David A. Sack
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View article: Prevalence and Patterns of Enteric Co-Infections Among Individuals Presenting with Cholera-like Diarrheal Disease During Seasonal Cholera Outbreaks
Prevalence and Patterns of Enteric Co-Infections Among Individuals Presenting with Cholera-like Diarrheal Disease During Seasonal Cholera Outbreaks Open
Cholera remains a major public health challenge, and co-infections can complicate clinical outcomes. In a cross-sectional study, we investigated the prevalence and patterns of enteric co-infections during Zambia’s 2023–2024 cholera outbrea…
View article: Recent progress in enterotoxigenic <i>Escherichia coli</i> vaccine research and development
Recent progress in enterotoxigenic <i>Escherichia coli</i> vaccine research and development Open
There are no licensed vaccines against enterotoxigenic Escherichia coli (ETEC), a group of E. coli strains that produce a heat-labile toxin and/or a heat-stable toxin (STa). ETEC is one of the top four leading causes of diarrhea in childre…
View article: Prevalence and Patterns of Enteric Co-Infections Among Individuals Presenting with Cholera-like Diarrheal Disease During Seasonal Cholera Outbreaks
Prevalence and Patterns of Enteric Co-Infections Among Individuals Presenting with Cholera-like Diarrheal Disease During Seasonal Cholera Outbreaks Open
Cholera remains a major public health challenge, and co-infections can complicate out-comes and case management. In a cross-sectional study, we investigated the prevalence and patterns of enteric co-infections during Zambia’s 2023–2024 cho…
View article: Intestinal inflammation induced by heat-labile toxin-producing enterotoxigenic E: Coli infection and impact on immune responses in an experimental human challenge model
Intestinal inflammation induced by heat-labile toxin-producing enterotoxigenic E: Coli infection and impact on immune responses in an experimental human challenge model Open
Enterotoxigenic Escherichia coli (ETEC) causes significant morbidity, mortality, and growth faltering among children, particularly in low- and middle-income countries. While gut inflammation contributes to growth faltering, the role of ETE…
View article: Evaluating the planning for and distribution of cholera rapid diagnostic tests in Nepal
Evaluating the planning for and distribution of cholera rapid diagnostic tests in Nepal Open
Background Cholera remains a significant public health threat in many low- and middle-income countries (LMICs). Rapid diagnostic tests (RDTs) offer a promising tool for improving surveillance and timely response, particularly as programs l…
View article: A colorimetric method for detecting virulent bacteriophage to <i>Vibrio cholerae</i> in fecal and environmental samples
A colorimetric method for detecting virulent bacteriophage to <i>Vibrio cholerae</i> in fecal and environmental samples Open
Background V. cholerae are often infected with vibriophages and these phages may be found associated with V. cholerae bacteria or may be detected independently from the bacteria, especially in environmental water samples. When detected, vi…
View article: Occurrence of enterotoxigenic Escherichia coli in the aquatic environment and impact of climatic factors
Occurrence of enterotoxigenic Escherichia coli in the aquatic environment and impact of climatic factors Open
Background The prevalence of ETEC in the environment could be influenced by environmental factors, which may contribute to seasonal outbreaks. This study assessed the seasonal prevalence of the ETEC population in water bodies in relation t…
View article: Building a Broader Understanding of Enterotoxigenic <i>E. coli</i>
Building a Broader Understanding of Enterotoxigenic <i>E. coli</i> Open
View article: Factors influencing post-diarrhea growth patterns among children under two years old in rural Bangladesh
Factors influencing post-diarrhea growth patterns among children under two years old in rural Bangladesh Open
Undernutrition in children is a major global health issue. Diarrhea exacerbates undernutrition, creating a vicious cycle of infection and malnutrition. This longitudinal study examined growth patterns and influencing factors among 138 chil…
View article: Cholera rapid diagnostic tests at the host-microbe interface: Key Considerations for Global Deployments
Cholera rapid diagnostic tests at the host-microbe interface: Key Considerations for Global Deployments Open
Background Effective cholera outbreak response requires accurate bedside rapid diagnostic tests (RDTs) because access to laboratories is often limited. Formative studies suggest cholera diagnostics have multiple vulnerabilities, including …
View article: Enhancing national cholera surveillance using rapid diagnostic tests (RDTs): A mixed methods evaluation
