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New-generation vaccines against cholera

Review article
Authors John Clemens
S Shin
D Sur
GB Nair
Jan Holmgren
Published in NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY
Volume 8
Issue 12
Pages 701-710
ISSN 1759-5045
Publication year 2011
Published at Institute of Biomedicine
Pages 701-710
Language en
Links dx.doi.org/10.1038/nrgastro.2011.17...
Subject categories Basic Medicine

Abstract

Cholera is a major global health problem, causing approximately 100,000 deaths annually, about half of which occur in sub-Saharan Africa. Although early-generation parenteral cholera vaccines were abandoned as public health tools owing to their limited efficacy, newer-generation oral cholera vaccines have attractive safety and protection profiles. Both killed and live oral vaccines have been licensed, although only killed oral vaccines are currently manufactured and available. These killed oral vaccines not only provide direct protection to vaccinated individuals, but also confer herd immunity. The combination of direct vaccine protection and vaccine herd immunity effects makes these vaccines highly cost-effective and, therefore, attractive for use in developing countries. Administration of these oral vaccines does not require qualified medical personnel, which makes their use practical--even in developing countries. Although new-generation oral cholera vaccines should not be considered in isolation from other preventive approaches, especially improved water quality and sanitation, they represent important tools in the public health armamentarium to control both endemic and epidemic cholera.

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