Hill David R, Ford Lisa, Lalloo David G
National Travel Health Network and Centre, London, UK.
Lancet Infect Dis. 2006 Jun;6(6):361-73. doi: 10.1016/S1473-3099(06)70494-7.
Cholera continues to occur globally, particularly in sub-Saharan Africa and Asia. Oral cholera vaccines have been developed and have now been used for several years, primarily in traveller populations. The licensure in the European Union of a killed whole cell cholera vaccine combined with the recombinant B subunit of cholera toxin (rCTB-WC) has stimulated interest in protection against cholera. Because of the similarity between cholera toxin and the heat-labile toxin of Escherichia coli, a cause of travellers' diarrhoea, it has been proposed that the rCTB-WC vaccine may be used against travellers' diarrhoea. An analysis of trials of this vaccine against cholera (serotype O1) shows that for 4-6 months it will protect 61-86% of people living in cholera-endemic regions; lower levels of protection continue for 3 years. Protection wanes rapidly in young children. Because the risk of cholera for most travellers is extremely low, vaccination should be considered only for those working in relief or refugee settings or for those who will be travelling in cholera-epidemic areas and who will be unable to obtain prompt medical care. The vaccine can be expected to prevent 7% or less of cases of travellers' diarrhoea and should not be used for this purpose.
霍乱仍在全球范围内发生，尤其是在撒哈拉以南非洲和亚洲。口服霍乱疫苗已研发出来，并且已经使用了数年，主要用于旅行者群体。一种将霍乱毒素重组B亚单位与灭活全细胞霍乱疫苗相结合的疫苗在欧盟获得许可，这激发了人们对霍乱预防的兴趣。由于霍乱毒素与旅行者腹泻的病因之一——大肠杆菌不耐热毒素之间存在相似性，有人提出重组B亚单位-全细胞疫苗可用于预防旅行者腹泻。对该疫苗预防霍乱（O1血清型）的试验分析表明，在4至6个月内，它能保护61%至86%生活在霍乱流行地区的人；较低水平的保护作用可持续3年。幼儿的保护作用迅速减弱。由于大多数旅行者感染霍乱的风险极低，仅应对那些在救援或难民环境中工作的人员，或那些将前往霍乱流行地区且无法获得及时医疗救治的人员考虑接种疫苗。该疫苗预计只能预防7%或更少的旅行者腹泻病例，因此不应为此目的使用。
