Response of Man to Infection with Vibrio cholerae. I. Clinical, Serologic, and Bacteriologic Responses to a Known Inoculum

Abstract

The spectrum of illness and the immunologic response produced by cholera in volunteers were studied. The strains of Vibrio cholerae used were classical Inaba 569B and classical Ogawa 395. An oral dose of 10⁸ organisms in buffered saline was required to induce the diarrhea of cholera. When given with live organisms, NaHCO₃ lowered the infecting dose from 10⁸ to 10⁴ organisms. Clinical manifestations of infection varied from culturally positive formed stools to “rice water” diarrhea. Severe diarrhea did not have an explosive onset but rather progressively increased in volume during a 24-hr period. In 45 % of cases the stool was positive for V. cholerae before the onset of diarrhea. Titers of vibriocidal antibody rose after diarrhea, peaked the second week after challenge, and rapidly fell during the next four weeks.

Footnotes

• This research was supported by contract no. NIH 69-2002 from the National Institutes of Health.

• We thank Dr. W. H. Mosley for his comments, Dr. Dennis K. Wentz for advice regarding gastric acid determination, and Ms. L. Grace for her excellent technical assistance. We gratefully acknowledge the participation of the volunteers and also thank the staff of the Maryland House of Correction for their cooperation in conducting these studies.