Summary
The recent spread of cholera in the Americas and the emergence of Vibrio cholerae 0139 in Asia have stimulated researchers to design efficient vaccine formulations to combat increasing cholera morbidity and mortality. Although the conventional heat-killed whole cell cholera vaccine continues to be offered during epidemics and in endemic foci, the novel whole cell killed plus recombinant cholera toxin B subunit vaccine and the live attenuated CVD 103-HgR vaccine are undergoing extensive field trials. Preliminary trials with Bengal-15, a vaccine composed of live V. cholerae 0139 without the toxin gene but containing recombinant B subunit, are promising.
Newly emerged clinical features of typhoid, such as increasing antibiotic resistance in Salmonella typhi, an aggravated clinical picture during concomitant infection with HIV and an increased risk for cancer among chronic typhoid and paratyphoid carriers, are alarming. Efficacy studies on live typhoid oral vaccine, Ty21a, and the parenteral Vi polysaccharide vaccine have confirmed their superiority over the conventional vaccine. Similar vaccines are indicated for protection against paratyphoid infections.
The development of simple 1- or 2-step laboratory tests for diagnosis of cholera, typhoid and paratyphoid would assist in therapeutic and prophylactic measures, and in monitoring the humoral and cellular immune response of patients, carriers or vaccine recipients.
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Arya, S.C. Cholera and Typhoid Vaccines. Clin. Immunother. 6, 28–38 (1996). https://doi.org/10.1007/BF03259350
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DOI: https://doi.org/10.1007/BF03259350