Enhancing national cholera surveillance using rapid diagnostic tests (RDTs): A mixed methods evaluation Open
Cholera rapid diagnostic tests (RDTs) can strengthen existing surveillance systems by offering a cost-effective screening method that improves understanding of cholera burden allowing for targeted prevention and control efforts. The RDT Im…
View article: Immunogenicity and preclinical efficacy characterization of ShecVax, a combined vaccine against <i>Shigella</i> and enterotoxigenic <i>Escherichia coli</i>
Immunogenicity and preclinical efficacy characterization of ShecVax, a combined vaccine against <i>Shigella</i> and enterotoxigenic <i>Escherichia coli</i> Open
No licensed vaccines are available for the largely antibiotic-resistant Shigella or enterotoxigenic Escherichia coli (ETEC), the two most common bacteria causing children’s diarrhea and travelers’ diarrhea. Virulence heterogeneity is a key…
View article: Intestinal inflammation induced by heat-labile toxin-producing Enterotoxigenic<i>E. Coli</i>infection and impact on immune responses in an experimental human challenge model
Intestinal inflammation induced by heat-labile toxin-producing Enterotoxigenic<i>E. Coli</i>infection and impact on immune responses in an experimental human challenge model Open
Enterotoxigenic Escherichia coli (ETEC) causes significant morbidity, mortality, and growthth faltering among children, particularly in low- and middle-income countries. While gut inflammation contributes to growth faltering, the role of E…
View article: Epidemiologic and Genomic Surveillance of <i>Vibrio cholerae</i> and Effectiveness of Single-Dose Oral Cholera Vaccine, Democratic Republic of the Congo
Epidemiologic and Genomic Surveillance of <i>Vibrio cholerae</i> and Effectiveness of Single-Dose Oral Cholera Vaccine, Democratic Republic of the Congo Open
We conducted 4 years of epidemiologic and genomic surveillance of single-dose effectiveness of a killed whole-cell oral cholera vaccine (kOCV) and Vibrio cholerae transmission in the Democratic Republic of the Congo. We enrolled 1,154 pati…
View article: Versatility of Cholera Rapid Tests
Versatility of Cholera Rapid Tests Open
View article: A Transformation in Cholera Surveillance
A Transformation in Cholera Surveillance Open
View article: Epidemiology of<i>Vibrio Cholerae</i>Infections in the Households of Cholera Patients in the Democratic Republic of the Congo: PICHA7 Prospective Cohort Study
Epidemiology of<i>Vibrio Cholerae</i>Infections in the Households of Cholera Patients in the Democratic Republic of the Congo: PICHA7 Prospective Cohort Study Open
Background The aim of this prospective cohort study is to build evidence on transmission dynamics and risk factors for Vibrio cholerae infections in cholera patient households. Methods Household contacts of cholera patients were observed f…
View article: Multicountry genomic analysis underscores regional cholera spread in Africa
Multicountry genomic analysis underscores regional cholera spread in Africa Open
Cholera remains a significant public health burden in many countries in sub-Saharan Africa, though the exact mechanisms of bacterial emergence and spread remain largely undefined. We generated genomic data from 763 Vibrio cholerae O1 isola…
View article: The Impact of Non-Dysentery Shigella Infection on the Growth and Health of Children over Time (INSIGHT)—A Prospective Case–Control Study Protocol
The Impact of Non-Dysentery Shigella Infection on the Growth and Health of Children over Time (INSIGHT)—A Prospective Case–Control Study Protocol Open
(1) Shigella spp. (Shigella) is known for causing dysentery with blood in stool, but most children infected with Shigella have non-dysentery Shigella-associated diarrhea (NDSD). The World Health Organization recommends the use of antibioti…
View article: Evaluation of a rapid diagnostic test for detection of <i>Vibrio cholerae</i><scp>O1</scp> in the Democratic Republic of the Congo: Preventative intervention for cholera for 7 days (<scp>PICHA7</scp> program)
Evaluation of a rapid diagnostic test for detection of <i>Vibrio cholerae</i><span>O1</span> in the Democratic Republic of the Congo: Preventative intervention for cholera for 7 days (<span>PICHA7</span> program) Open
Objective Globally, there are estimated to be 2.9 million cholera cases annually. Early detection of cholera outbreaks is crucial for resource allocation for case management and for targeted interventions to be delivered to stop the spread…
View article: Seroconversion and Kinetics of Vibriocidal Antibodies during the First 90 Days of Re-Vaccination with Oral Cholera Vaccine in an Endemic Population
Seroconversion and Kinetics of Vibriocidal Antibodies during the First 90 Days of Re-Vaccination with Oral Cholera Vaccine in an Endemic Population Open
