Cholera Vaccine Live Oral
Class: Vaccines
Brands: Vaxchora
Introduction
Live, attenuated bacterial vaccine containing Vibrio cholerae strain CVD 103-HgR derived from V. cholerae serogroup O1. Other cholera vaccines (e.g., oral inactivated vaccine containing whole-cell V. cholerae O1 with recombinant cholera toxin B subunit, oral inactivated vaccine containing whole-cell V. cholerae O1 and O139) may be available in other countries.
Uses for Cholera Vaccine Live Oral
Prevention of Cholera Infection
Prevention of disease caused by V. cholerae serogroup O1 in adults 18 through 64 years of age traveling to cholera-affected areas.
Cholera is an acute, intestinal infection caused by toxigenic V. cholerae and may be associated with sudden onset of profuse watery diarrhea and rapid progression to volume depletion, severe dehydration, hypovolemic shock, and death. Many individuals with V. cholerae infection are asymptomatic or have only mild to moderate disease; 10–20% of infected individuals develop severe disease and potentially fatal dehydration. Transmitted principally by ingestion of water and/or food contaminated with feces from individuals with V. cholera infection and generally occurs in countries that lack clean drinking water or proper sanitation. Although more than 200 V. cholerae serogroups identified, only toxigenic strains of V. cholerae serogroups O1 and O139 have been associated with cholera epidemics; serogroup O1 is the leading cause of cholera worldwide.
Cholera is uncommon in US, but endemic in approximately 50–60 countries, principally in less well-developed areas of the world that have poor sanitation and primitive water systems (e.g., areas of Africa, South and Southeast Asia, the Caribbean). In 2015, 172,454 cases (including 1304 fatalities) were reported in 42 different countries. However, many cases unreported and it has been estimated that up to 3–4 million cholera cases (up to 95,000–143,000 fatalities) may occur annually worldwide. Large cholera epidemic began in Haiti in 2010 following a devastating earthquake; CDC states cholera likely to persist at endemic levels in Haiti for the foreseeable future and sporadic cases may continue be associated with travel to and from Caribbean countries, including Haiti, the Dominican Republic, and Cuba.
During 2001–2013, there were 123 confirmed cases of cholera in the US in individuals who had been traveling abroad. Risk of acquiring cholera is highest in those traveling to countries where cholera is endemic or epidemic, and is especially high in travelers who drink untreated water, eat raw or poorly cooked food (especially seafood), or do not follow proper hygiene recommendations while in cholera endemic or outbreak settings. Individuals at increased risk for poor clinical outcome if infected with toxigenic V. cholerae include those without rapid access to medical care and rehydration therapy; those with certain chronic medical conditions (e.g., immunosuppression, cardiovascular disease, renal disease); those with low gastric acidity related to antacid therapy, partial ga...
