Open Access Open Badges Research article

Effectiveness and economic analysis of the whole cell/recombinant B subunit (WC/rbs) inactivated oral cholera vaccine in the prevention of traveller's diarrhoea

Rosa López-Gigosos12*, Pedro Garcia-Fortea1, Maria J Calvo3, Emilia Reina1, Rosa Diez-Diaz1 and Elena Plaza1

Author Affiliations

1 International Vaccination Centre of Malaga, Ministry of Health, Subdelegation in Malaga, Paseo Marítimo Pablo Ruiz. Picasso 43, 29017 Málaga (Spain)

2 Dept. Preventive Medicine and Health Public. Malaga University, Malaga, Spain

3 International Vaccination Centre of Santander Ministry of Health, Delegation in Cantabria, Cantabria, Spain

For all author emails, please log on.

BMC Infectious Diseases 2009, 9:65  doi:10.1186/1471-2334-9-65

Published: 16 May 2009



Nowadays there is a debate about the indication of the oral whole-cell/recombinant B-subunit cholera vaccine (WC/rBS) in traveller's diarrhoea. However, a cost-benefit analysis based on real data has not been published.


A cost-effectiveness and cost-benefit study of the oral cholera vaccine (WC/rBS), Dukoral® for the prevention of traveller's diarrhoea (TD) was performed in subjects travelling to cholera risk areas. The effectiveness of WC/rBS vaccine in the prevention of TD was analyzed in 362 travellers attending two International Vaccination Centres in Spain between May and September 2005.


The overall vaccine efficacy against TD was 42,6%. Direct healthcare-related costs as well as indirect costs (lost vacation days) subsequent to the disease were considered. Preventive vaccination against TD resulted in a mean saving of 79.26 € per traveller.


According to the cost-benefit analysis performed, the recommendation for WC/rBS vaccination in subjects travelling to zones at risk of TD is beneficial for the traveller, regardless of trip duration and visited continent.