Jesse Shapiro and Abu Sayeed describe a nation-wide surveillance program of diarrheal patients of Bangladesh. An exploratory metagenomic analysis of stool samples from cholera patients in this cohort led us to discover that the ratio of phages (viruses that kill bacteria) to bacteria (in this case, Vibrio cholerae) was inversely associated with milder disease severity.
They further show how V. cholerae coevolves with its phages within these patients and discuss the implications for phage therapy. On an applied level, we designed a new cholera rapid diagnostic test that integrates information from both V. cholerae and phages. Together, this work highlights how an eco-evolutionary perspective on infectious disease can inform diagnostics, and eventually treatments.
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