New Vaccine Development Establishing Priorities: Volume II, Diseases of Importance in Developing Countries (1986) / Chapter Skim
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Appendix D-15: The Prospects for Immunizing Against Shigella spp.
Appendix D-15: The Prospects for Immunizing Against Shigella spp.
Pages 329-337
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From page 329... ...
In many patients, the initial presentation is watery diarrhea, which becomes bloody or dysenteric in a matter of hours to a day or two. The severity of the disease is determined in part by the infecting species; Shigella sonnet generally causes a self-limited watery diarrhea, whereas Shigella dysenteriae 1 usually progresses rapidly to bloody diarrhea or dysentery.
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Selective media are employed for this purpose; these media contain bile salts to inhibit the growth of other fecal organisms and a dye indicator to demonstrate lactose fermentation. Although many media have been devised, some are highly inhibitory to shigellas, especially to S
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Indeed, parenteral immunization of Rhesus monkeys with toxoid resulting in high serum antitoxin titers does not protect against clinical shigellosis following oral bacterial challenge (McIver et al., 1977~. DISTRIBUTION OF DISEASE Geographic Distribution Shigellas are worldwide in distribution, but the prevalence of different species varies from country to country.
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332 C to P~ o ~D to s~ a P~ a' l U~ s~ P~ 1 U~ ~a s~ a U)
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From page 333... ...
A vaccine incorporating protective antigens from the most common infecting strains in a given geographic area should prevent 80 to 90 percent of the shigella infections, depending on the prevalence of these strains and assuming total coverage of the target population with a "perfect" vaccine delivered at the earliest feasible age. Observed or apparent vaccine efficacy will depend, therefore, on knowledge of appropriate antigens from the different strains infecting the population in the regions where vaccine is used.
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From page 334... ...
Epidemic _ dysenteriae 1 infection caused by multiply resistant organisms is now occurring in India, Bangladesh, and Central Africa. In some instances, the only usable drugs are expensive third generation penicillins or cephalosporins (Kabir et al., 1984)
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In contrast, oral immunization using live attenuated shigella strains or mutants to induce local immunity has been effective. While none of the attenuated candidate vaccine strains developed thus far (including colonial mutants, streptomycin-dependent mutants, and hybrids prepared by insertion of E
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1981. Construction of a potential bivalent vaccine strain: Introduction of Shigella sonnet form I antigen genes into the gale Salmonella typhi Ty 21a typhoid vaccine strain.
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From page 337... ...
1982. Epidemiologic and clinical features of patients infected with Shigella who attended a diarrhoeal disease hospital in Bangladesh.
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