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Infection and Immunity, November 2005, p. 7422-7427, Vol. 73, No. 11
0019-9567/05/$08.00+0     doi:10.1128/IAI.73.11.7422-7427.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Blood Group, Immunity, and Risk of Infection with Vibrio cholerae in an Area of Endemicity

Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts,¹ Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts,² ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh,³ Department of Medicine, Harvard Medical School, Boston, Massachusetts,⁴ Department of Biostatistics, Massachusetts General Hospital, Boston, Massachusetts,⁵ Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts,⁶ Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts⁷

Received 8 June 2005/ Returned for modification 18 July 2005/ Accepted 9 August 2005

Individuals with blood group O are more susceptible than other individuals to severe cholera, although the mechanism underlying this association is unknown. To assess the respective roles of both intrinsic host factors and adaptive immune responses that might influence susceptibility to infection with Vibrio cholerae, we prospectively followed a cohort of household contacts of patients with cholera in Bangladesh. In this study, we made the novel observation that persons with blood group O were less likely than those with other blood groups to become infected with V. cholerae O1 (odds ratio [OR], 0.67; 95% confidence interval [CI], 0.53 to 0.85; P = 0.008). Consistent with prior studies, however, household contacts with blood group O were more likely to develop severe illness if infected with V. cholerae O1 (OR, 2.3; 95% CI, 0.98 to 5.59; P = 0.05). While blood group O protected significantly against infection with V. cholerae O1, there was no evidence of protection against V. cholerae O139. A multivariate analysis demonstrated that the association between blood group O and protection from infection with V. cholerae O1 was independent of age, gender, and baseline anti-cholera toxin and vibriocidal antibody titers. Based on this epidemiologic evidence, we propose a hypothesis for understanding the association between blood group O and the risk of infection with V. cholerae O1 and O139 as well as the risk of developing severe symptoms once infected.

Editor: W. A. Petri, Jr.

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