Completed Infection & Immunity Digestion, Kidneys & Other Organs

‘DuoChol: A low-cost, thermostable dry formulation whole-cell / B-subunit enterocoated capsule oral cholera vaccine.’

In plain English

AI plain-English summary

Cholera vaccines currently require refrigeration and contain five active ingredients, but a new two-ingredient capsule called Hillchol-B™ stays stable without cooling and can be manufactured at lower cost. This matters because the three WHO-approved oral cholera vaccines—Dukoral, Shanchol, and Euvichol-Plus—are all liquid formulations that demand a complete cold chain from factory to clinic. Their five-component composition limits production capacity and drives up manufacturing costs. Hillchol-B™ replaces this complexity with just two active ingredients: formalin-killed Hikojima bacteria and cholera toxin B subunit, packaged as a dry, enterocoated capsule. If successful, this vaccine could transform cholera control in two ways. For endemic regions, its thermostability and low cost would simplify supply chains—no refrigerated trucks, no cold storage at rural clinics. For outbreak response, where speed matters most, the dry capsule formulation allows immediate deployment without cold-chain logistics. The researchers aim to help meet WHO’s target of reducing cholera deaths by 90% and eliminating transmission in most affected countries within a decade.

View original technical description
Our vision is to develop a novel, much improved oral cholera vaccine (OCV) which will substantially contribute to achieving WHO´s stated goals to reduce cholera deaths by at least 90% and eliminate transmission of cholera in the majority of afflicted countries in the coming decade. The currently WHO prequalified OCVs – Dukoral™, Shanchol™ and Euvichol-Plus™ – are effective but have a complex composition with five components each, which limits the production capacity and adds to the manufacturing costs. They are all of them liquid vaccines in less than ideal formulations, and require a complete cold chain. The proposed OCV, Hillchol-B™ , is a thermostable, dry formulation enterocoated capsule vaccine having two rather than five active ingredients (formalin-killed single-strain Hikojima bacteria + cholera toxin B subunit) that can be produced at low cost. Its thermostability, ease of production, practical formulation, affordable cost, and increased efficacy compared to current OCVs should make Hillchol-B™ to a highly attractive vaccine for use in national control programs of endemic cholera and the ideal OCV for use in cholera outbreaks where maximal short-term efficacy is of essence.

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Researchers

Jan Holmgren (EPMC Awardee)Manuela Terrinoni (EPMC Awardee)Michael Lebens (EPMC Awardee)Stefan Nordqvist (EPMC Awardee)

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Original classification

Innovations AIGH Enterics Flagship

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