Cholera vaccine

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A cholera vaccine is a vaccine against the bacterium Vibrio cholerae , the causative agent of cholera .

properties

The two approved oral cholera vaccines are inactivated vaccines that are usually administered orally two or three times. There is also an injection vaccine. There are two approved oral cholera vaccines called WC-rBS ( Dukoral ) and BivWC ( Shanchol and, in Vietnam, mORCVAX ). WC-rBS contains the inactivated vaccine strain V. cholerae O1 and the inactivated, recombinantly produced B-subunit of the cholera toxin . BivWC contains the inactivated vaccine strains V. cholerae O1 and V. cholerae O139.

More than a million doses of the vaccines have been given since the Dukoral and Shanchol cholera vaccines were developed. Cholera vaccines are on the World Health Organization's Essential Medicines List . The World Health Organization stores two million doses of the cholera vaccine for emergencies. In cooperation with the GAVI Alliance , the stock is to be increased further.

immunology

After a two-fold inoculation arise neutralizing antibodies , a immunity cause in about 85% of subjects for about six months and in about 50 to 60% for the first year. Neutralizing antibodies against the cholera toxin reduce the diarrhea in the case of a cholera infection. In the first year about 52% of the orally vaccinated people are immune, in the second year about 62%.

Side effects

Adverse drug effects include mild abdominal pain and diarrhea.

history

Cholera vaccinations with a vaccination gun by a Guinean nurse in Ziguinchor , Senegal (1973)

The first vaccines against cholera were developed in the late 19th century. They were the first widely used vaccine made in a laboratory. There were several pioneers in developing the vaccine. In 1884, the Catalan doctor Jaume Ferran i Clua developed a live vaccine that he isolated from cholera patients in Marseille. The vaccine was used in over 30,000 people in Valencia during the cholera epidemic. Waldemar Haffkine then developed a vaccine with less severe side effects and tested it on more than 40,000 people in the Calcutta area from 1893 to 1896. Finally, in 1896, Wilhelm Kolle introduced a heat-treated vaccine, which was much easier to manufacture than Haffkine's, and used it on a large scale in Japan in 1902.

The first orally administered cholera vaccines were first introduced in the 1990s.

Individual evidence

  1. ↑ a b c d e Cholera vaccines: WHO position paper. . In: Weekly epidemiological record . 13, No. 85, March 26, 2010, pp. 117-128. PMID 20349546 .
  2. ↑ a b Graves PM, Deeks JJ, Demicheli V, Jefferson T: Vaccines for preventing cholera: killed whole cell or other subunit vaccines (injected) . In: Cochrane Database Syst Rev . No. 8, 2010, p. CD000974. doi : 10.1002 / 14651858.CD000974.pub2 . PMID 20687062 .
  3. ↑ Jason B Harris, Regina C LaRocque, Firdausi Qadri, Edward T Ryan, Stephen B Calderwood: Cholera. In: The Lancet . 379, 2012, p. 2466, doi: 10.1016 / S0140-6736 (12) 60436-X .
  4. ^ WHO Model List of Essential Medicines . In: World Health Organization . March 2017. Retrieved July 21, 2017.
  5. ↑ Oral cholera vaccine stockpile . World Health Organization. Retrieved December 18, 2013.
  6. ↑ GAVI Board Approves Support to Expand Oral Cholera Vaccine Stockpile . The Task Force on Global Health. Archived from the original on December 16, 2013. Info: The archive link was automatically inserted and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved December 18, 2013. @1@ 2Template: Webachiv / IABot / www.taskforce.org
  7. ↑ a b Sinclair D, Abba K, Zaman K, Qadri F, Graves PM: Oral vaccines for preventing cholera . In: Cochrane Database Syst Rev . No. 3, 2011, p. CD008603. doi : 10.1002 / 14651858.CD008603.pub2 . PMID 21412922 .
  8. ↑ Lawrence R. Stanberry: Vaccines for biodefense and emerging and neglected diseases , 1st edition, Academic, Amsterdam 2009, ISBN 9780080919027 , p. 870.