Cholera
Cholera has existed since at least 500 B.C. and is a bacterial disease transmitted in water or food contaminated with Vibrio cholerae bacteria. Symptoms typically include diarrhea and vomiting and can be mild or fatal.
The earliest discovery of the bacterium was in 1854 by Italian Filippo Pacini. His work went mostly unnoticed.
National Library of Medicine
In the 1880s, Dr. Robert Koch discovered cholera bacteria, traveling from Germany to Egypt and India during outbreaks. They confirmed the bacteria during autopsies and concluded it was linked to infected water supplies. Koch also discovered that people infected with cholera were protected from it afterwards.
In 1885, Spanish doctor Jaime Ferran, who studied under Louis Pasteur (Koch’s rival), created the first cholera vaccine from working with live bacteria. He did a mass vaccination (50,000 people) during an outbreak in Spain.
Two scientists, Sawtschenko and Sabolotny, experimented with a killed cholera bacteria “broth” in 1893, which prevented cholera but was impractical because it required many doses.
Several cholera vaccines were invented worldwide, including Haffkine’s vaccine trials in India in 1893, and his heat-killed vaccine in 1911. In 1927, Alexandre Besredka’s oral bilivaccine was tested in India and China alongside an injected vaccine. At the National Institutes of Health (NIH) from 1943 until her retirement in 1971, Dr. Margaret Pittman worked to assess the efficacy of and establish national and international standards for the production of the cholera vaccine.
Dr. Pittman was active with SEATO and traveled to the cholera research laboratory in Dacca, East Pakistan (now Bangladesh). For five years she was the SEATO Cholera Research Project director at the NIH. Pittman helped design the laboratory, the equipment, and the research that would take place at SEATO. With Pittman leading the team their findings demonstrated that the effectiveness of a cholera vaccination directly relates to its potency assay. This research project also verified the importance of IV restorative fluids in treatment procedures for victims of cholera. Today SEATO has been replaced by the International Center for Diarrhoeal Disease Research, Bangladesh.
The 1980s and 1990s brought increased research and understanding of the complexity of the cholera bacteria, leading to many more vaccines around the world. Trials around the world expanded knowledge on the theory of herd immunity or herd protection. Vaxchora, approved by the FDA in 2016 and the vaccine currently in use, is a single-dose vaccine taken before traveling to at-risk areas.
World Health Organization (WHO)