Seroepidemiological Studies of EI Tor Cholera in Bangladesh: Association of Serum Antibody Levels with Protection

Glass, Roger I.; Svennerholm, Ann‐Mari; Khan, M. R.; Huda, Shamsul; Huq, M. I.; Holmgren, Jan

doi:10.1093/infdis/151.2.236

Cited by 181 publications

(172 citation statements)

References 19 publications

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“…The peak of bactericidal antibody activity occurred 2 weeks postvaccination, correlating with peak IgG levels and suggesting that S. Typhi-specific IgGs are largely responsible for complementmediated killing (31). Similar studies measuring vibriocidal antibody responses following exposure to V. cholerae implicated anti-LPS IgMs as the primary antibody subtype contributing to complement-mediated cell lysis (5,16,29,48). The IgM response to S. Typhi has heretofore been uncharacterized.…”

Section: Discussionmentioning

confidence: 89%

Antibodies in Action: Role of Human Opsonins in Killing Salmonella enterica Serovar Typhi

et al. 2011

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Although vaccines have been available for over a century, a correlate of protection for typhoid fever has yet to be identified. Antibodies are produced in response to typhoid infection and vaccination and are generally used as the gold standard for determining vaccine immunogenicity, even though their role in clearance of Salmonella enterica serovar Typhi infections is poorly defined. Here, we describe the first functional characterization of S. Typhi-specific antibodies following vaccination with a new vaccine, M01ZH09 (Ty2 ⌬aroC ⌬ssaV). We determined that postvaccination sera increased the uptake of wild-type S. Typhi by human macrophages up to 2.3-fold relative to prevaccination (day 0) or placebo samples. These results were recapitulated using immunoglobulins purified from postvaccination serum, demonstrating that antibodies were largely responsible for increases in uptake. Imaging verified that macrophages internalized 2-to 9.5-fold more S. Typhi when the bacteria were opsonized with postvaccination sera than when the bacteria were opsonized with day 0 or placebo sera. Once inside macrophages, the survival of S. Typhi was reduced as much as 50% when opsonized with postvaccination sera relative to day 0 or placebo serum samples. Lastly, bactericidal assays indicated that antibodies generated postvaccination were recognized by complement factors and assisted in killing S. Typhi: mean postvaccination bactericidal antibody titers were higher at all time points than placebo and day 0 titers. These data clearly demonstrate that there are at least two mechanisms by which antibodies facilitate killing of S. Typhi. Future work could lead to improved immunogenicity tests associated with vaccine efficacy and the identification of correlates of protection against typhoid fever.

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Section: Discussionmentioning

confidence: 89%

Antibodies in Action: Role of Human Opsonins in Killing Salmonella enterica Serovar Typhi

et al. 2011

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“…10,17,18 Presumably, this increase over a lifetime is caused by frequent exposure to V. cholerae. The present study suggests that, in a highly cholera-endemic area, patients have exposures to V. cholerae sufficient to generate a vibriocidal response that begins as early as 6 months after an episode of severe cholera.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is no threshold level of vibriocidal titer that confers complete protection from infection or symptoms, and the vibriocidal antibody is thought to be a surrogate marker of a protective mucosal immune response. [7][8][9][10] In areas where cholera is endemic, most residents have detectable vibriocidal antibodies by the teenage years, and titers increase with age. 10,11 Because of the background rate of vibriocidal antibodies in these populations, there is no threshold cutoff diagnostic of infection in an endemic area.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9][10] In areas where cholera is endemic, most residents have detectable vibriocidal antibodies by the teenage years, and titers increase with age. 10,11 Because of the background rate of vibriocidal antibodies in these populations, there is no threshold cutoff diagnostic of infection in an endemic area. Rather, a fourfold or greater increase between paired acute and convalescent measurements of the serogroup-specific vibriocidal titer is preferred for documentation of recent V. cholerae exposure in endemic areas.…”

