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The use of cholera vaccines has been increasingly recognized as an effective control measure in cholera endemic countries. However, guidelines for using vaccination during cholera outbreaks are still to be established, and it remains an open question as to how and when the vaccines should be deployed to best control ongoing cholera outbreaks. Here we formulate a new optimal control model to assess the value of cholera vaccines in epidemic settings and cost-effective optimal times to deploy a vaccine. Our results suggest that as long as the vaccine prices are sufficiently low, vaccination should always start from or immediately after the onset of a cholera outbreak.

The use of cholera vaccines has been increasingly recognized as an effective control measure in cholera endemic countries. Also, the disease transmissions are getting more complicated and thus comprehensive strategies to implement public health control measures are worthwhile to be investigated. In this paper, we aim to better understand the effects of HI states of vibrios from the environment and from human contacts that cause cholera outbreaks. We also present and analyze our cholera mathematical model with vaccine incorporated. Equilibrium analysis is conducted in the case with constant control for both epidemic and endemic dynamics. Optimal control theory is applied to seek cost-effective solutions of time-dependent vaccination strategies against cholera outbreaks. Our results show that using vaccination during cholera outbreaks at the very beginning of the onset can reduce the number of infections significantly.

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