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Epidemic and global pandemic cholera have claimed millions of lives since the first pandemic in 1817 and it continues to exact a huge annual toll, with endemics established in approximately 50 countries worldwide (Ryan, 2011). More than 200 serogroups have been reported to date (Safa et al., 2009), but only two serogroups of Vibrio cholerae, the O1 and O139 serogroups, are known to have the potential for unleashing epidemic and pandemic cholera. The O1 serogroup of V. cholerae can be further divided into the classical or El Tor biotypes based on a number of phenotypic and genotypic characteristics (Sack et al., 2004). Seven pandemics of cholera have been recorded to date, where the first six pandemics were associated with V. cholerae serogroup O1 of the classical biotype, whereas the current ongoing seventh pandemic (1961 until present day) is caused by V. cholerae serogroup O1 of the El Tor biotype (Faruque et al., 1998). In 1992, the emergence and rapid spread of V. cholerae serogroup O139 from the Indian subcontinent to neighbouring countries was viewed as a possible threat that might initiate an eighth cholera pandemic. At the height of the O139 outbreak, the Indian subcontinent saw a dramatic displacement of the V. cholerae O1 El Tor as the dominant strain. However, rather than being driven to gradual extinction like the classical biotype, an unprecedented turn of events in 1994 saw V. cholerae O1 El Tor regain its predominance over the O139 serogroup and both serogroups continue to cause disease on the Indian subcontinent (Faruque et al., 2003).

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Genetic Analysis of CTX Prophage and Antibiotic Resistance Determinants in Vibrio cholerae O1 Belonging to the Atypical El Tor Biotype from Kelantan, Malaysia