Despite the fact that cholera is not endemic in our country, there is currently a risk of cases occurring due to the proximity of Haiti where the transmission, since the first documented epidemic in at least the last 100 years, occurred in October 2010. , ten months after the fatal earthquake. A new outbreak was recently confirmed requiring an epidemiological alert in the Dominican Republic when the first imported case was detected on 2 October.
Indeed, at the moment, we have some cases of cholera in the vicinity of La Zurza, a poor community, very overcrowded, with recently arrived Haitians, without drinking water. The risk of contamination increases due to the proximity of this population to the Isabela River, where they bathe and defecate practically in the open. For this reason, the authorities of the Ministry of Public Health have invited the population not to carry out activities in the said river.
In the presence of an outbreak, among the most important interventions are the reduction of the number of deaths through prompt treatment, control of its spread by providing clean water and health education to improve hygiene, such as hand washing and handling food safe. . However, oral cholera vaccines are important means of its prevention and control.
It is for this last reason that we draw attention to this new vaccine which has been tested in a phase III research study in our country with excellent results, in case there is a need to vaccinate groups of people in the vicinity of some outbreaks which could be detected in the country.
The Shanchol vaccine is bivalent, i.e. it contains the whole dead cells of the Tor Inaba O1 and Tor Ogawa O139 strains, which makes it more effective. It is available for oral administration in two doses, with an interval between the first and second dose of 14 days.
The study of this new vaccine composition was conducted by the research teams of Dr. Lina Cordero and Dr. Jesús Feris Iglesias in two different centers in the Dominican capital. They evaluated three groups of people: a one- to four-year-old group; another group from five to 14 years old and the third from 15 years and older. We enrolled 336 participants divided into 112 in each group.
In all groups, post-second dose seroconversion for both Inaba O1 and Ogawa O139 was 87% or greater for all ages, which was shown to be acceptable and safe with robust immunogenicity. For more information on the study, the scientific article published in Human Vaccines and Immunotherapeutics can be located by searching for it as: Hum Vaccin Imunother, 2018; 14(6): 1403-1411.
We believe that just as the Pan American Health Organization -PAHO- has donated 1.2 million doses of cholera vaccine to Haiti, our Minister of Health should request from PAHO a quantity of cholera vaccines according to studies on population around the cases detected in La Zurza, in order to prevent their spread to other people, in consideration of the fact that the impact of all the measures relating to the reduction of poverty, a condition of greatest risk for its transmission, would have an effect in the long run, however, immunization would be an option to consider to prevent and avoid the spread of cholera.
The author is an Infectologist-Pediatrician
