The epidemic and pandemic potential of Vibrio cholerae O139 is such that a vaccine against this newly emerged serogroup of V. cholerae is required. A conjugate made of the polysaccharide moiety (O-specific polysaccharide plus core) of the lipopolysaccharide (LPS) of V. cholerae O139 (pmLPS) was prepared by derivatization of the pmLPS with adipic acid dihydrazide and coupling to tetanus toxoid (TT) by carbodiimidemediated condensation. The immunologic properties of the conjugate were tested using BALB/c mice injected subcutaneously three times at 2 weeks interval and then a fourth time 4 weeks later. Mice were bled 7 days after each injection and then once each month for the following 6 months. LPS and TT antibody levels were determined by enzyme-linked immunosorbent assay using immunoplates coated with either O139 LPS or TT. Both pmLPS and pmLPS-TT conjugate elicited low levels of immunoglobulin M (IgM), peaking 5 weeks after the first immunization. The conjugate elicited high levels of IgG antibodies, peaking 3 months after the first immunization and declining slowly during the following 5 months. TT alone, or as a component of conjugate, induced mostly IgG antibodies. Antibodies elicited by the conjugate recognized both capsular polysaccharide and LPS from V. cholerae O139 and were vibriocidal. They were also protective in the neonatal mouse model of cholera infection. The conjugation of the O139 pmLPS, therefore, enhanced its immunogenicity and conferred T-dependent properties to this polysaccharide.Since the appearance of Vibrio cholerae O139 in the suburb of Madras, India, in October 1992, epidemic cholera caused by this strain has spread rapidly throughout the Indian subcontinent (1). Clinical illness associated with V. cholerae O139 infection appears to be virtually identical to that due to V. cholerae O1 E1 Tor infections. However, in contrast to infection with V. cholerae O1, V. cholerae O139 infection has largely affected the adult population in areas of V. cholerae O1 endemicity, indicating a lack of protective immunity against this newly evolved strain (1). Presumably, there are differences between the immune responses against O1 and O139 strains, which may be of considerable importance in terms of protection (33). A quiescent period followed the appearance of V. cholerae O139, and it was thought that it was a one-time event. However, there was an upsurge of cases in Calcutta, India, in 1996, and the O139 serogroup again became the dominant serogroup causing cholera in India by September 1996 (32). The O139 serogroup has remained present in India and Bangladesh since this last outbreak (15) and requires careful monitoring.It has been suggested that the emergence of V. cholerae O139 is the result of a complex chromosomal rearrangement involving the horizontal transfer of genes encoding enzymes involved in O-specific polysaccharide (O-SP) biosynthesis (3,8,14,43). Indeed, the major differences between V. cholerae O1 and V. cholerae O139 reside in their cell surface components. V. cholerae O139, unlike ...