{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:20:23Z","timestamp":1790198423344,"version":"4.1.0"},"reference-count":34,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01 AI137164"],"award-info":[{"award-number":["R01 AI137164"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01 AI106878"],"award-info":[{"award-number":["R01 AI106878"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI099243"],"award-info":[{"award-number":["R01AI099243"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["U01 AI058935, U01 HD39165"],"award-info":[{"award-number":["U01 AI058935, U01 HD39165"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01 AI135115"],"award-info":[{"award-number":["R01 AI135115"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["TW005572"],"award-info":[{"award-number":["TW005572"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["TW010362"],"award-info":[{"award-number":["TW010362"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["mBio"],"published-print":{"date-parts":[[2025,11,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Mass oral cholera vaccination campaigns targeted at subnational areas with high incidence are central to global cholera elimination efforts. Serological surveillance offers a complementary approach to address gaps in clinical surveillance in these regions. However, similar immune responses from vaccination and infection can lead to overestimates of the incidence of infection. To address this, we analyzed antibody dynamics in infected and vaccinated individuals to refine seroincidence estimation strategies for partially vaccinated populations. We tested 757 longitudinal serum samples from confirmed\n                      <jats:italic toggle=\"yes\">Vibrio cholerae<\/jats:italic>\n                      O1 cases and uninfected contacts in Bangladesh as well as vaccinees from Bangladesh and Haiti, using a multiplex bead assay to measure IgG, IgM, and IgA binding to five cholera-specific antigens. Infection elicited stronger and broader antibody responses than vaccination, with rises in cholera toxin B-subunit (CTB) and toxin-coregulated pilus A (TcpA) antibodies uniquely associated with infection. Previously proposed random forest models frequently misclassified vaccinated individuals as recently infected (over 20% at some time points) during the first 4 months post-vaccination. To address this, we developed new random forest models incorporating vaccinee data, which kept false-positive rates among vaccinated (1%) and unvaccinated (6%) individuals low without a significant loss in sensitivity. Simulated serosurveys demonstrated that unbiased seroincidence estimates could be achieved within 21 days of vaccination campaigns by ascertaining the vaccination status of participants or applying updated models. These approaches to overcome biases in serological surveillance enable reliable seroincidence estimation even in areas with recent vaccination campaigns enhancing the utility of serological surveillance as an epidemiologic tool in moderate-to-high cholera incidence settings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>Serological surveillance can improve how we monitor cholera in high-burden areas where clinical surveillance is limited. However, vaccination can produce immune responses similar to infection, leading to overestimates in seroincidence. This study extends seroincidence estimation techniques using machine learning models to partially vaccinated populations. We analyzed antibody dynamics from vaccinated and infected individuals to develop methods that reduce the misclassification of vaccinated individuals as recently infected. These methods enable reliable seroincidence estimates in areas with recent vaccination campaigns, providing a step toward better epidemiologic monitoring in the context of global cholera control initiatives. Studies in other populations are needed to further validate our results and understand their generalizability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/mbio.01898-25","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T13:00:13Z","timestamp":1759842013000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":2,"title":["Expanding cholera serosurveillance to vaccinated populations"],"prefix":"10.1128","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0914-6722","authenticated-orcid":false,"given":"Forrest K.","family":"Jones","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3755-4763","authenticated-orcid":true,"given":"Taufiqur R.","family":"Bhuiyan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04vsvr128","id-type":"ROR","asserted-by":"publisher"}],"name":"Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)","place":["Dhaka, Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1115-0894","authenticated-orcid":true,"given":"Damien M.","family":"Slater","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/002pd6e78","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Massachusetts General Hospital","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Ternier","sequence":"additional","affiliation":[{"name":"Zanmi Lasante","place":["Port au Prince, Haiti"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kian Robert","family":"Hutt Vater","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/002pd6e78","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Massachusetts General Hospital","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraful I.","family":"Khan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04vsvr128","id-type":"ROR","asserted-by":"publisher"}],"name":"Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)","place":["Dhaka, Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahima","family":"Chowdhury","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04vsvr128","id-type":"ROR","asserted-by":"publisher"}],"name":"Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)","place":["Dhaka, Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kennia","family":"Visieres","sequence":"additional","affiliation":[{"name":"Zanmi