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Affordable Cholera Vaccine May Be Key To Containing Cholera Epidemics

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Given as part of routine health services, Sanchol, an oral cholera vaccine, has been found by researchers as safe and effective in protecting children and adults against severe cholera, supporting efforts to use the drug in mass vaccination programs to stem the spread of the disease in endemic countries.

In a study published in the journal The Lancet, the researchers administered Shanchol in Bangladesh where cholera is endemic. Their findings showed that severe cholera was reduced by almost 40 percent in those who were vaccinated, resulting in better management of the disease compared to just providing clean water for drinking and encouraging hand-washing.

Cholera is endemic to over 50 countries in the world and that means more than a billion people are at risk of contracting the disease. Every year, about 2.8 million people from endemic regions are diagnosed with cholera while 91,000 succumb to the disease. Up to 40 percent of those with cholera end up with severe dehydration that can be fatal when left untreated.

For over a decade now, oral cholera vaccines have been routinely used by travelers from richer countries to protect them during their trips. However, Shanchol is affordable, costing just $1.85 for every dose. Unfortunately, the drug has not been used to control the disease on a wide scale because effectiveness and feasibility remained unknown until now.

Nearly 270,000 residents from Dhaka in Bangladesh were included in the study. The subjects varied in age, going as low as one year old, but all were at high risk of contracting cholera because of poor sanitation and overcrowding. After being grouped into clusters depending on where they lived, the subjects were then randomly chosen to get doses of Shanchol, get the vaccine and participate in a behavioral change program that promotes hand-washing and provides clean drinking water, or no intervention at all.

When the recommended two doses of the vaccine were received, the subjects in the vaccination-only group showed a reduction of 37 percent in cases of severely dehydrating cholera, while a 45-percent drop was reported in the group that received the vaccine and became part of the behavioral change program.

"Our findings show that a routine oral cholera vaccination program ... could substantially reduce the burden of the disease and greatly contribute to cholera control efforts," said Dr. Firdausi Qadri, the lead author of the study.

There are only two licensed vaccines for cholera: Shanchol and Dukoral. Shanchol costs just about a third of the price of Dukoral.

Photo: CDC Global | Flickr

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