National Institute of Cholera and Enteric Diseases

Institute Profile

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History

 

  The National Institute of Cholera and Enteric Diseases originally known as the Cholera Research Centre was established in February, 1962 to conduct in-depth studies on cholera and to suggest remedial measures. The centre initiated a number of studies in collaboration with WHO, Geneva including two cholera vaccine field trials, cholera carrier, serological and chemoprophylaxis studies and a number of hospital based clinical trials. The centre was recognized as the WHO International Reference Centre for Vibriophage Typing in 1968 and designated as the WHO Collaborating Centre for Reference and Research in Vibrios in 1977, providing various referral services to the member countries. In 1978, the centre was renamed as the National Institute of Cholera and Enteric Diseases, in view of its expanding potential and activities covering a large number of micro-organisms concerned with enteric diseases. It was designated as the "WHO Collaborating Centre for Research and Training in Diarrhoeal Diseases" in 1979. The institute was shifted to its present campus at Beliaghata in 1982. The Institute was involved in HIV/AIDS research since May, 1986 and subsequently designated as one of the "Reference Centre for HIV Diagnosis" in Eastern India by National AIDS Control Organization, Govt. of India.

 

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Objectives

 

a.      To conduct biomedical and operational research in diarrhoeal diseases with the ultimate goal of developing appropriate strategies for their control.

 

b.     To disseminate research information through training as well as to develop teaching modules and methodologies for training of the health care personnel at different levels.

 

c.      To provide referral services and to extend support to the National Diarrhoeal Disease Control Programme.

 

d.     To provide research information and expertise for tackling National emergencies caused by epidemics of cholera and other diarrhoeal diseases.

 

e.      To conduct research in HIV/AIDS

 

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Thrust Areas of Research

 

a.      Community studies and epidemiological investigation.

 

b.     Molecular epidemiology.

 

c.      Biochemistry and Molecular Biology.

 

d.     Clinical research.

 

e.      Microbiology, Virology and Parasitology.

 

f.        Immunology

 

g.     Ultrastructure Analysis and Histopathology.

 

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Staff/ Departmental structure

 

Departmental Structure of the Institute

 

Office of the Director

Laboratories

Animal House

Training & Extension

Library

Administration

  Biochemistry

  Clinical Medicine

  Epidemiology

  Electron Microscope

  Immunology & Vaccine Development

  Molecular Genetics

  Microbiology

  Parasitology

  Pathophysiology

  Virology

  Vibriophage Reference Laboratory

  HIV NACO Reference Centre

 

Accounts

Store

Cash

Personnel

Pay/Bill

Vehicle

Despatch

Maintenance

 

 

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Staff structure of the Institute

 

DIRECTOR

Scientific staff

Technical staff

Administrative staff

Maintenance staff

Transport staff

Office of the Director

Deputy Director (Senior Grade)

Deputy Director

Assistant Director

Senior Research Officer

Research Officer

Senior Technical Officer

Technical Officer

Senior Technical Assistant

Technical Assistant

Technician

Senior Laboratory Assistant

Laboratory Assistant

Laboratory Attendant

Attender

Veterinary fficer

Programming Assistant

Librarian

Assistant Social Worker

Field Worker

Library Attendant

Administrative Officer

Accounts Officer

Section Officer

Superintendent

Assistant

Upper Division Clerk

Lower Division Clerk

Store Attendant

Daftry

Peon

Maintenance Engineer

Care-taker

Electrician

Plumber

Head Sweeper

Sweeper

Head Watchman

Chowkider

Senior Gardener

Senior Driver

Driver

Mechanic

Helper

Private Secretary

Personal Assistant

Stenographer

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Laboratory facilities

 

  The activities of the institute cover a wide range of microbiological, biochemical, immunological and virological aspects of enteric pathogens. Most modern and sophisticated technologies like ultracentrifugation, HPLC, FPLC systems are available for isolation, purification and characterization of proteins. All the microbiological techniques and facilities are available for isolation and maintenance of aerobic and non-aerobic pathogens. Tissue culture facilities are adequate to work on animal cell culture and virology. Liquid scintillation system is used for work using radio isotopes. A modern hybridoma facility is operative for making monoclonals in immunology research besides the routine facilities like ELISA reader, micro well plate washer, Fluorescence microscope. Equipments like Thermal cycler, Pulsed field gel electrophoresis, Automated DNA sequencer are functional for molecular biology research. Structural biology research is also one of the areas studied with Transmission Electron Microscope. A sophisticated documentation system together with scanner enables the scientist to create, edit the final data and to make slides.

