Jpn. J. Infect. Dis., 53, 181-188, 2000
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Invited Review
Current Status of Cholera and Rise of Novel Mucosal Vaccine
Tatsuo Yamamoto*
Department of Bacteriology, School of Medicine, Niigata University, 757 Ichibanchou, Asahimachidori, Niigata 951-8510, Japan
(Received November 2, 2000)
SUMMARY: Three serious cholera epidemics have threatened
the world during the last 10 years. As a countermeasure against
such cholera epidemics, three vaccines, CVD 103-HgR, WC/rBS, and
Vietnamese WC, showed good performance. CVD 103-HgR is a recombinant
attenuated live vaccine for travelers, and its highly safety and
protective efficacy have been demonstrated in volunteers in advanced
countries. WC/rBS, which consists of heat- and formalin-killed
bacteria and cholera toxin B subunit, protects the vaccinees (>5
years old) from cholera for 6 months. Vietnamese WC, a heat- and
formalin-killed vaccine, is inexpensive and effective even for
1 to 5-year-old children. Additionally, irradiated WC vaccines
and new serotype (O139) vaccines are being developed. Regarding
intestinal immunity, secretory IgA has been mainly examined. In
addition, mucosal IgG, as induced by the irradiated WC vaccine,
should also be investigated. Development of mucosal adjuvant,
such as holotoxin-type mutants of cholera toxin and related Escherichia
coli heat-labile enterotoxin, has been actively undertaken.
Diverse custom-made vaccines may be one countermeasure for the
changing situations in endemic countries or areas and for "barriers"
against live vaccines in such areas.
* Corresponding author: Tel: +81-25-227-2050, Fax: +81-25-227-0762, E-mail: tatsuoy@med.niigata-u.ac.jp
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