Section: Introductionmentioning

confidence: 99%

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Frequency of Reexposure to Vibrio cholerae O1 Evaluated by Subsequent Vibriocidal Titer Rise after an Episode of Severe Cholera in a Highly Endemic Area in Bangladesh

Weil¹,

Chowdhury²,

Khan³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. Vibriocidal antibody is a marker of recent exposure to Vibrio cholerae O1 infection. We examined vibriocidal titers for 1 year after an episode of severe cholera in patients in Dhaka, Bangladesh; 16 of 53 (30%) patients had a fourfold or greater increase in vibriocidal titer between 6 and 12 months after an episode of severe cholera, suggesting reexposure to the organism. Among patients with rises in titers during follow-up, the patients initially infected with serotype Ogawa had earlier rises in titer than the patients initially infected with serotype Inaba. These data and others suggest that an episode of severe cholera protects against symptomatic disease for several years, but reexposure to the organism occurs frequently in an endemic area, with immunological boosts beginning as early as 6 months after severe disease. Repeated exposures to V. cholerae in endemic areas may be a necessary component for long-lasting protection against severe disease.

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“…There is no standard of care for the household members of patients, who are often at very high risk of developing a subsequent enteric infection. [13][14][15][16][17][18][19][20] A study in urban Dhaka, Bangladesh, found that household members of cholera patients had more than a 100 times higher risk of a cholera infection than the general population during the 1-week period after the presentation of the index cholera patient at the hospital. 21,22 Consistent with this finding, a recent study in rural Bangladesh found that the odds of a Shigella infection were 44 times higher for household members of pediatric shigellosis patient during this 1-week window.…”

Section: Introductionmentioning

confidence: 99%

Sustained Uptake of a Hospital-Based Handwashing with Soap and Water Treatment Intervention (Cholera-Hospital-Based Intervention for 7 Days [CHoBI7]): A Randomized Controlled Trial

George¹,

Jung²,

Saif‐Ur‐Rahman³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Diarrhea is the second leading cause of death in children under 5 years of age globally. The time patients and caregivers spend at a health facility for severe diarrhea presents the opportunity to deliver water, sanitation, and hygiene (WASH) interventions. We recently developed Cholera-Hospital-Based Intervention for 7 days (CHoBI7), a 1-week hospital-based handwashing with soap and water treatment intervention, for household members of cholera patients. To investigate if this intervention could lead to sustained WASH practices, we conducted a follow-up evaluation of 196 intervention household members and 205 control household members enrolled in a randomized controlled trial of the CHoBI7 intervention 6 to 12 months post-intervention. Compared with the control arm, the intervention arm had four times higher odds of household members' handwashing with soap at a key time during 5-hour structured observation (odds ratio [OR]: 4.71, 95% confidence interval [CI]: 2.61, 8.49) (18% versus 50%) and a 41% reduction in households in the World Health Organization very high-risk category for stored drinking water (OR: 0.38, 95% CI: 0.15, 0.96) (58% versus 34%) 6 to 12 months post-intervention. Furthemore, 71% of observed handwashing with soap events in the intervention arm involved the preparation and use of soapy water, which was promoted during the intervention, compared to 9% of control households. These findings demonstrate that the hospital-based CHoBI7 intervention can lead to significant increases in handwashing with soap practices and improved stored drinking water quality 6 to 12 months post-intervention.

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Seroepidemiological Studies of EI Tor Cholera in Bangladesh: Association of Serum Antibody Levels with Protection

Cited by 181 publications

References 19 publications

Antibodies in Action: Role of Human Opsonins in Killing Salmonella enterica Serovar Typhi

Antibodies in Action: Role of Human Opsonins in Killing Salmonella enterica Serovar Typhi

Frequency of Reexposure to Vibrio cholerae O1 Evaluated by Subsequent Vibriocidal Titer Rise after an Episode of Severe Cholera in a Highly Endemic Area in Bangladesh

Sustained Uptake of a Hospital-Based Handwashing with Soap and Water Treatment Intervention (Cholera-Hospital-Based Intervention for 7 Days [CHoBI7]): A Randomized Controlled Trial

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