Despite the successful introduction of oral cholera vaccines, Zambia continues to experience multiple, sporadic, and protracted cholera outbreaks in various parts of the country. While vaccines have been useful in staying the cholera outbr…
View article: Validation of a Human Challenge Model Using an LT-Expressing Enterotoxigenic E. coli Strain (LSN03-016011) and Characterization of Potential Amelioration of Disease by an Investigational Oral Vaccine Candidate (VLA1701)
Validation of a Human Challenge Model Using an LT-Expressing Enterotoxigenic E. coli Strain (LSN03-016011) and Characterization of Potential Amelioration of Disease by an Investigational Oral Vaccine Candidate (VLA1701) Open
Controlled human infection models are important tools for the evaluation of vaccines against diseases where an appropriate correlate of protection has not been identified. Enterotoxigenic Escherichia coli (ETEC) strain LSN03-016011/A (LSN0…
View article: Whole genome sequencing and transmission analysis of <i>Vibrio cholerae</i> isolates from Eastern and Southern Africa: a genomic epidemiology study
Whole genome sequencing and transmission analysis of <i>Vibrio cholerae</i> isolates from Eastern and Southern Africa: a genomic epidemiology study Open
SUMMARY Background Despite ongoing containment and vaccination efforts, cholera remains prevalent in many countries in sub-Saharan Africa. Part of the difficulty in containing cholera comes from our lack of understanding of how it circulat…
View article: Population-level effect of cholera vaccine on displaced populations, South Sudan, 2014
Population-level effect of cholera vaccine on displaced populations, South Sudan, 2014 Open
Following mass population displacements in South Sudan, preventive cholera vaccination campaigns were conducted in displaced persons camps before a 2014 cholera outbreak. We compare cholera transmission in vaccinated and unvaccinated areas…
View article: The First Use of the Global Oral Cholera Vaccine Emergency Stockpile: Lessons from South Sudan
The First Use of the Global Oral Cholera Vaccine Emergency Stockpile: Lessons from South Sudan Open
In December 2013, violence erupted in South Sudan’s capital, Juba, and quickly spread throughout the country. The crisis exacerbated an already dire humanitarian situation in the youngest and one of the poorest countries in the world, wher…
View article: Effectiveness of one dose of oral cholera vaccine in response to an outbreak: a case-cohort study
Effectiveness of one dose of oral cholera vaccine in response to an outbreak: a case-cohort study Open
Background Oral cholera vaccines represent a new effective tool to fight cholera and are licensed as two-dose regimens with 2-4 weeks between doses. Evidence from previous studies suggests that a single dose of oral cholera vaccine might p…
View article: Immune Responses to an Oral Cholera Vaccine in Internally Displaced Persons in South Sudan
Immune Responses to an Oral Cholera Vaccine in Internally Displaced Persons in South Sudan Open
Despite recent large-scale cholera outbreaks, little is known about the immunogenicity of oral cholera vaccines (OCV) in African populations, particularly among those at highest cholera risk. During a 2015 preemptive OCV campaign among int…
View article: The Impact of a One-Dose versus Two-Dose Oral Cholera Vaccine Regimen in Outbreak Settings: A Modeling Study
The Impact of a One-Dose versus Two-Dose Oral Cholera Vaccine Regimen in Outbreak Settings: A Modeling Study Open
In 2013, a stockpile of oral cholera vaccine (OCV) was created for use in outbreak response, but vaccine availability remains severely limited. Innovative strategies are needed to maximize the health impact and minimize the logistical barr…
View article: MecVax supplemented with CFA MEFA-II induces functional antibodies against 12 adhesins (CFA/I, CS1–CS7, CS12, CS14, CS17, and CS21) and 2 toxins (STa, LT) of enterotoxigenic <i>Escherichia coli</i> (ETEC)
MecVax supplemented with CFA MEFA-II induces functional antibodies against 12 adhesins (CFA/I, CS1–CS7, CS12, CS14, CS17, and CS21) and 2 toxins (STa, LT) of enterotoxigenic <i>Escherichia coli</i> (ETEC) Open
Enterotoxigenic Escherichia coli (ETEC) strains that produce various adhesins and one or two enterotoxins are the leading causes of children’s diarrhea and travelers’ diarrhea. MecVax, a multivalent ETEC vaccine candidate, consists of two …
View article: Epidemiology of Enterotoxigenic Escherichia coli among Children and Adults Seeking Care at Hospitals in Two Geographically Distinct Rural Areas in Bangladesh
Epidemiology of Enterotoxigenic Escherichia coli among Children and Adults Seeking Care at Hospitals in Two Geographically Distinct Rural Areas in Bangladesh Open
Enterotoxigenic Escherichia coli (ETEC) infections undeniably continue to have substantial morbidity and mortality in younger children; however, limited data are available on the disease burden of older children and adults and on ETEC epid…