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A database of blood group correlations to common diseases



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Infectious disease, Cholera


Description:Cholera offers a huge selective disadvantage to Blood Type O. Effectively speaking, Blood Type O is almost guaranteed to be the blood type that gets the most severe form of this once dreaded epidemic infection. It has been speculated that the low incidence of Type O over Type A in Mediterranean cities with ancient roots may in fact have been the selective effect of Type O people dying more frequently from cholera. The constant selective pressure of cholera against Type Os may account in part for the extremely low prevalence of Type O genes and the high prevalence of Type B genes found among the people living in the Ganges Delta in India. Type ABs appear to have the highest degree of protection from cholera infections.Worse for Type Os, their outcome after infection is poor. In a household survey conducted in Trujillo, Peru, in 1991, at the onset of a Latin American cholera epidemic, Type O was strongly associated with severe cholera: Infected persons had more diarrhea-like stools per day than persons of other blood groups, were more likely to report vomiting and muscle cramps, and were almost eight times more likely to require hospital treatment. In an independent study, similar findings were reported. Individuals with the most severe diarrhea compared with those with asymptomatic infection were more often Type O.

Group AB may be associated with the lowest risk and least severe symptoms.

Type O and cholera: This 'interaction' between the type O antigen and a bacterial toxin may also help explain why type O's have been strongly associated with severe attacks of the debilitating and life-threatening intestinal infection, cholera. You don't hear much about cholera these days, as modern public health measures in the industrialized countries have pretty much eradicated it. However cholera still accounts for enormous numbers of deaths (diarrhea is the number one cause of death worldwide) and as little as 100 years ago was common in the slums of many modern cities, such as London and New York. In ancient times cholera epidemics routinely decimated large cities. Several highly lethal plagues which were the scourge of the Roman world are now though to have been in fact cholera.

A household survey conducted in 1991, at the onset of a Latin American cholera epidemic, investigated high attack rates in Trujillo, Peru. (1) Blood group O was strongly associated with severe cholera: Infected persons had more diarrhea-like stools per day than persons of other blood groups, were more likely to report vomiting and muscle cramps, and were almost eight times more likely to require hospital treatment.

It has been speculated that the low incidence of type O over type A in Mediterranean cities with ancient roots may in fact have been the selective effect of type O dying more frequently from infectious diseases, such as cholera.

The constant selective pressure of cholera against people of O blood group may account in part for the extremely low prevalence of O group genes and the high prevalence of B group genes found among the people living in the Ganges Delta in India. (2) Mourant has also speculated that the effect of endemic cholera infection may also be responsible for the low numbers of type O inhabitants of ancient Mediterranean cities. (1) If so, this would imply that differences between the blood types in surviving the common and lethal infections found in the prehistoric and ancient world were powerful and selective influences on their distribution in different populations.

Individuals with the most severe diarrhea compared with those with asymptomatic infection were more often of blood group O (68% versus an expected frequency of 36) and less often of AB (0% versus an expected frequency of 7). In essence, cholera patients were twice as likely to have blood group O and one-ninth as likely to have blood group AB.
References:1. Mourant AE Blood Types and Disease Oxford university Press 1979

2. Swerdlow DL, Mintz ED, Rodriguez M, Tejada E, Ocampo C, Espejo L, Barrett TJ, Petzelt J, Bean NH, Seminario L, et al Severe life-threatening cholera associated with blood group O in Peru: implications for the Latin American epidemic J Infect Dis 1994 Aug;170(2):468-72

3.Glass RI, Holmgren J, Haley CE, Khan MR, Svennerholm AM, Stoll BJ, Belayet Hossain KM, Black RE, Yunus M, Barua D Predisposition for cholera of individuals with O blood group. Possible evolutionary significance. Am J Epidemiol 1985 Jun;121(6):791-6





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