 

 

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Clinical facilities

 

 

Division of Clinical Medicine has been set up for clinical research with units at Infectious Diseases Hospital and Dr. B.C. Roy Memorial Hospital for Children, Calcutta. Ten beds are always available for clinical trial. Four scientists and 3 medical fellows (Junior doctors) are working in this division. Facilities for clinical studies including drug trials or any other hospital based interventional studies on diarrhoeal diseases or typhoid fever are available. Paramedical and nursing staffs are also engaged to assist the doctors. Every year 3/4 clinical trials are conducted in these hospitals. A systematic surveillance system for diarrhoeal pathogens has been established in the hospital.

 

 

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Communication and computation facilities

 

 

  The institute has a set up of local area net work (LAN) where seventeen personal computers are connected to a pentium III server. A TCP/IP account of VSNL has been installed by which the internet and e-mail facilities can be accessed and from one e-mail address, several personal e-mail addresses have been created through a software. There is provision for medline search through LAN with the help of OVID medline software. The institute has a good set up of data management facilities which are being used for sophisticated and meaningful data analysis. Statistical softwares like SPSS, SPLUS are mainly used for statistical analysis and data base package (d-Base-IV) and Microsoft Excell is used for data entry purpose. Besides these, some programs have been developed for field management as well as for data entry purpose. Microsoft office is generally used for typing, graphics, preparation of presentation slides etc.

 

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Education and training programme

 

 

National Institute of Cholera and Enteric Diseases was designated as the WHO Collaborating Centre for Research and Training in diarrhoeal Diseases in 1980. As a WHO Collaborative Centre the Institute conducted the following seminars/workshops supported by WHO and also conducted other seminar/workshop supported by Govt. of India/UNICEF/other agencies.

 

"National Seminars on Oral Rehydration Therapy" for the doctors in different states and various organisation of the country in joint collaboration of WHO-ICMR-DGHS. From 1984 emphasis was put on the training of general practitioners under the aegis of the Indian Medical Association and the programme were being conducted in joint collaboration of WHO-ICMR-DGHS-IMACGP. Till 1989, the Institute conducted 82 such seminars covering different states in the country. These helped in creating awareness amongst the doctors regarding oral rehydration therapy and later also about Home Available Fluid in the treatment of diarrhoea.

 

In the year 1981

 

1.      WHO Inter-Regional Course for Managers of National CDD Programme

2.      WHO Inter-Country Course for Clinical Management of Acute Diarrhoeal Diseases

3.      WHO Inter-Country Course on Laboratory Aspects of Acute Diarrhoeal Diseases

 

In the year 1982

 

1.      WHO Inter-Country Course on Clinical Management of Acute Diarrhoeal Diseases

2.      WHO Inter-Country Course on Laboratory Aspects of Acute Diarrhoeal Diseases

3.      WHO Inter-Country Course on Epidemiological Research Methodology in Diarrhoeal Diseases

 

In the year 1983

 

1.      WHO Inter-Country Course on Clinical Management of Acute Diarrhoeal Diseases

2.      WHO Inter-Country Course on Epidemiological Research in Diarrhoeal Diseases

3.      WHO Inter-Country Course on Laboratory Aspects of Acute Diarrhoeal Diseases

 

"Second Asian Conference on Acute Diarrhoeal Diseases" was held at NICED during February 21-24, 1983 and was jointly organised by NICED and ICDDR(B), Dhaka and was patronised by WHO. About eighty participants from different S.E. Asian countries including India as well as Belgium and WHO, Geneva, participated and contributed valuable papers.

