Cholera vaccines.
Cholera causes significant morbidity and mortality worldwide. For travelers, the risk of developing cholera per month of stay in a developing country is approximately 0.001%-0.01%, and cholera may present as traveler's diarrhea. In the United States, only a poorly tolerated, marginally effective, parenterally administered, phenol-inactivated vaccine is available. Outside the United States, 2 additional vaccines are commercially available: an oral killed whole cell-cholera toxin recombinant B subunit vaccine (WC-rBS) and an oral live attenuated Vibrio cholerae vaccine (CVD 103-HgR). These oral vaccines are well tolerated. In field trials, WC-rBS provides 80%-85% protection from cholera caused by V. cholerae serogroup O1 for at least 6 months. In volunteer studies, CVD 103-HgR provides 62%-100% protection against cholera caused by V. cholerae for at least 6 months. No commercially available cholera vaccine protects against disease caused by V. cholerae serogroup O139. New cholera vaccines are being developed.
Ryan
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Tropical and Geographic Medicine Center, Travelers' Advice and Immunization Center, Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA. etryan@partners.org
Calderwood
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D002771:Cholera / Q000517:prevention & control*; D002772:Cholera Toxin / Q000235:genetics / Q000276:immunology; D022121:Cholera Vaccines / Q000008:administration & dosage / Q000276:immunology; D006801:Humans; D007115:Immunization Schedule; D014195:Travel; D014613:Vaccines, Attenuated / Q000276:immunology; D022223:Vaccines, Subunit / Q000276:immunology; D014614:Vaccines, Synthetic / Q000276:immunology; D014734:Vibrio cholerae / Q000276:immunology*
D022121:Cholera Vaccines; D014613:Vaccines, Attenuated; D022223:Vaccines, Subunit; D014614:Vaccines, Synthetic; D002772:Cholera Toxin