Promising Phase I/II Trial for Cuban Vaccine Candidate amidst Growing Cholera Threat

In August, the World Health Organization (WHO) published alarming data on the re-emergence of cholera in many African and Asian countries, noting that the outbreaks run “parallel with the ever-increasing proportion of vulnerable populations living in unsanitary conditions. ” A total of 236,896 cases were notified to the WHO in 2006 from 52 countries, a case level not seen since the,90s and representing an increase of 79 % over 2005. Deaths reached more than 6,000, a three-fold increase from 2005. However, the WHO has long warned that cholera is widely under-reported, and in August renewed its description of the disease as “a global threat to public health and one of the key indicators of social development.”[1] Until social determinants drastically improve for millions, oral cholera vaccines (OCV’s) may provide a life-saving opportunity to stem outbreaks – especially in high-risk areas where the case-fatality rate (CFR) reaches up to 30 % – when they are used in conjunction with effective public health and clinical strategies in epidemic-prone settings. This is the current position of the WHO, a reversal of earlier thinking that doubted the value of cholera vaccines. However, due to several catastrophic epidemics in the 90s and new research, the WHO reassessed the vaccines ’ potential in 2002.[2] Since then, others have concurred that OCV’s may become effective partners in rolling back the ever-more-aggressive Vibrio cholerae bacterium, causal agent of the disease. In this context, results just in from a Cuban vaccine candidate’s Phase I/II trial show promise