• Journal Article

Impact of epidemic cholera in a previously uninfected island population: evaluation of a new seroepidemiologic method

Citation

Harris, J. R., Holmberg, S., Parker, R. D., Kay, D. E., Barrett, T. J., Young, C. R., ... Blake, P. A. (1986). Impact of epidemic cholera in a previously uninfected island population: evaluation of a new seroepidemiologic method. American Journal of Epidemiology, 123(3), 424-430.

Abstract

During an investigation of a 1982 cholera outbreak in Truk, an area without endemic cholera, 254 post-outbreak serum specimens were collected from ill and well inhabitants of a single island. These were compared with 57 specimens collected in Truk in 1964, when heat-labile toxin-producing enterotoxigenic Escherichia coli was presumably endemic but cholera did not exist. The serum was tested for vibriocidal antibody and antitoxic antibodies to cholera toxin and heat-labile toxin and the ratio of the anti-cholera antitoxin to the anti-heat-labile antitoxin was calculated. The prevalences of elevated anti-cholera antitoxin and anti-heat-labile antitoxin levels were similar in both years: an elevated anti-cholera antitoxin was found in 30% of the 1964 and 80% of the 1982 specimens, while an elevated anti-heat-labile antitoxin was found in 40% (1964) and 84% (1982). In contrast, vibriocidal antibody titers were elevated in none of the 1964 but in 64% of the 1982 specimens, and the anti-cholera/anti-heat-labile antitoxin ratio was elevated in 4% (1964) and 42% (1982). The anti-cholera/anti-heat-labile antitoxin ratio appears to differentiate the antitoxic responses to Vibrio cholerae O1 and heat-labile toxin-producing enterotoxigenic E. coli, even in areas where both are prevalent, and should serve as a useful seroepidemiologic tool