 

In the year 1984

 

As a major endeavour to help the National CDD programme, the Institute carried out the following training & extension activities in joint collaboration with WHO-ICMR-DGHS:

 

1.      WHO/CDD State Programme Managers' course

2.      WHO/CDD Supervisory skills course for District Health Diseases

3.      National Course on Laboratory Aspects of Diarrhoeal Diseases

4.      WHO Inter-country Course on Clinical Management of Acute Diarrhoeal Diseases

 

Booklet entitled "Management of Acute Diarrhoea" was prepared by the Institute with WHO fund for Primary Health Centre doctors. A set of slides on different aspects of diarrhoeal diseases were also prepared to be used during training for PHC level doctors.

 

In the year 1985

 

1.      Two WHO/CDD Supervisory Skills Courses for District Health Officer

2.      National Course on Laboratory Aspects of Diarrhoeal Diseases

3.      WHO Inter-Country Course on Clinical Management of Acute Diarrhoeal Diseases

 

Booklet entitled "Management and Control of Diarrhoeal Diseases" for paramedical staff was prepared by the Institute in English as well as in Bengali.

 

In the year 1986

 

1.      WHO Inter-Country CDD/TDR Workshop on Epidemiological Methods for Research in Diarrhoeal and Tropical Diseases

2.      WHO Inter-country Course on Laboratory Aspects of Diarrhoeal Diseases

3.      Two Inter-Country Course on Clinical Management of Acute Diarrhoeal Diseases

4.      Workshop on Acquired Immuno-deficiency Syndrome (AIDS) - organised jointly by NICED and British Council, Calcutta.

 

Two training modules (1) Management of Diarrhoeal diseases (2) Nutritional care during diarrhoea were prepared by the Institute to be used for training of faculty members of HFWTC.

 

In addition, a separate module was prepared on the Management of Diarrhoeal Diseases for Health Workers only.

 

In the year 1987

 

1.      Two WHO Inter-Country Course on Clinical Management of Acute Diarrhoeal Diseases

2.      WHO Inter-Country Course on Laboratory Diagnosis of Diarrhoeal diseases

3.      Five Workshops on Oral Rehydration Therapy (ORT) Programme of the Govt. of India - Participants in two workshops were staffs of HFWTC and in others two were senior teachers from HFWTC and in another State Level officers responsible for the ORT programme in different states.

 

Three Training Modules were prepared by the Institute in consultation with Ministry of Health & Family Welfare, Govt. of India and WHO. Three modules are on (i) Treatment of Diarrhoeal Diseases and Programme Management, (ii) Nutritional case during diarrhoea, (iii) Training of Health Workers on Treatment of Diarrhoeal Diseases and Programme Implementation.

 

All the above modules were prepared in English and sent to different states to be used during training. First two modules are ment for Medical Officers and other doctors and the third module is ment for health workers which is to be translated into regional language.

 

In addition a set of 40 slides along with a copy of introduction to the slides were prepared and sent to all the states for the above training purpose.

 

In the year 1988

 

1.      Two Workshop on Oral Rehydration Therapy (ORT) Programme of the Govt. of India - In 1st Workshop Participants were State Level Programme officers including senior teachers of HFWTC and in other personnel of State run Rural Health Training Centre.

The main objective of all the above ORT Workshops was to develop skill and knowledge among the State/UT level Programme officers and staff of HFWTC for effective implementation and monitoring of the national CDD programme.

2.      WHO Inter-Country Course on Laboratory Diagnosis of Diarrhoeal Diseases

3.      Training course on the management of diarrhoeal diseases for District Public Health Nurses from different N.E. States of India.

 

In the year 1989

 

1.      Indo-UK Workshop on Diarrhoeal Diseases

2.      Training course on the management of diarrhoeal diseases was organised for the Nurse-Teachers, Govt. of West Bengal

3.      Training course on laboratory methods for detection of HIV antibody in blood transfusion services of West Bengal. Technicians working in different blood banks of Govt. hospitals participated in the above training course.

 

In the year 1990

 

1.      Three Workshop on Oral Rehydration Therapy (ORT) Programme of the Govt. of India. Senior Teaching Staff from HFWTC were participants in one and district level programme officers were participants in other two workshops.

 

In the year 1991

 

1.      Three Workshop on Oral Rehydration Therapy (ORT) Programme of the Govt. of India. Senior teaching staff from HFWTC were participants in one and district level programme officers were participants in other two workshops.

