Cholera: assessing the risk to travellers and identifying methods of protection

Steffen, Robert; Acar, J. F.; Walker, Eric; Zuckerman, Jane N.

doi:10.1016/s1477-8939(03)00062-0

Cited by 36 publications

(23 citation statements)

References 23 publications

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“…When cholera invades immunologically naive underprivileged populations in so-called "virgin soil" epidemic areas, as occurred recently in Haiti (1), the attack rates can be exceedingly high. Whereas the overall risk of becoming infected with cholera is not high among travelers from industrialized countries who visit developing countries (2), for certain types of individuals (e.g., providers of emergency aid during cholera outbreaks, as in Haiti) (3), hosts with known risk factors for cholera gravis (e.g., hypochlorhydria, O blood type, and cardiac or renal disease), and those who will not have ready access to clinical care, immunization against cholera is both indicated and prudent (4). Regrettably, no cholera vaccine is presently available for travelers from the United States.…”

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confidence: 99%

Safety and Immunogenicity of Single-Dose Live Oral Cholera Vaccine Strain CVD 103-HgR, Prepared from New Master and Working Cell Banks

Chen¹,

Greenberg²,

Pasetti³

et al. 2013

Clin. Vaccine Immunol.

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c Currently, no cholera vaccine is available for persons traveling from the United States to areas of high cholera transmission and who for reasons of occupation or host factors are at increased risk for development of the disease. A single-dose oral cholera vaccine with a rapid onset of protection would be particularly useful for such travelers and might also be an adjunct control measure for cholera outbreaks. The attenuated Vibrio cholerae O1 vaccine strain CVD 103-HgR harbors a 94% deletion of the cholera toxin A subunit gene (ctxA) and has a mercury resistance gene inserted in the gene encoding hemolysin A. We undertook a phase I randomized placebo-controlled two-site trial to assess the safety and immunogenicity of a preliminary formulation of CVD 103-HgR prepared from new master and working cell banks. Healthy young adults were randomized (5:1 vaccinees to placebo recipients) to receive a single oral dose of ϳ4.4 ؋ 10 8 CFU of vaccine or a placebo. Blood serum vibriocidal and cholera toxin-specific IgG antibodies were measured before and 10, 14, and 28 days following vaccination or placebo. Excretion of the vaccine strain in the stool was assessed during the first week postvaccination. A total of 66 subjects were enrolled, comprising 55 vaccinees and 11 placebo recipients. The vaccine was well tolerated. The overall vibriocidal and anti-cholera toxin seroconversion rates were 89% and 57%, respectively. CVD 103-HgR is undergoing renewed manufacture for licensure in the United States under the auspices of PaxVax. Our data mimic those from previous commercial formulations that elicited vibriocidal antibody seroconversion (a correlate of protection) in ϳ90% of vaccinees. (This study has been registered at ClinicalTrials.gov under registration no. NCT01585181.)

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confidence: 99%

Safety and Immunogenicity of Single-Dose Live Oral Cholera Vaccine Strain CVD 103-HgR, Prepared from New Master and Working Cell Banks

Chen¹,

Greenberg²,

Pasetti³

et al. 2013

Clin. Vaccine Immunol.

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“…The latter, designed to protect travellers against cholera, has been proven effective against TD caused by enterotoxic E. coli, the most frequent cause of this type of disease. Protection against TD can reach 80% [33,34] .…”

Section: Treatment Of Foodmentioning

confidence: 99%

Focus on acute diarrhoeal disease

Baldi¹,

Bianco²,

Nardone³

et al. 2009

WJG

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Diarrhoea is an alteration of normal bowel movement characterized by an increase in the water content, volume, or frequency of stools. Diarrhoea needs to be classified according to the trends over time (acute or chronic) and to the characteristics of the stools (watery, fatty, inflammatory). Secretory diarrhoeas, mostly acute and of viral aetiology in more than 70% of cases, are by far the most important subtype of diarrhoeas in terms of frequency, incidence and mortality (over 2

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“…Cholera is an acute, watery diarrhoeal disease, caused by the Gram-negative bacterium Vibrio cholerae belonging to serogroups O1 and O139 [1]. Transmission is via the faecal-oral route through contaminated water or food [1].…”

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confidence: 99%

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confidence: 99%

“…Transmission is via the faecal-oral route through contaminated water or food [1]. Management of cholera with simple, inexpensive rehydration treatment has shown to be highly effective in reducing mortality [1,2]. Human cholera epidemics and the mortality associated with such water-borne diseases still remains a public health threat worldwide, particularly in regions with poor sanitation facilities and limited access to clean drinking water.…”

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confidence: 99%

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