At the Matlab Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh, the authors examined the blood groups of patients hospitalized between January and September 1979 for diarrheal disease due to a variety of bacterial and viral agents. A significant association was identified only for cholera, in which cholera patients were twice as likely to have blood group O and one-ninth as likely to have blood group AB as community controls. A follow-up study of family contacts of cholera patients, carried out between September 1980 and July 1982, indicated that blood group did not affect an individual's risk of having a culture-proven infection with V. cholerae 01 but was directly related to the severity of disease. Individuals with the most severe diarrhea compared with those with asymptomatic infection were more often of blood group O (68% versus 36%, p less than 0.01) and less often of AB (0% versus 7%, p less than 0.01). It was not possible to identify the molecular basis for this genetically related protection using biologic models of cholera that are currently available. 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 Gangetic Delta.

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The ABO blood group of 87 bacteriologically proven cases of cholera and 33 bacteriologically negative cholera-like diarrhoea cases was determined. When compared with the normal blood group distribution in the population of the Philippines of the same racial group to which the patients belonged, a relatively larger number of cases were found to occur in individuals of group O and a lesser number in those of group A. A plea is made for further studies on these lines to explain the host susceptibility in cholera and other acute enterotoxigenic diarrhoeas.

In the course of studies of immunity to experimental cholera in man, 10(5) or 10(6) Vibrio cholerae were given to 66 college students and other community volunteers under quarantine in an isolation ward. HLA antigen and blood group determinations were carried out to test the hypothesis that severity of clinical cholera is dependent in part upon genetically-determined host susceptibility. Fifty-five volunteers developed diarrhoea; 38 had mild illness and 17 had severe cholera (stool volume greater than or equal to 5.0 litres). HLA antigens were found in similar frequency in volunteers with severe, mild or no diarrhoea; antigen A1, A2, A3 and B7 were most common. Blood group O, however, was found in 64% of persons with severe cholera versus 36-38% of volunteers with mild or absent illness. Thus, while no correlation was found between HLA type and severity of cholera, these results do support the claims of other investigators that blood group O is found more frequently in patients with severe cholera than in the normal population.

SUMMARYYersinia enterocolitica serotype IX has been found to stimulate the production of vibriocidal antibody against Vibrio cholerae, particularly in Inaba serotype, in experimental rabbits and infected man to a significant degree. This activity could be absorbed by both Inaba and Yersinia antigens from anti-yersinia sera, but Yersinia antigen could not absorb vibriocidal activity from the anti-cholera sera, indicating a unilateral relation.Vibrio agglutinating antibody, particularly against Ogawa, in anti-yersinia rabbit or human sera was found to be less liable to non-specific stimulation.V. cholerae, while removing vibriocidal antibody, could not absorb the Yersinia agglutinin from anti-yersinia sera, suggesting that there is a different determinant for these two types of antibody activities. The non-specific production of vibriocidal antibody by Y. enterocolitica type IX indicates the need for caution in the interpretation of the results of vibriocidal tests where such organisms are prevalent.