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Cholera in a Vaccinated American: Immunological Response to Vaccination and Disease

[+] Article, Author, and Disclosure Information

Supported in part by Research Agreement 196802 between the National Institutes of Health, Bethesda, Md., and the Pakistan-SEATO Cholera Research Laboratory, Dacca, East Pakistan.

The Pakistan-SEATO Cholera Research Laboratory is a part of the SEATO Cholera Research Program and is supported by the U.S. Agency for International Development, Department of State, Washington, D.C.; the National Institutes of Health, Education, and Welfare, Washington, D.C.; and by the governments of Pakistan, United Kingdom, and other SEATO nations. The NIH Cholera Advisory Committee coordinates the research program.

▸Requests for reprints should be addressed to Elias Abrutyn, M.D., Center for Disease Control, Field Services Branch, Atlanta, Ga. 33033

Ann Intern Med. 1971;74(2):228-231. doi:10.7326/0003-4819-74-2-228
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A case of clinical cholera in an American physician and his serologic response to cholera vaccine and the illness are described. In July 1968 he participated in a study evaluating monovalent Inaba vaccine. Initially his vibriocidal antibody titers were lower than the geometric mean titers of the other nine study participants, but at 6 months his titer was comparable with titers of other Americans at 6 months after immunization. In December 1968 he traveled to East Pakistan from Atlanta, Georgia, and in January he had clinical cholera. Although the reciprocal vibriocidal antibody titer in the acute and convalescent serum specimens was unchanged (320), the reciprocal toxin neutralizing antibody titer rose from less than 1 on the day the illness began to 8 on the ninth day and 13 on the fifteenth day after onset. Whereas IgM vibriocidal antibody was detectable in sera collected before and after the illness, IgG vibriocidal antibody was detectable only in serum collected 15 days after onset. This case emphasizes that healthy persons inoculated with vaccine of proved efficacy can still develop clinical cholera when exposed to it.


cholera ; vaccination





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