Bottle Feeding as a Risk Factor for Cholera in Infants

Gunn, RobertA.; Pollard, RobertA.; Kimball, A M; Feeley, James C.; Feldman, RogerA.; Dutta, SamirR.; Matthew, P.; Mahmood, RifaatA.; Levine, M. M.

doi:10.1016/s0140-6736(79)90653-6

Cited by 54 publications

(24 citation statements)

References 5 publications

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“…Breastfeeding is protective against cholera for infants in endemic countries [161,162]. It is unclear whether this is due to reduced exposure to V. cholerae when infants are breastfed or because breast milk contains protective agents, such as cholera-specific antibodies (for V. cholerae -immune mothers) or innate factors such as lysozyme, lactoferrin and oligosaccharides that correlate with reduced diarrhea and/or can inhibit V. cholerae hemagglutinins [163,164].…”

Section: Expert Commentary and Five-year Viewmentioning

confidence: 99%

Vibrio cholerae: lessons for mucosal vaccine design

Bishop

Camilli

2011

Expert Review of Vaccines

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The ability of Vibrio cholerae to persist in bodies of water will continue to confound our ability to eradicate cholera through improvements to infrastructure, and thus cholera vaccines are needed. We aim for an inexpensive vaccine that can provide long-lasting protection from all epidemic cholera infections, currently caused by O1 or O139 serogroups. Recent insights into correlates of protection, epidemiology and pathogenesis may help us design improved vaccines. This notwithstanding, we have come to appreciate that even marginally protective vaccines, such as oral whole-cell killed vaccines, if widely distributed, can provide significant protection, owing to herd immunity. Further efforts are still required to provide more effective protection of young children. Keywords cholera; classical; El Tor; IgA; protection; vaccine; Vibrio cholerae; vibriocidal Cholera prevention by vaccinationCholera is mainly a fecal-orally transmitted disease and humans are the only known natural veterbrate host. Cholera has been endemic in southern Asia since recorded history. Cholera has spread globally in seven pandemic waves since 1817, of which the current one began in 1961. In 2008, the WHO reported 190,130 cholera cases worldwide, associated with 5143 deaths (98% in Africa), but cholera is globally under-reported and the true disease burden is estimated to be in the millions [1,2]. In countries such as Bangladesh, cholera is endemic and both the rural and urban population is afflicated with biannual outbreaks [3]. In addition to endemic outbreaks, sporadic outbreaks can occur whenever sanitation and clean water provisions are lacking, such as occurred in Zimbabwe in [2008][2009] following the collapse of infrastructure [2].A lack of good animal models for immunization and challenge has hampered the study of cholera vaccines. For example, adult mice are refractory to acute cholera, but infant mice up to 1 week of age are permissive for intestinal colonization [4]. Therefore, passive protection models have been developed, either using immunization of adult female mice and challenge of their pups, which are protected by sucking, or mixing antibodies with Vibrio cholerae in © 2011 Expert Reviews Ltd † Author for correspondence: Tel.: +1 617 636 2144, Fax: +1 617 636 2175, andrew.camilli@tufts.edu. Financial & competing interests disclosureThe authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. No writing assistance was utilized in the production of this manuscript. NIH Public Access Author ManuscriptExpert Rev Vaccines. Author manuscript; available in PMC 2011 November 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript vitro prior to infection [5,6]. Despite the limitations of preclinical models, a number of cholera vaccines have been developed (discussed in detail later).Since 1999, the WHO has advocated the use of oral cholera vac...

