If Smallpox can be Conquered, Why Not Cholera?

Review

English

Noel W. Preston

Department of Bacteriology and Virology, University Medical School, Manchester M13 9PT, England.

Garyounis Medical Journal Vol. 4, No.1. January 1981:69-72

Abstract

The conquering of smallpox was brought about by the widespread use of a live vaccine effective against all known forms of the virus. With cholera, measures to prevent contamination of water (and food) with human sewage are effective; but they are not readily applied in many parts of the world. Moreover, progress in the treatment of cholera may have reduced efforts towards prevention. Conquest of a disease, however, is better achieved by prevention, rather than by treatment after it has occurred.
Vaccination against cholera has been only partially successful in the past. But progressive study of the vibrio, and understanding of the pathogenicity of cholera,point the way towards the goal of a fully effective vaccine. Immunity is type-specific in this disease, and must cover both the Inaba and Ogawa serotypes. The relatively poor human response to the Inaba component of vaccine demands the use of adjuvant. There are no signs yet of a live attenuated vaccine that would be both safe and effective. The effective use of dead vaccine probably necessitates a course of more than just one or two injections.