2.      WHO Inter-Country Short Course on Clinical Management of Diarrhoea at Health Centres and small Hospitals.

3.      DBT Laboratory Workshop on Nucleic Acid Probes in Infectious Diseases Research.

 

In the year 1992

 

1.      WHO Inter-Country CDD Programme Mangers Course

2.      WHO Inter-Country Training of Trainers course on Clinical Management of Diarrhoeal Diseases.

 

In the year 1993

 

1.      WHO Inter-Regional CDD case Management Training Course for consultants - The WHO at this training course, for the first time, field tested the module of Advising Mothers developed by them. The main objective was to train doctors who will act as future WHO/CDD consultants.

2.      Workshop on HIV screening and counselling related to Blood Banking Services.

 

In the year 1995

 

1.      UNICEF (East India) sponsored workshop on Research Methodology and Epidemic Preparedness for Diarrhoeal Diseases

2.      Four UNICEF (East India) sponsored workshop on Management of Acute Diarrhoea for doctors and paramedical staff of Dr. B.C. Roy Memorial Hospital for Children, Calcutta.

 

In the year 1997

 

1.      WHO workshop "Identification of research issue in new, emerging and re-emerging infectious diseases"

2.      Workshop on Hybridoma.

 

In the year 1998

 

1.      Training programme in "Human Lactation Management and Counseling" supported by UNICEF and Breast-feeding Promotion Network of India.

2.      National Workshop on "Electron Microscopy and its Application in biological Sciences" supported by Electron Microscope Society of India (Zonal Chapter Calcutta)

 

In the year 1999

 

1.      WHO training course on "Antimicrobial Resistance Monitoring" in collaboration with NICED, Delhi

2.      Three UNICEF supported training course on "Clinical Management of Cholera and other Diarrhoeal Diseases" organised at Malda District, W.B.

 

TRAINING OF W.H.O. FELLOW

 

As a WHO collaborative centre for research & training in diarrhoeal diseases, NICED impart training to visiting WHO Fellows from different S.E. Asian countries on different aspects of diarrhoeal diseases. Till 1999, seventy one WHO Fellows had undergone training at NICED.

 

OTHER TRAINING PROGRAMMES

 

In addition to the training programme mentioned above post graduate student from AIIH&PH, 5th semester batch of M.B.B.S. students from National Institute of Homeopathy are visiting this Institute regularly to acquaint themselves with different aspects of diarrhoeal diseases and its management. M.Sc. (Physiology, Zoology and Botany) classes of the University with special paper in Microbiology visit the Institute every year to get training in Microbiological aspects of diarrhoeal diseases. Some of the M.Sc. students undertake their dissertation work at the Institute. Moreover, when requested the Institute also impart training on different aspects of diarrhoeal diseases to the internees, staff members of different Govt. and voluntary organisation of West Bengal. Staff of Health Department, postgraduate students, research scholar from other states of India are also deputed for their training on different aspects of diarrhoeal diseases.

 

 

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Achievements

 

 

  There has been a tremendous development in our knowledge of pathophysiology and treatment of cholera and the introduction of Oral Rehydration Therapy (ORT) has simplified the treatment to a large extent and most cases of cholera can now be treated at the domiciliary level even by uneducated mothers. However, ORT was not much practiced particularly for children. The study conducted at this institute showed that if repeated small amounts of oral rehydration solution (ORS) were administered orally at frequent intervals, nearly 91% of diarrhoeal children below 5 years with moderate degree of dehydration could be successfully rehydrated by ORS alone. Based on all these studies as well as the 3-tier implementation strategy developed by this Institute in a community based study where mothers were found to play a pivotal role in preventing dehydration with early institution "home available fluid" therapy, Govt. of India in a comprehensive manner launched the National Diarrhoeal Disease Control Programme.

