Vaccines Against Diarrheal Diseases

Progress in enteric vaccine development

“…12 Two doses were equally effective as three doses, and the CTB-WC vaccine was significantly more effective than the WC component alone during the initial 6-month period. 2 In a second randomized placebo-controlled field vaccine trial in Peruvian military personnel the rCTB-WC vaccine was as effective as in Bangladesh, i.e. 85% protective efficacy, ðP ¼ 0:004Þ after 5 months of follow-up.…”

“…The poor protection by previous parenteral cholera vaccines, which afforded only 50% protection for 3 to-at most-6 months, could be due to the fact that they neither induced enterotoxigenic immunity nor significant levels of mucosal immune responses locally in the gut. 2 Recently, however, two improved oral cholera vaccines have been licensed and are now available in several different countries (Table 1).…”

“…The other most important bacterial pathogens include various Shigella spp., Campylobacter jejuni, Salmonella enterica serovar typhi as well as various non-ETEC E. coli that cause disease by different mechanisms. 2 Non-typhoid salmonellae are also important causes of enteric infections, although their relative importance is higher in developed countries.…”

“…2 Among the parasites, Giardia lamblia, Entamoeba histolytica and Cryptosporidium spp are the most important ones. Based on the health impact of infections with these enteropathogens, both in children and adults in developing countries and in travellers to these areas, there is great interest in providing and developing effective vaccines against the most important diarrhoeal diseases.…”

“…It has been estimated that approximately 2 -4 billion episodes of diarrhoea, resulting in about 2.2 million deaths, occur annually in developing countries, with the highest incidence in children below the age of 5 years. 1,2 Diarrhoeal disease also constitutes the main health problem in travellers to developing countries in Africa, Asia and Latin America. The vast majority of diarrhoeal diseases are caused by enteric infections.…”