Vibrio
Dongyou Liu in 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].
‘Controlling wildfire diseases'
Christopher Aldous, Akihito Suzuki in Reforming Public Health in Occupied Japan, 1945–52, 2011
Although some of these prescriptions may seem overly rigorous, the precautionary approach adopted may explain why there was no major outbreak of cholera. Yet another example of playing it safe was an article in the Tokyo Shimbun on 18 April 1946. This advised residents of the dangers of consuming seafood caught in the vicinity of the cholera ships, the ability of flies to ‘carry the germs’ and the resultant need to desist from eating raw foods and to undergo preventive inoculation.136 Regarding the supply of cholera vaccine, it seems that the Japanese government had less than adequate stocks at the beginning of the cholera siege, but was considered capable of producing sufficient quantities over the next few months. That at least was the judgement of the Deputy Chief of the PH&W, Colonel Weaver, who noted on 15 April 1946 that there were five million doses available and a ‘production capacity’ of 100 million by 1 July.137 Around a fortnight later, on 28 April 1946, the Nippon Times stated that the metropolitan authorities were preparing an extensive cholera prevention campaign – they already had the capacity to immunize 400,000 people and would soon have enough to protect one million residents. Sure enough, an article in the Mainichi Shimbun on 4 May 1946 stated that about one million people living in the 23 wards would receive preventive injections for cholera through their neighbour-hood associations by 10 June 1946.138
Infectious diseases
Sol Levine, Abraham M. Lilienfeld in Epidemiology and Health Policy, 1987
These events took place 100 years ago. It is worth reviewing some events in the present era. Since 1960, extensive epidemiological work has been carried out in Asia and in research laboratories in the western world. These have conclusively shown that currently available cholera vaccines afford protection against infection for a short period of time (3-4 months), and that the disease can be simply and effectively treated by oral rehydration and appropriate antibiotics. For many years, vaccination against cholera was required for travel to or between many countries. Epidemiologic studies demonstrated and confirmed that cholera vaccine gave protection against manifest disease not only for a short period of time, but it also did not prevent asymptomatic intestinal infection (Benenson 1977). Thus, it constituted no barrier to importation, and the United States Public Health Service (PHS) eliminated any requirement for cholera vaccine for entry into the United States. Shortly thereafter, the World Health Organization (WHO) recommended to all members that cholera vaccine no longer be a requirement for international travel. Thus, national and international health policy with respect to vaccination requirements, an action at the governmental level, was established rapidly and effectively.
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.
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.
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].
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