ABSTRACT
A controlled field trial comparing the effectiveness of a plain cholera vaccine with that of a vaccine adsorbed to aluminium hydroxide was carried out in a cholera-endemic area of Indonesia during 1973-75. Tetanus toxoid adsorbed to aluminium phosphate was used as the control. In vaccinees aged 1-4 years, the adsorbed cholera vaccine provided about 88% protection for 6 months following vaccination and still provided about 50% protection between 11 and 14 months after vaccination. In the same age group, the plain vaccine provided only 53% protection during the first 6 months and no appreciable protection beyond that period. In those aged 5 years and over, both vaccines provided 50-60% protection throughout the period of observation (14 months). Neither vaccine caused any serious side effects.
Subject(s)
Adjuvants, Immunologic , Aluminum Hydroxide , Cholera Vaccines , Cholera/prevention & control , Adolescent , Adult , Age Factors , Aged , Child , Child, Preschool , Cholera/epidemiology , Cholera Vaccines/adverse effects , Clinical Trials as Topic , Female , Humans , Indonesia , Infant , Male , Middle AgedABSTRACT
A controlled field trial on some 584 000 people in an endemic cholera El Tor area in the Philippines demonstrated that cholera vaccines gave moderate protection of short duration. Injection of a single dose of vaccine prepared from either Vibrio cholerae or El Tor vibrios gave over 50% protection for the first 2 months. The immunity conferred by the V. cholerae vaccine declined rapidly after 3 to 4 months. The effectiveness of the El Tor vaccine continued for 6 months. An oil-adjuvant vaccine prepared from V. cholerae conferred an equally high degree of protection for a longer period of time, but, owing to severe vaccination reactions, its use could not be recommended.
Subject(s)
Cholera Vaccines/therapeutic use , Cholera/prevention & control , Adjuvants, Immunologic , Adolescent , Adult , Aged , Child , Child, Preschool , Cholera/immunology , Cholera Vaccines/administration & dosage , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Philippines , VaccinationABSTRACT
Cholera carrier studies in the Philippines in 1964-66 showed a prevalence rate of 21.7% among household contacts of cholera patients, and 8.4% in occupants of houses next door to one where a cholera patient lived, as opposed to 0.34% in the general population. The duration of the carrier state among 19 household carriers isolated for examination varied from 5 to 19 days. The vibrio concentration in the stool of contact carriers was 10(2)-15(5) per gram, as compared with 10(6)-19(9) per ml of rice-water stool in cholera cases.The agglutinin titre increased with time for carriers, as it does for patients. It declined to a very low level 8-12 weeks after recovery, with the exception of one proved long-term carrier.The strains isolated from carriers were identical in all respects, including virulence in infant rabbits, with strains isolated from patients-except that 3 carrier strains were rough.
Subject(s)
Carrier State/epidemiology , Cholera/epidemiology , Adolescent , Adult , Child , Child, Preschool , Cholera/immunology , Cholera/microbiology , Feces/microbiology , Follow-Up Studies , Humans , Infant , Infant, Newborn , Philippines , Vibrio/isolation & purificationABSTRACT
The first known long-term carrier of cholera, found in the Philippines, is described. The carrier, Dolores M., who had suffered from El Tor cholera in August 1962, continued intermittently to excrete vibrios of the same characteristics as the original isolates until the date of reporting (1966). Duodenal intubation proved that the vibrios are lodged in her biliary tract. Her serum antibody titre continued to remain high in the absence of vaccination against cholera.