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Section: Expert Commentary and Five-year Viewmentioning

confidence: 99%

Vibrio cholerae: lessons for mucosal vaccine design

Bishop

Camilli

2011

Expert Review of Vaccines

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“…More than 40 years ago it was reported that the cholera case fatality rate among children one to five years old was more than 10 times that of adults [2], but description of this disparity has not resulted in large-scale studies of cholera risk factors unique to young children. Most prior studies have been small [3], focused on specific risk factors such as breastfeeding [4], [5], or assessed risk factors for diarrhea in general [6]. More recently, other studies have examined risks for duration of diarrheal illness [7] and diarrheal disease associated death [8], [9].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Severe Cholera among Children under Five in Rural and Urban Bangladesh, 2000–2008: A Hospital-Based Surveillance Study

2013

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BackgroundChildren under five bear the largest cholera burden. We therefore sought to identify modifiable risk factors among Bangladeshi children.Methodology/Principal FindingsWe used multivariate Poisson regression to assess risk factors for severe cholera among diarrheal patients presenting at hospitals in Matlab (rural) and Dhaka (urban), Bangladesh. Risk increased with age. Compared to those under one, rural and urban four-year-olds had adjusted risk ratios (aRR) of 4.17 (95% confidence interval (CI) 2.43–7.15) and 6.32 (95% CI: 4.63–8.63), respectively. Breastfeeding halved the risk in both rural (aRR = 0.49, 95% CI: 0.35–0.67) and urban (aRR = 0.51, 95% CI: 0.41–0.62) settings. Rural children’s risk decreased with maternal education (P-trend: <0.001) and increased among those with a family member with diarrhea in the past week (aRR = 1.61, 95% CI: 1.22–2.14) and those with prior vitamin A supplementation (aRR = 1.65, 95% CI: 1.12–2.43). Urban children whose mothers daily (aRR = 0.41, 95% CI: 0.21–0.79) or occasionally (aRR = 0.55, 95% CI: 0.36–0.84) read a newspaper experienced reduced risk. Urban children from households with incomes between 34–84 USD/month had a 30% increased risk compared to those from households with incomes >84 USD/month.Conclusion/SignificanceIncreasing age, lower socioeconomic status, and lack of breastfeeding are key correlates of increased risk for cholera hospitalization among those under five in rural and urban Bangladesh. In addition, having a family member with diarrhea in the past week was associated with increased risk among rural children. Continued attention should be directed to the promotion of breastfeeding. Further research is needed to elucidate the relationship between maternal education and cholera risk. Renewed research regarding the use of chemoprophylaxis among family members of cholera cases may be warranted in rural endemic settings.

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“…Breast-feeding has been associated with protection against gastrointestinal tract infections (enteromammary axis of immunity) (38), such as those caused by E. coli, Vibrio cholerae, Campylobacter, and Shigella (26,28,(39)(40)(41). Protection against respiratory tract infections (bronchomammary axis) is less definite.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Herpes Simplex Virus Specific Antibodies Found in Human Milk and Serum

et al. 1992

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ABSTRACT. It is not known if milk antibody protects infants from herpes simplex virus (HSV) infection. As a first step to test this hypothesis, anti-HSV antibodies were studied in human milk. Paired serum and milk samples were analyzed for anti-HSV antibodies by ELISA, Western blot analysis (WBA), neutralization (NT) plaque assay, and antibody-dependent cellular cytotoxicity (ADCC) assay. Nineteen of the 20 serum samples showed anti-HSV activity by ELISA and ADCC, and 18 showed activity by WBA and NT. We found a significant association between the immunoassays for detection of anti-HSV antibodies in sera. Fewer of the human milk samples showed anti-HSV activity; only one milk sample was positive by ELISA and one by N T assay, four by ADCC and 12 by WBA. The milk sample from the seronegative donor was also negative. We found a poor association of antibody titers in human milk and serum antibody titers using ELISA, NT, and ADCC assays. There was a significant (p = 0.022) association between serum and milk results using WBA. Among the four assays, WBA was the most sensitive for antibody detection. It will be used in an on-going prospective study to determine the role of anti-HSV antibody in the protection against HSV infections in infants. (Pediatr Res 31: 591-595,1992)

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Bottle Feeding as a Risk Factor for Cholera in Infants

Cited by 54 publications

References 5 publications

Vibrio cholerae: lessons for mucosal vaccine design

Vibrio cholerae: lessons for mucosal vaccine design

Risk Factors for Severe Cholera among Children under Five in Rural and Urban Bangladesh, 2000–2008: A Hospital-Based Surveillance Study

A Comparison of Herpes Simplex Virus Specific Antibodies Found in Human Milk and Serum

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