Reduction of travellers' diarrhoea by WC/rBS oral cholera vaccine in young, high-risk travellers.
OBJECTIVE
A bidirectional cohort study investigates whether pre-travel vaccination with whole cell/recombinant B subunit inactivated, killed oral cholera vaccine reduces the incidence of diarrhoea in young adult travellers to high-risk areas.


METHODS
Risk of travellers' diarrhoea was assessed according to destination and reason for travel in high-risk travellers of a travel clinic in Barcelona, Spain. Those at high-risk between January and December 2005 were advised on water/food safety and hygiene. High-risk travellers between January and December 2006 were additionally vaccinated with WC/rBS oral cholera vaccine. Data regarding diarrhoea were gathered by structured telephone interview or e-mailed questionnaire following the travellers' return. The incidence of diarrhoea in the group vaccinated with WC/rBS oral cholera vaccine (n=321) was 17.4%, compared with 39.7% in the non-vaccinated group (n=337) (adjusted risk ratio 0.40). The first episode was significantly shorter in the vaccinated group (mean 2.3 days) than in the non-vaccinated group (mean 3.8 days) (p<0.001).


CONCLUSIONS
The protective effect of the WC/rBS oral cholera vaccine was 57% in the young, high-risk travellers. Vaccination with the WC/rBS oral cholera vaccine as well as food safety and hygiene advice could offer effective means of reducing the risk of diarrhoea while abroad.
International Vaccination Center, Hospital Universitario de Bellvitge, L'Hospitalet, Barcelona, Spain. jmramon@ub.edu
Josep Ma Ramon
JM
Torrell
Cristina Masuet
CM
Aumatell
Sergi Morchon
SM
Ramos
Laura Gavaldà
LG
Mestre
Carme Micheo
CM
Salas
D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D022121:Cholera Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D015331:Cohort Studies; D003967:Diarrhea / Q000276:immunology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D040242:Risk Reduction Behavior; D013030:Spain; D011795:Surveys and Questionnaires; D014195:Travel; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000276:immunology; D014614:Vaccines, Synthetic / Q000008:administration & dosage / Q000276:immunology; D055815:Young Adult
D022121:Cholera Vaccines; D015164:Vaccines, Inactivated; D014614:Vaccines, Synthetic