (OR: 9.45, 95% CI: 2.14, 41.72). Older age was significantly associated with a lower odds of a  V .  cholerae  infection (OR: 0.96, 95% CI: 0.93, 0.99). Households with both water and clinical  V .  cholerae -positive samples all had isolates that were closely related by MLVA.    Conclusions/Significance  These findings emphasize the need for interventions targeting water treatment and food hygiene to reduce  V .  cholerae  infections.

A prospective cohort study comparing household contact and water Vibrio cholerae isolates in households of cholera patients in rural Bangladesh