Overview Product Pipeline V. Leishmaniasis Diarrheal Disease Malaria Chagas

		Related Press Releases and Articles: Institute For OneWorld Health Announces Strategic Advisory Board For Diarrheal Disease Program OneWorld Health Press Release  04.29.08 Roche and the Institute for OneWorld Health Announce Research Collaboration to Fight Neglected Diarrheal Diseases in Developing Countries OneWorld Health Press Release  04.17.08 OneWorld Health Sponsors Diarrheal Diseases Symposium at PEDICON 2008 to Share Information on Effective Therapies against Major Child Killer OneWorld Health Press Release  01.19.08 Dr. Victoria Hale to Build upon OneWorld Health’s Success for Broader Global Health Impact OneWorld Health Press Release  09.27.07		Five Common Types of Diarrheal Pathogens: Cholera Global Burden Cholera is a water-borne bacterial illness that causes acute diarrhea. In endemic regions, including parts of Africa and Asia, cholera is most common among children under five years of age, although the affected age groups vary during outbreaks. Cholera infects an estimated three to five million people annually and causes 100,000-120,000 deaths every year, although some health officials presume these numbers represent only 10% of the actual number of cases worldwide1,2. The bacterial species that causes cholera is called Vibrio cholerae (shown at left). Over 200 variants of V cholerae exist in nature, but only two subtypes (O1 and O139) are known to cause disease in humans. Most patients contract the disease from drinking contaminated water or eating contaminated food. The onset of the disease is rapid and acute. Five to 18 hours after ingesting the bacterium, patients will begin to vomit and pass loose, watery stools; adult patients with an acute infection can lose up to one liter of fluids per hour due to this purging. This rapid dehydration can lead to apathy, shock, and death, often on the first day of illness. If left untreated, up to 50% patients with severe cholera will die from the disease3. Current Treatment The current treatment for cholera includes administering intravenous fluids to replace those lost due to purging. Once the patient is able to drink, he or she is treated with Oral Rehydration Therapy (ORT). A short course of doxycycline is often recommended. This antibiotic lessens diarrheal purging and shortens the required treatment period. However, strains resistant to antibiotics have appeared in over the past three decades 3. The existence of these antibiotic resistant strains underlines the urgent need for an effective and safe cholera vaccine or a drug that will prevent the massive fluid loss associated with the disease. Recently, two promising oral vaccines for cholera have been developed. One, licensed under the trademark Dukoral in Sweden, is more effective in adults than in children, but offers up to 60% protection from cholera up to three years after immunization4. The other vaccine, WC, is produced locally in Vietnam. Data from a small number of individuals indicate that the WC vaccine is effective in both adults and children5. The WC vaccine is inexpensive (about 20 cents per dose) and therefore more affordable for affected populations; the experience in Vietnam has encouraged other manufacturers in India and Indonesia to produce the vaccine locally1. A recent study in Uganda has shown that the vaccine is equally effective in populations with a high incidence of HIV infection6. Svennerholm, A. M., and Steele, D. (2004) Best Pract Res Clin Gastroenterol 18, 421-445 (2001) Wkly Epidemiol Rec 76, 117-124 Sack, D. A., Sack, R. B., Nair, G. B., and Siddique, A. K. (2004) Lancet 363, 223-233 Clemens, J. D., Sack, D. A., Harris, J. R., Van Loon, F., Chakraborty, J., Ahmed, F., Rao, M. R., Khan, M. R., Yunus, M., and Huda, N. (1990) Lancet 335, 270-273 Trach, D. D., Clemens, J. D., Ke, N. T., Thuy, H. T., Son, N. D., Canh, D. G., Hang, P. V., and Rao, M. R. (1997) Lancet 349, 231-235 Lucas, M. E., Deen, J. L., von Seidlein, L., Wang, X. Y., Ampuero, J., Puri, M., Ali, M., Ansaruzzaman, M., Amos, J., Macuamule, A., Cavailler, P., Guerin, P. J., Mahoudeau, C., Kahozi-Sangwa, P., Chaignat, C. L., Barreto, A., Songane, F. F., and Clemens, J. D. (2005) N Engl J Med 352, 757-767 Return to Common Types of Diarrheal Pathogens page > Return to Diarrheal Disease main page >

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