 

  The global cholera scenario experienced an unprecedented event during 1992-93, when a new toxigenic non-O1 strain, designated as Vibrio cholerae O139 Bengal, appeared in the Indian subcontinent and later reported from many other countries of the region as well as from the developed countries like U.K. and U.S.A. The scientists of NICED are credited for bringing this to the notice of global scientific community for the first time. The Institute with all its expertise in various disciplines immediately embarked upon a number of research activities related to V.cholerae O139 in the area of microbiology, clinical medicine and epidemiology. These studies revealed that from the beginning of November 1992, there was an unusual increase in relative rate of isolation of V.cholerae non-O1 as compared to V.cholerae O1 from cases of cholera-like illness admitted to the Infectious Diseases Hospital, Calcutta. By December 1992, V.cholerae non-O1 became the predominant organism (>95%) isolated from cholera-like diarrhoea patients examined in the said hospital. The unusual trait of these isolates is their ability to produce large amounts of cholera toxin (CT). Simultaneously, similar strains were identified by us from different parts of the country. This was the first report of a major epidemic of cholera caused by CT producing V.cholerae non-O1. Clinical studies clearly showed that the disease produced by V.cholerae non-O1 (O139) was clinically indistinguishable from the disease caused by V.cholerae O1 and that the management is essentially the same as that applicable to O1 cholera. It was earlier demonstrated by well controlled clinical trial that norfloxacin, a fluoroquinolone, is an effective alternative to tetracycline for the treatment of O1 cholera and after the appearance of O139 cholera, they also demonstrated that multiple dose of the same drug is perhaps superior to Doxycycline. In 1975, Scientists from this Institute showed that single dose of Doxycycline (300 mg) is as effective as multiple dose of tetracycline for the treatment of cholera. WHO also advocates Doxycycline for adult cholera. A highly specific monoclonal antiserum for detection of O139 strains was developed at this Institute which has been supplied to WHO (SEARO), New Delhi for distribution to various national and international laboratories.

 

  Studies carried out at this Institute showed that cholera carriers actually act as reservoir for ElTor cholera vibrios in the community during inter-epidemic period even when cholera cases are absent. It was further observed that carriers are responsible for the transmission of V.cholerae infection to other family members by contaminating unprotected stored water and cooked food with their infected fingers. Transmission studies with V.cholerae O139 also showed that at the community level there exists a large (14.6%) number of asymptomatic infected persons which indicate an epidemiological similarity to that of ElTor cholera. In order to find out interventions for blocking the transmission of infection at the community level, studies conducted at this Institute showed a lower incidence of cholera carrier amongst contacts in cholera affected houses provided with narrow-necked pitchers (Sorai) and this led to the concept of preventing contamination of stored water by storing water in a narrow necked storage container which has been widely accepted. It was also demonstrated from this institute the effectiveness of simple measures like hand washing with soap and water, coupled with health education, in reducing the incidence of diarrhoeal diseases particularly dysentery cases in Calcutta slums. The WHO has recommended these strategies for prevention of diarrhoea.

 

  A live oral candidate vaccine strain has been recently developed and is currently undergoing clinical trials.

 

 

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Services provided to outsiders

 

  Institute provide clinical facilities to community and hospital by providing medical help including drugs and medicines. Laboratory training is provided in the field of microbiology, molecular biology as well as diagnostics of HIV/AIDS. Institute has in-built facility of breeding and maintaining Balb/c mouse and we provide these animals to several laboratories. Our library is frequently used by students, research workers, health workers from other places. In brief our institute is always providing services like clinical, technical, information etc. to the general community, scientific workers as well as to the state government as and when required.

 

 

 

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External funding

 

 

 

No.

Title of the Project

Name of Principal Investigator

1.

Human volunteer study on oral recombinant cholera vaccine VAI.3 - A multigenic study (DBT oral cholera vaccine)

Dr. S.K. Bhattacharya

 

2.

Human volunteer study on oral recombinant cholera vaccine VAI.3 - A multigenic study (DBT oral cholera vaccine)

Dr. G.B. Nair

 

3.

Molecular analysis of virulence genes of toxigenic Vibrio cholerae isolated over a period of three decades (CSIR Cholera Project)

Dr. G.B. Nair

 

4.

Microbial degradation of Petroleum Hydrocarbon as oil pollutant in the coastal water of deltaic Sunderbans. (BECP)

Dr. R. Kumar

 

5.

Molecular typing of Human immunodeficiency virus Type-I strains circulating in India (DBT-HIV)

Dr. S. Chakraborty

6.

