Cholera is the most prominent diarrheal disease in Bangladesh. Its widespread infection is due to unsanitary conditions because of constant, invasive flooding. Worldwide cholera kills about 110,000 people each year, and medical agencies around the world have been trying to reduce the number of infections for decades (WHO).
Oral rehydration therapy is used to treat cholera patients, relieving dehydrated bodies with fluids packed with nutrients and electrolytes. Oral cholera vaccines are also available. In an article published in The Lancet last week, scientists showed the impact of supplying an entire vulnerable population with a cholera vaccine. The vaccine is called Shanchol, and it works by killing whole cells of cholera bacteria (StopCholera).
In an interview on Friday with The Lancet's Richard Lane, scientist Firdausi Qadri from the International Centre for Diarrhoeal Disease and Research shared her experience with the cholera study in Bangladesh. In addition to flooding, the highly migrating population in Bangladesh is another roadblock for anti-cholera campaigns, Qadri explained. However, the "real-life study" they were able to conduct administering Shanchol to people in Bangladesh showed 53% protection. Qadri emphasized that "the important thing is that protection was sustained for two years in all age groups." The elements of vaccine sustainability and longevity are vital for the success of Shanchol in Bangladesh. It only costs 3.70$ for two doses of the vaccine and does not require a buffer for administration, in comparison to the "Traveler's Vaccine," also known as Dukoral (International Vaccine Institute). Lifestyle habits such as handwashing and maintaining good hygiene surprisingly did not have a significant effect on reducing cases of cholera when compared to vaccine administration.
The National Immunization Program of Bangladesh strives to continue "looking at different strategies for using the vaccine in Bangladesh." Among these strategies include enabling Shanchol to be locally produced, increasing its ability to be produced at an even lower cost.
Currently in Bangladesh, 25 million people out of the 160 million total population are at risk for cholera. Hopefully with the continued production, distribution, and usage of the Shanchol vaccine, these numbers of vulnerable people will decrease to the point where cholera is no longer endemic in Bangladesh.
Source: The Lancet
Epidemiologist Dr. David Boulware discusses in more detail cholera virulence and the cholera pandemic:
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