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Infection and Immunity, December 1999, p. 6346-6349, Vol. 67, No. 12
Gamble Program for Clinical Studies,
Received 26 July 1999/Returned for modification 3 September
1999/Accepted 24 September 1999
Until recently, all epidemic strains of Vibrio cholerae
were of the O1 serotype. Current epidemics have also been caused by a
new serotype, Vibrio cholerae O139. Although the
pathogenesis and clinical features of O139 cholera are similar to those
of O1 cholera, immunity to serotype O1 does not confer immunity to serotype O139. Therefore, prior to beginning vaccine efficacy studies,
we sought to validate the use of a large standardized frozen inoculum
of virulent V. cholerae O139 4260B for use in a human
volunteer challenge model. Healthy volunteers (n = 25) were recruited for an Internal Review Board-approved inpatient dose-escalation challenge. Our goal was to identify a dose at which the
cholera attack rate and the geometric mean purge were sufficient for
determining vaccine efficacy against moderate and severe disease. At a
dose of 105 CFU, 8 of 10 volunteers experienced purging and
had a positive stool culture for V. cholerae. However, at
this dose, the geometric mean stool volume of 2,175 g was insufficient
by study criteria. At a dose of 106 CFU, 14 of 15 volunteers experienced purging, with a geometric mean stool volume of
5,621 g. Disease severity was significantly greater in volunteers with
blood group O than those with non-O blood types (10,353 g versus 3,555 g, P < 0.001). Following challenge, all volunteers
demonstrated a significant rise in antitoxin antibodies but the serum
vibriocidal titer was attenuated compared to that seen after challenge
with an O1 strain. This model provides a reproducible illness of
sufficient severity for testing the efficacies of new O139 or combined
O1-O139 vaccines.
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Validation and Characterization of a Human
Volunteer Challenge Model for Cholera by Using Frozen Bacteria of the
New Vibrio cholerae Epidemic Serotype, O139
*
Corresponding author. Mailing address: Division of
Pediatric Gastroenterology and Nutrition, 3333 Burnet Ave., Cincinnati, OH 45229. Phone: (513) 636-4415. Fax: (513) 636-7805. E-mail: mitchell.cohen{at}chmcc.org.
Infection and Immunity, December 1999, p. 6346-6349, Vol. 67, No. 12
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
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