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Oral vaccines for cholera control

S Chaturvedi¹, S Chaturvedi

¹University College of Medical Sciences, New Delhi, India.

The National Medical Journal of India

|January 1, 1997

Summary

Oral cholera vaccines, including inactivated WC/rBS, show promise for endemic cholera control. Recent trials confirm efficacy in diverse groups, though protection against Vibrio cholerae 0139 Bengal is lacking.

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Area of Science:

Vaccinology
Infectious Diseases
Public Health

Background:

Two oral cholera vaccines, inactivated WC/rBS and live CVD 103 HgR, are now available in Europe.
The inactivated oral vaccine demonstrates encouraging field trial results across various populations.
The public health utility of cholera vaccines in epidemics and for travelers is under scrutiny, with endemic settings being the primary focus.

Purpose of the Study:

To re-evaluate and explore the protective efficacy of the WC/rBS vaccine in specific populations.
To address questions regarding vaccine effectiveness in individuals with EI Tor biotype infection, O blood group, and no prior cholera immunity.

Main Methods:

Field trials were conducted in South America to assess vaccine performance.
The study reconsidered and explored efficacy in previously questioned demographic and immunity subgroups.

Main Results:

Satisfactory results were obtained in the South American field trial, addressing previous concerns.
The WC/rBS vaccine demonstrated efficacy in diverse population groups, including those with EI Tor biotype, O blood group, and no prior immunity.
Crucially, neither vaccine provides protection against the Vibrio cholerae 0139 Bengal strain.

Conclusions:

Oral cholera vaccines, particularly the inactivated WC/rBS, show significant safety and efficacy.
These vaccines are poised to supersede injectable cholera vaccines.
Endemic cholera control remains the most relevant application, despite limitations against specific strains like Vibrio cholerae 0139 Bengal.

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