Dukoral, a new cholera vaccine, licensed in the UK
Last week a new cholera vaccine was launched in the UK. Dukoral, manufactured by Chiron Vaccines Evans, is active against disease caused by Vibrio
cholerae serogroup 01, and is licensed for adults and children over two years who will be visiting areas where the disease is endemic or epidemic.
The vaccine triggers a local intestinal protective immune response, inducing
antibodies which prevent the bacterium from attaching to the intestinal
wall, impeding its colonisation.
The efficacy of the vaccine was assessed in three separate clinical trials.
Results from a trial in Bangladesh showed that the vaccine gave overall
protection of 85 per cent for the first six months. Duration of protection
varied with age, lasting for six months in children and for two years
in adults. A trial conducted in Peru also found the short-term protective
efficacy of the vaccine to be 85 per cent, although a third study failed
to show any protective efficacy against cholera during the first year.
However, a booster dose 10 to 12 months after primary immunisation resulted
in vaccine efficacy of 60.5 per cent.
Dukoral comes as an oral suspension and is added to a mixture of sodium
hydrogen carbonate buffer dissolved in water. Food and drink should be
avoided one hour before and after vaccination. Adults and children over
six should take two doses over a period of one to six weeks. For children
between two and six years, three doses should be given. Immunisation
should be completed at least one week before potential exposure to the
disease. For longer-term protection against cholera, a single booster
can be given after two years for adults and after six months for children
aged two to six years.
The vaccine is intended to complement the recommended food and hygiene
protective measures and does not protect against
V cholerae serogroup O139 or other species of Vibrio.
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