Vaccine, Cholera

Cholera Vaccine USP Package Insert, Wyeth Laboratories, Marietta, Pa., 1994. 

An example of the use of an attenuated virus is the administration of the measles vaccine to an individual who has not had measles. The m easles (rubeola) vaccine contains the live, attenuated measles virus. The individual receiving the vaccine develops a mild or modified measles infection, which then produces immunity against the rubeola virus. The measles vaccine protects 95% of the recipients for several years or, for some individuals, for life. An example of a killed virus used for immunization is the cholera vaccine. This vaccine protects those who receive the vacdne for about 3 to 6 months. 

Killing. The proeess by which the live bacteria in the culture are killed and thus rendered harmless. Heat and disinfectants are employed. Heat and/or formalin are required to kill the cells of Bordetella pertussis used to make whooping-cough vaccines, and phenol is used to kill the Vibrio cholerae in cholera vaccine and the Salmonella typhi in typhoid vaeeine. 

BCG (bacillus Calmette-Guerin) vaccine Brucellosis vaccine Cholera vaccine Cytomegalovirus vaccines... 

Examples of killed or inactivated vaccines are cholera vaccine containing dead strains of Vibrio cholerae, hepatitis A vaccine with inactivated hepatitis A virus, pertussis vaccine with killed strains of Bordetella pertussis, typhoid vaccine with killed Salmonella typhi, and influenza vaccine with various strains of inactivated influenza viruses (see Exhibit 4.2 for a discussion of influenza viruses and vaccines and Exhibit 4.3 on avian influenza H5N1). 

Cholera vaccine Dead strain(s) of Vibrio cholerae Active immunization against cholera... 

Intravaginal vaccination with whole cell and cholera toxin B subunit (CTB) oral cholera vaccine provided a greater success rate in providing a mucosal immune response in the female genital tract than an oral vaccination [152]. This study demonstrated that in a single individual, systemic immunity did not directly reflect the local antibody response in the mucosal... 

Vaginal immunization experiments with a cholera vaccine containing killed vibrios and CTB have been conducted in both the follicular (V-FPimm) and luteal (V-LPimm) menstrual cycle phase. With both producing comparable cervical CTB-specific IgA responses, however, only the V-FPimm induced cervical IgA2-restricted Ab to the bacterial lipopolysaccharide (LPS) vaccine component and induced CTB-specific IgA in rectal secretions. 

Cholera vaccines are produced by inactive bacteria and are administered subcutaneously, intramuscularly, or intradermally. Cholera vaccines should not be administered intradermally in children less than 5 years of age. The vaccination is particularly indicated for people living in highly endemic areas, as well as laboratory and medical personnel exposed to Vibrio cholerae. Diphtheria tetanus pertussis (DTP) vaccine can be made either as toxoids or inactivated whole bacteria. Hemophillus influenzae vaccine is a bacterial polysaccharide conjugated to proteins and is given as one intramuscular dose. A booster dose is not recommended. This vaccine is given to all children in cases such as plenia and other at-risk condiUons. 

Chaignat CL, Monti V (2007) Use of oral cholera vaccine in complex emergencies What next Summary report of an expert meeting and recommendations of WHO. J Health Pop Nutr 25(2) 244-261... 

Rabies vaccine (9-year-old boy, with permission) Cholera vaccine (self)... 

A cholera vaccine, comprising killed Vibrio cholerae cells and the recombinant cholera toxin B (CTB) subunit (the CTB subunit is used extensively as an adjuvant in mucosal immunization protocols, as it... 

Driehorst J, Laubenthal F. Akute Myocarditis nach Choleraschutzimpfung. [Acute myocarditis after cholera vaccination.] Dtsch Med Wochenschr 1984 109(5) 197-8. 

Mall T, Gyr K. Episode resembling immune complex disease after cholera vaccination. Trans R Soc Trop Med Hyg 1984 78(l) 106-7. 

Eisinger AJ, Smith JG. Acute renal failure after TAB and cholera vaccination. BMJ 1979 l(6160) 381-2. 

Gatt DT. Pancreatitis following monovalent typhoid and cholera vaccinations. Br J Clin Pract 1986 40(7) 300-1. 

Cholera vaccines consist of live attenuated or heat-kiUed Vibrio cholerae organisms. They can be given orally or parenteraUy. 

Following the administration of live oral cholera vaccine (containing the attenuated strain V. cholerae CVD 103-HgR, prepared from V. cholerae 01 strain 569B), there were significant rises in serum antitoxin concentrations and only few mild adverse effects (SED-13, 925). There was protective efficacy in 82-100% of healthy adult volunteers and no difference in adverse effects between 25 recipients of the vaccine and 26 controls (1). 

A randomized, double-blind, placebo-controUed trial using a live oral cholera vaccine (strain CVD 103, derived from the V. cholerae 01 classical Inaba strain 569B by deletion of the genes encoding the A subunit of cholera toxin) was conducted in 50 healthy Swiss adults. There was a significant rise in serum antitoxin titers in 76% of the volunteers. Two vaccinees reported watery stools after immunization (2). 

When an oral single-dose cholera vaccine against V. cholerae 0139 was given to ten volunteers there was... 

The results with an oral cholera vaccine consisting of the immunogenic but completely non-toxic B subunit of cholera toxin in combination with heat- and formalin-kiUed V. cholerae represent an improvement compared with previous parenteral vaccines (4). The frequency of adverse effects (pain at the injection site, nausea, diarrhea) was low (5). 

Davis R, Spencer CM. Live oral cholera vaccine. A preliminary review of its pharmacology and clinical potential in providing protective immunity against cholera. Clin Immunother 1998 4 235 7. 

Cryz SJ Jr, Levine MM, Kaper JB, Purer E, Althaus B. Randomized double-blind placebo controlled trial to evaluate the safety and immunogenicity of the live oral cholera vaccine strain CVD 103-HgR in Swiss adults. Vaccine 1990 8(6) 577-80. 

Markman B. Symptoms of reactogenicity in field trial of oral cholera vaccine. Lancet 1990 336(8710) 320. 

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