Comparison of clinical features and immunological parameters of patients with dehydrating diarrhoea infected with Inaba or Ogawa serotypes of Vibrio cholerae O1

Abstract

Vibrio cholerae O1, Ogawa and Inaba serotypes, both cause severe cholera. We compared clinical and immunological features in patients in Bangladesh infected with these 2 serotypes. Blood was collected from hospitalized Ogawa (N=146) or Inaba (N=191) patients at the acute stage (day 2) and 5 and 19 days later. Ogawa patients were younger than Inaba, presented with shorter duration of diarrhoea, and had more frequent abdominal pain, vomiting and need for intravenous fluids (p<0.05). Inaba patients more frequently had dark-field positive stools (p<0.01). Inaba strains were more susceptible to tetracycline and erythromycin than Ogawa strains (p<0.001). Ogawa infection produced higher plasma vibriocidal as well as IgG responses to cholera toxin B subunit, toxin-coregulated pilus subunit and lipopolysaccharide (LPS); higher IgA responses to LPS in ‘antibody in lymphocyte supernatant’ (ALS) specimens were also seen. These results suggest that a cholera vaccine based on the Ogawa serotype needs to be further investigated.

Acknowledgements

We wish to thank the study participants as well as the dedicated field and laboratory workers of the Cholera Immune Response Study at the ICDDR, B. This research was supported by ICDDR, B: Centre for Health and Population Research; grants D43 TW05572 and R24 TW007988 from the Fogarty International Center (E.T.R. and S.B.C.); grant U01 AI058935 from the National Institute of Allergy and Infectious Diseases (S.B.C.); grant AI40725 from the National Institute of Allergy and Infectious Diseases (E.T.R.); grant K01 TW007144 from the Fogarty International Center (R.C.L.); and grant K01 TW007409 from the Fogarty International Center (J.B.H.)

Declaration of interest: The authors report no conflicts of interest.