Topps Maureen H
Department of Family Medicine, University of Calgary, 1707, 1632-14 Avenue NW, Calgary, Alta., Canada T2N 1M7.
Travel Med Infect Dis. 2006 Jan;4(1):38-42. doi: 10.1016/j.tmaid.2004.12.002.
The search for a safe, effective, well tolerated, low cost vaccine against the ancient cholera enemy has been ongoing since the 19th century and has been revitalized in the past two decades since the advent of recombinant technology. Large-scale field trials have readily demonstrated the tolerability and safety of oral cholera vaccine in various forms. Variable levels of protection have been shown and one challenge has been to demonstrate whether this is a cost effective treatment in differing environments including its use in endemic and epidemic areas as well as for travelers. A review of recent literature was undertaken to assess the effectiveness and uses of currently available oral cholera vaccine. While the evidence does not support the creation of formal guidelines, some clear recommendations can be made. There is undoubtedly the potential to reduce the burden of illness both in endemic and epidemic situations. For travelers, certain higher risk groups may benefit from protection against cholera. More significantly, the short term cross-protection afforded by whole cell, B subunit (WC BS) oral cholera vaccine formulations against enterotoxigenic E. coli, (ETEC), the commonest causative agent of traveler's diarrhoea, may prove to be the most important raison d'être.
自19世纪以来，人们一直在寻找一种安全、有效、耐受性良好且低成本的疫苗来对抗古老的霍乱敌人，自重组技术出现后的过去二十年里，这一探索得以重振。大规模现场试验已充分证明了各种形式的口服霍乱疫苗的耐受性和安全性。研究显示了不同程度的保护效果，而其中一个挑战在于证明在不同环境下，包括在霍乱流行地区和疫区以及旅行者中使用时，这是否是一种具有成本效益的治疗方法。本文对近期文献进行了综述，以评估目前可用的口服霍乱疫苗的有效性和用途。虽然现有证据不支持制定正式指南，但可以提出一些明确的建议。毫无疑问，在地方病和流行病情况下，都有减轻疾病负担的潜力。对于旅行者而言，某些高风险群体可能会从霍乱防护中受益。更重要的是，全细胞、B亚单位（WC BS）口服霍乱疫苗制剂对产肠毒素大肠杆菌（ETEC）（旅行者腹泻最常见的病原体）提供的短期交叉保护，可能被证明是其存在的最重要理由。
