Cholera causes significant morbidity and mortality worldwide. For travelers
, the risk of developing cholera per month of stay in a developing country
is similar to 0.001%-0.01%, and cholera may present as traveler's diarrhea.
In the United States, only a poorly tolerated, marginally effective, paren
terally administered, phenol-inactivated vaccine is available. Outside the
United States, 2 additional vaccines are commercially available: an oral ki
lled whole cell-cholera toxin recombinant B subunit vaccine (WC-rBS) and an
oral live attenuated Vibrio cholerae vaccine (CVD 103-HgR), These oral vac
cines are well tolerated. In field trials, WC-rBS provides 80%-85% protecti
on front cholera caused by V. cholerae serogroup O1 for at least 6 months.
In volunteer studies, CVD 103-HgR provides 62%-100% protection against chol
era caused by V. cholerae for at least 6 months. No commercially available
cholera vaccine protects against disease caused by V. cholerae serogroup O1
39. New cholera vaccines are being developed.