Comparative genome analysis of rotavirus strains prevalent in India (DBT-CG)

Dr. T.N. Naik

7.

Study of the carbohydrate-binding property of Vibrio cholerae haemolysin implication of lectin like property in transportation of the cytolysin through bacterial outermembrane (S.C.B.P. - CSIR)

Dr. K. Banerjee

 

8.

Cloning and characterization of recombinant protein encoding for a surface glycoprotein of E.histolytica in immunodiagnosis and immunoprophylaxis against amoebiasis (CSIR CCIA)

Dr. P. Das

 

9.

Identification and characterization of multiple genes in Entamoeba histolytica during human collagen type 1 and Ca2+ interaction. (IC Eh ICMR)

Dr. P. Das

 

10.

Retrospective analysis to determine the compliance of standard treatment guideline in acute and persistent diarrhoea in malnourished children (UNICEF Project)

Dr. P. Dutta

11.

A prospective study on gender bias in health care practices with special reference to childhood diarrhoea, acute respiratory infection and protein energy malnutrition (UNICEF Project).

Dr. A. Pandey

 

12.

Operation research on H2S strip test vials (WPCS Project)

Dr. Santa Dutta

13.

Indian senior scientist fellowship under the programme of basic sciences (INSA Project)

Dr. Maharani Chakravorty

 

14.

Phase II and III human trials with candidate oral cholera vaccine VAI-3 a multicentric study (DBT-Phase II & III oral cholera vaccine)

Dr. S.K. Bhattacharya

 

15

Phase II and III human trials with candidate oral cholera vaccine VAI-3 a multicentric study (DBT-Phase II & III oral cholera vaccine)

Dr. G.B. Nair

 

16.

Stability of cholera vaccine VA 1.3 (Physiological and Genetic) upon scale up-A multicentric study (DBT).

Dr. G.B. Nair

 


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Reports on Seminar/Symposium/Workshop conducted in the Institute

 

  Institute, as one of the prime institute on diarrhoeal diseases, conduct seminars, symposium and workshop frequently. These meetings are often sponsored by UNICEF, WHO and ICMR. Distinguished scientists from India and abroad act as resource person in these workshops and participants are selected from different regions of India and South East Asian countries. Some of the important training workshop held in the institute are "Identification of research issues in new, emerging and re-emerging infectious diseases", "workshop on Hybridoma", "Seminars on diarrhoeal diseases as a part of celebration of 85th Anniversary of ICMR", "Research methodology and epidemic preparedness for diarrhoeal diseases", etc.

 

 

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Announcements of new discovery

 

 

                  The genesis of the new serogroup V.cholerae O139 formed the impetus to search for O139 phages in and around the country. Five newly isolated phages lytic to V.cholerae O139 strain differed from each other and also differed from O1 phages in lytic pattern, morphologies, restriction endonuclease digestion profile and immunological criteria. A total of 500 strains of V.cholerae O139 could be clustered into ten different phage types. The most important is that O1 phages do not react with O139 strains and O139 phages do not react with O1 strains. Except the serology, the phage specially O139 phages are the marker to differentiate between O1 and O139. The scheme comprising of five newly isolated phages would be another useful tool in the study of the epidemiology of cholera caused by V.cholerae O139.

 

               National Institute of Cholera and Enteric Diseases proudly announces the two recent discoveries originated from the studies conducted by the scientists in recent years. The appearance of a new toxigenic non O1 Vibrio cholerae designated as Vibrio cholerae O139 Bengal was for the first time reported from this Institute. A new oral recombinant cholera vaccine was developed in a collaborative effort with the scientists from two other Institutes, institute of Microbial Technology, Chandigarh and Indian Institute of Chemical Biology, Calcutta. This new recombinant vaccine strain, designated as VA 1.3 was directed from a parental strain VA1 which was found to be non-toxigenic with the deletion of all known toxin genes. A cryptic hemolysin gene (hly) locus was introduced in the chromosome of this strain and through a series of genetic manipulation, ctxB gene was integrated. This strain gave full protection against the challenge dose of V.cholerae in animal model. This vaccine strain is now under human volunteer trial.

 

 

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