Frequency of Reexposure to Vibrio cholerae O1 Evaluated by Subsequent Vibriocidal Titer Rise after an Episode of Severe Cholera in a Highly Endemic Area in Bangladesh

Ana A. Weil Department of Medicine, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts

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Fahima Chowdhury Department of Medicine, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts

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Ashraful I. Khan Department of Medicine, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts

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Daniel T. Leung Department of Medicine, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts

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Taher Uddin Department of Medicine, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts

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Yasmin Ara Begum Department of Medicine, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts

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Nirod Chandra Saha Department of Medicine, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts

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Richelle C. Charles Department of Medicine, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts

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Regina C. LaRocque Department of Medicine, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts

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Jason B. Harris Department of Medicine, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts

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Edward T. Ryan Department of Medicine, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts

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Firdausi Qadri Department of Medicine, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts

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Stephen B. Calderwood Department of Medicine, Harvard Medical School, Boston, Massachusetts; Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka, Bangladesh; Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts

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DOI:
https://doi.org/10.4269/ajtmh.2012.12-0323
Volume/Issue:
Volume 87: Issue 5
Page(s):
921–926
Restricted access
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Vibriocidal antibody is a marker of recent exposure to Vibrio cholerae O1 infection. We examined vibriocidal titers for 1 year after an episode of severe cholera in patients in Dhaka, Bangladesh; 16 of 53 (30%) patients had a fourfold or greater increase in vibriocidal titer between 6 and 12 months after an episode of severe cholera, suggesting reexposure to the organism. Among patients with rises in titers during follow-up, the patients initially infected with serotype Ogawa had earlier rises in titer than the patients initially infected with serotype Inaba. These data and others suggest that an episode of severe cholera protects against symptomatic disease for several years, but reexposure to the organism occurs frequently in an endemic area, with immunological boosts beginning as early as 6 months after severe disease. Repeated exposures to V. cholerae in endemic areas may be a necessary component for long-lasting protection against severe disease.

Author Notes

* Address correspondence to Stephen B. Calderwood, Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02481. E-mail: scalderwood@partners.org
† These authors are co-first authors.
‡ These authors are co-senior authors.

Financial support: This work was supported by a Partners Healthcare Center of Expertise in Global and Humanitarian Health Travel Grant (to A.A.W.); Fogarty International Clinical Research Scholars Award R24 TW007988 (to F.C. and A.I.K.) from the Fogarty International Center; American Recovery and Reinvestment Act (ARRA) Post-Doctoral Fellowship in Global Infectious Diseases TW05572 (to D.T.L.); a Postdoctoral Fellowship in Tropical Infectious Diseases from the American Society for Tropical Medicine and Hygiene—Burroughs Wellcome Fund (to D.T.L.); the Harvard Initiative for Global Health Post-Doctoral Fellowship in Global Infectious Diseases (to D.T.L); a Training Grant in Vaccine Development and Public Health TW005572 (to T.U., E.T.R., and F.Q.); Career Development Awards K08 AI089721 (to R.C.C.), K01 TW07144 (to R.C.L.), and K01 TW07409 (to J.B.H.); a Physician Scientist Early Career Award from the Howard Hughes Medical Institute (to R.C.L.); National Institutes of Health Grants U01 AI077883 (to E.T.R.), AI058935 (to E.T.R. and S.B.C.), and R03 AI063079 (to F.Q.); and the Swedish Agency for International Development and Cooperation (F.Q.).

Authors' addresses: Ana A. Weil, Department of Medicine, Massachusetts General Hospital, Boston, MA, E-mail: aweil@partners.org. Fahima Chowdhury, Ashraful I. Khan, Daniel T. Leung, Taher Uddin, Yasmin Ara Begum, Nirod Chandra Saha, and Firdausi Qadri, Centre for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh, E-mails: fchowdhury@icddrb.org, ashrafk@icddrb.org, dleung@partners.org, taher_imm@icddrb.org, yasmin@icddrb.org, nirod@icddrb.org, and fqadri@icddrb.org. Richelle C. Charles, Regina C. LaRocque, Jason B. Harris, Edward T. Ryan, and Stephen B. Calderwood, Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, E-mails: rccharles@partners.org, rclarocque@partners.org, jbharris@partners.org, etryan@partners.org, and scalderwood@partners.org.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2012
Received:
19 May 2012
|
Accepted:
27 Jul 2012
|
Published Online:
07 Nov 2012
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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