Protection afforded by previous Vibrio cholerae infection against subsequent disease and infection: A review

• Published in: PLoS neglected tropical diseases Vol. 15; no. 5; p. e0009383
• Main Authors: Leung, Tiffany, Matrajt, Laura
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.05.2021; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Antibodies, Bacterial - blood; Antibodies, Bacterial - immunology; Bacteria; Biology and Life Sciences; Child; Child, Preschool; Cholera; Cholera - immunology; Cholera - prevention & control; Cholera Toxin - immunology; Cross Protection - immunology; Diarrhea; Epidemics; Gram-negative bacteria; Humans; Immunity; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Immunologic Memory - immunology; Immunology; Infant; Infections; Lipopolysaccharides; Lipopolysaccharides - immunology; Markers; Mathematical models; Medical research; Medicine and Health Sciences; Medicine, Experimental; Middle Aged; Observational studies; Patient outcomes; Persistence; Protection; Review; Serology; Surveillance; Tropical diseases; Vibrio cholerae; Vibrio cholerae O1 - immunology; Vibrio cholerae O139 - immunology; Waterborne diseases; Young Adult; United States; Bangladesh
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0009383

Cholera is an acute, diarrheal disease caused by Vibrio cholerae O1 or 139 that is associated with a high global burden. We analyzed the estimated duration of immunity following cholera infection from available published studies. We searched PubMed and Web of Science for studies of the long-term immunity following cholera infection. We identified 22 eligible studies and categorized them as either observational, challenge, or serological. We found strong evidence of protection at 3 years after infection in observational and challenge studies. However, serological studies show that elevated humoral markers of potential correlates of protection returned to baseline within 1 year. Additionally, a subclinical cholera infection may confer lower protection than a clinical one, as suggested by 3 studies that found that, albeit with small sample sizes, most participants with a subclinical infection from an initial challenge with cholera had a symptomatic infection when rechallenged with a homologous biotype. This review underscores the need to elucidate potential differences in the protection provided by clinical and subclinical cholera infections. Further, more studies are warranted to bridge the gap between the correlates of protection and cholera immunity. Understanding the duration of natural immunity to cholera can help guide control strategies and policy.