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Vibrio
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Prevention of cholera outbreaks should focus on personal hygiene, water treatment, emergency responses, and immunization. For personal hygiene, use of soap and handwashing promotion can achieve a significant decrease in the incidence of diarrhea in endemic areas. Water treatment includes boiling the water for drinking, washing, and cooking purposes; and treating sewage and drainage systems. Proper disposal of infected materials (e.g., waste products, clothing, and bedding of cholera victims) and treatment by boiling or by using chlorine bleach are also crucial. Adequate emergency responses are dependent on the provision of manpower, equipment, drugs, and consumables, along with improved surveillance systems, communication, and transport. Immunization with cholera vaccines is recommended in areas where cholera is endemic or at risk of outbreaks. Of the two WHO-prequalified oral cholera vaccines, one contains killed whole cells of V. cholerae classical and El Tor O1, supplemented with recombinant CtxB subunit (WC-rBS; Dukoral, Crucell, Sweden), while the other is bivalent, containing killed V. cholerae classical and El Tor O1 as well as O139, without CtxB supplementation (WC; Shanchol, Shantha Biotechnics, India). Dukoral has been shown to provide short-term (4–6 months) protection of 85%–90% against V. cholerae O1 among all age groups, and Shanchol provides longer-term protection against V. cholerae O1 and O139 in children older than 5 years and adults [41].
WHO mediates the global right to health?
Published in Theéodore H MacDonald, Halfdan Mahler, Hani Serag, Health, Human Rights and the United Nations, 2018
‘We are still in the very early days with the new cholera vaccine, which potentially could be used in similar settings. But we seem to be moving in the right direction’, says Dr. Neira. ‘Cholera is not only a feared killer disease. It wreaks havoc on economies of developing countries, seriously hurting trade and tourism. Cholera vaccine is a welcome development, but fighting the disease with medications only is an uphill battle. The root causes of the virtually global cholera outreach go much deeper, and poverty is by far the most important one.’
Sample Size Calculation in Other Areas
Published in Shein-Chung Chow, Jun Shao, Hansheng Wang, Yuliya Lokhnygina, Sample Size Calculations in Clinical Research: Third Edition, 2017
Shein-Chung Chow, Jun Shao, Hansheng Wang, Yuliya Lokhnygina
In the previous subsections, the procedures for sample size calculation in vaccine clinical trials were discussed based on a primary efficacy study endpoint using a parametric approach. Durham et al. (1998) considered a nonparametric survival method to estimate the long-term efficacy of a cholera vaccine in the presence of warning protection. For the evaluation of long-term vaccine efficacy, as indicated by Chan, Wang, and Heyse (2003), the analysis of time to event may be useful for determining whether breakthrough rates among vaccines change over time. However, it should be noted that sample size calculation may be different depending upon the study objectives, the hypotheses of interest, and the corresponding appropriate statistical tests.
Mucosal and systemic immune responses to Vibrio cholerae infection and oral cholera vaccines (OCVs) in humans: a systematic review
Published in Expert Review of Clinical Immunology, 2022
Akshayata Naidu, Sajitha Lulu S
Cholera, although considered as a disease of previous centuries, still holds grounds in many parts of the world and can cause havoc anywhere hygiene is compromised. The recent catastrophic cholera outbreak in Cameroon is a testament to this fact [74]. The Global Task Force on Cholera Control (GTFCC) have developed a global roadmap to reduce cholera induced deaths by 90% by the year 2030 [75]. OCVs along with the WaSH strategy are essential elements of the multi-sectorial approach aimed by the taskforce. Several studies have aimed at elucidating the immune responses triggered by the infection and by the licensed vaccines, but spatial, temporal and study design-based variations makes it challenging to derive robust conclusions. Nevertheless, through this review we try to present a comprehensive overview of the immune responses studied against cholera infection and cholera vaccines with the intention to underline required molecular and cellular immunogenicity for protection.
Update on CVD 103-HgR single-dose, live oral cholera vaccine
Published in Expert Review of Vaccines, 2022
James McCarty, Lisa Bedell, Paul-Andre De Lame, David Cassie, Michael Lock, Sean Bennett, Douglas Haney
Long-term immunogenicity has been studied both after cholera challenge as well as following immunization. In a study of duration of infection-derived immunity 3 years after an initial cholera infection, four previously challenged volunteers and five cholera-naïve control subjects were challenged with 106 classical Ogawa organisms. None of the four cholera ‘veterans’ and four out of five control subjects developed diarrhea (P = 0.04). When compared to a control group of increased size comprising a pooled experience of challenge in cholera-naïve subjects, the difference in attack rates (0/4 vs 26/28) was highly significant (P < 0.0004) [23]. This pivotal study suggested that a good approach to development of cholera vaccines might be to mimic natural immunity with orally administered, attenuated strains of V. cholerae.
Challenges for programmatic implementation of killed whole cell oral cholera vaccines for prevention and control of cholera: a meta-opinion
Published in Expert Opinion on Biological Therapy, 2018
Pranab Chatterjee, Suman Kanungo, Shanta Dutta
Cholera vaccine preparations have some characteristics, which may contribute to a cultural hesitancy in vaccine uptake. For example, the fishy odor of OCVs were a barrier in the Indian context, as it was interpreted by people to be a non-vegetarian preparation. This can be a significant problem in areas where large segments of the society are strict vegetarians or have specific days of the week when they do not consume foods perceived to be of non-vegetarian sources [24].