TL;DR: It is found that approximately 1.3 billion people are at risk for cholera in endemic countries, and Sub-Saharan Africa accounts for the majority of this burden.
Abstract: Background
The global burden of cholera is largely unknown because the majority of cases are not reported. The low reporting can be attributed to limited capacity of epidemiological surveillance and laboratories, as well as social, political, and economic disincentives for reporting. We previously estimated 2.8 million cases and 91,000 deaths annually due to cholera in 51 endemic countries. A major limitation in our previous estimate was that the endemic and non-endemic countries were defined based on the countries’ reported cholera cases. We overcame the limitation with the use of a spatial modelling technique in defining endemic countries, and accordingly updated the estimates of the global burden of cholera.
TL;DR: A review of available information leads to the conclusion that an oral vaccine consisting of a combination of antigens, intending to stimulate both antibacterial and antitoxic immunity, would be most likely to succeed.
TL;DR: The bacterium Vibrio cholerae is studied for its role in cholera control programs, and the role of vaccines in this research is investigated.
Abstract: Introduction The bacterium Vibrio cholerae, Isolation and identification of toxigenic Vibrio cholerae 01 from fecal specimens Toxigenic Vibrio cholerae in food and water Detection of cholera toxin genes Detection of toxins of Vibrio cholerae 01 and non-01 Non-toxigenic Vibrio cholerae 01 infections in the United States Molecular basis for O-antigen biosynthesis in Vibrio cholerae 01 Ogawa-Inaba switching Non-O group 1 Vibrio cholerae Vibrios in the environment Serologic diagnosis of Vibrio cholerae 01 infection Virulence factors Toxins of Vibrio cholerae 01 Regulation of toxin (CT) expressions The toxin-coregulated pilus: biogenesis and function Animal models in cholera research Cholera: the disease Cholera: pathophysiology Immunity to Vibrio cholerae infection Host susceptibility Epidemiology and surveillance Cholera before 1970 The African epidemic 1970-92 Endemic cholera in Australia and the United States The Latin American epidemic Transmission of cholera Molecular epidemiology of Vibrio cholerae 01 Cholera surveillance Vaccines Polysaccharide-protein conjugate vaccines for prevention of cholera Molecular recombinant cholera vaccines Protective oral cholera vaccine based on a combination of cholera toxin B subunit and inactivated Cholera vibrios Public health consideration for the use of cholera vaccines in cholera control programs Cholera: the future Cholera: unanswered questions
TL;DR: Protection was similar against severe and non-severe cholera, but was significantly lower in children who were vaccinated at 2-5 years than in older persons (63% for BS-WC; 68% for WC); and PE was substantially higher against classical cholero than against El Tor cholERA.
TL;DR: These rice-based mucosal vaccines offer a highly practical and cost-effective strategy for orally vaccinating large populations against mucosal infections, including those that may result from an act of bioterrorism.
Abstract: Capable of inducing antigen-specific immune responses in both systemic and mucosal compartments without the use of syringe and needle, mucosal vaccination is considered ideal for the global control of infectious diseases. In this study, we developed a rice-based oral vaccine expressing cholera toxin B subunit (CTB) under the control of the endosperm-specific expression promoter 2.3-kb glutelin GluB-1 with codon usage optimization for expression in rice seed. An average of 30 μg of CTB per seed was stored in the protein bodies, which are storage organelles in rice. When mucosally fed, rice seeds expressing CTB were taken up by the M cells covering the Peyer's patches and induced CTB-specific serum IgG and mucosal IgA antibodies with neutralizing activity. When expressed in rice, CTB was protected from pepsin digestion in vitro. Rice-expressed CTB also remained stable and thus maintained immunogenicity at room temperature for >1.5 years, meaning that antigen-specific mucosal immune responses were induced at much lower doses than were necessary with purified recombinant CTB. Because they require neither refrigeration (cold-chain management) nor a needle, these rice-based mucosal vaccines offer a highly practical and cost-effective strategy for orally vaccinating large populations against mucosal infections, including those that may result from an act of bioterrorism.