Cross-protection by B subunit-whole cell cholera vaccine against diarrhea associated with heat-labile toxin-producing enterotoxigenic Escherichia coli: results of a large-scale field trial

J Infect Dis. 1988 Aug;158(2):372-7. doi: 10.1093/infdis/158.2.372.

Abstract

The B subunit (BS) of cholera toxin and that of the heat-labile enterotoxin (LT) of enterotoxigenic Escherichia coli (ETEC) are antigenically similar. We therefore assessed whether a combined cholera toxin BS/whole-cell (BS-WC) oral vaccine against cholera conferred cross-protection against LT-producing ETEC (LT-ETEC) diarrhea in a randomized, double-blind field trial among rural Bangladeshi children and women. The 24,770 persons who ingested two or more doses of BS-WC vaccine were compared with 24,842 controls who took two or more doses of killed whole-cell (WC) oral cholera vaccine. Sixty-seven percent fewer episodes of LT-ETEC diarrhea were noted in the BS-WC group than in the WC group during short-term (three-month) follow-up (P less than .01), but no reduction was evident during the ensuing nine months. Short-term protection was particularly notable against LT-ETEC diarrhea causing life-threatening dehydration (protective efficacy, 86%; P less than .05).

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Bacterial Toxins / metabolism
  • Child
  • Child, Preschool
  • Cholera Toxin / immunology*
  • Cholera Vaccines / immunology*
  • Clinical Trials as Topic
  • Cross Reactions*
  • Diarrhea / microbiology
  • Diarrhea / prevention & control*
  • Double-Blind Method
  • Enterotoxins / metabolism
  • Escherichia coli / metabolism
  • Escherichia coli Infections / microbiology
  • Escherichia coli Infections / prevention & control*
  • Escherichia coli Proteins*
  • Female
  • Humans
  • Immunity
  • Peptide Fragments / immunology*
  • Random Allocation
  • Vaccination

Substances

  • Bacterial Toxins
  • Cholera Vaccines
  • Enterotoxins
  • Escherichia coli Proteins
  • Peptide Fragments
  • cholera toxin, B subunit (50-64)
  • Cholera Toxin
  • heat-labile enterotoxin, E coli