Lasante","place":["Port au Prince, Haiti"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajib","family":"Biswas","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04vsvr128","id-type":"ROR","asserted-by":"publisher"}],"name":"Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)","place":["Dhaka, Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Kamruzzaman","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04vsvr128","id-type":"ROR","asserted-by":"publisher"}],"name":"Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)","place":["Dhaka, Bangladesh"]},{"id":[{"id":"https:\/\/ror.org\/00gvj4587","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Biochemistry and Molecular Biology, Mawlana Bhashani Science and Technology University, Santosh","place":["Tangail, Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0169-394X","authenticated-orcid":true,"given":"Edward T.","family":"Ryan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/002pd6e78","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Massachusetts General Hospital","place":["Boston, USA"]},{"name":"Department of Medicine, Harvard Medical School","place":["Boston, USA"]},{"name":"Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen B.","family":"Calderwood","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/002pd6e78","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Massachusetts General Hospital","place":["Boston, USA"]},{"name":"Department of Medicine, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina C.","family":"LaRocque","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/002pd6e78","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Massachusetts General Hospital","place":["Boston, USA"]},{"name":"Department of Medicine, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8881-1849","authenticated-orcid":true,"given":"Richelle C.","family":"Charles","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/002pd6e78","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Massachusetts General Hospital","place":["Boston, USA"]},{"name":"Department of Medicine, Harvard Medical School","place":["Boston, USA"]},{"name":"Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8401-0801","authenticated-orcid":true,"given":"Daniel T.","family":"Leung","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Utah School of Medicine","place":["Salt Lake City, USA"]},{"name":"Division of Microbiology and Immunology, University of Utah School of Medicine","place":["Salt Lake City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Lessler","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of North Carolina Gillings School of Global Public Health","place":["Chapel Hill, USA"]},{"id":[{"id":"https:\/\/ror.org\/0130frc33","id-type":"ROR","asserted-by":"publisher"}],"name":"Carolina Population Center, The University of North Carolina at Chapel Hill","place":["Chapel Hill, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise C.","family":"Ivers","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/002pd6e78","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Massachusetts General Hospital","place":["Boston, USA"]},{"id":[{"id":"https:\/\/ror.org\/002pd6e78","id-type":"ROR","asserted-by":"publisher"}],"name":"Center for Global Health, Massachusetts General Hospital","place":["Boston, USA"]},{"name":"Department of Global Health and Social Medicine, Harvard Medical School","place":["Boston, USA"]},{"id":[{"id":"https:\/\/ror.org\/055avk103","id-type":"ROR","asserted-by":"publisher"}],"name":"Harvard Global Health Institute","place":["Cambridge, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8928-9888","authenticated-orcid":true,"given":"Firdausi","family":"Qadri","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04vsvr128","id-type":"ROR","asserted-by":"publisher"}],"name":"Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)","place":["Dhaka, Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason B.","family":"Harris","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/002pd6e78","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Massachusetts General Hospital","place":["Boston, USA"]},{"name":"Department of Pediatrics, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8662-9077","authenticated-orcid":true,"given":"Andrew S.","family":"Azman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health","place":["Baltimore, USA"]},{"name":"Centre for Emerging Viral Diseases, Geneva University Hospitals","place":["Geneva, Switzerland"]},{"name":"Division of Tropical and Humanitarian Medicine, Geneva University Hospitals","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_5_2_2","unstructured":"Global Taskforce on Cholera Control. 2017. Ending cholera: a global roadmap to 2030. https:\/\/www.gtfcc.org\/about-gtfcc\/roadmap-2030."},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003003"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30359-6"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2206.151592"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiab418"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-02810-4"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aau6242"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00378-14"},{"key":"e_1_3_5_10_2","unstructured":"World Health Organization. Shortage of cholera vaccines leads to temporary suspension of two-dose strategy as cases rise worldwide. Available from: https:\/\/www.who.int\/news\/item\/19-10-2022-shortage-of-cholera-vaccines-leads-to-temporary-suspension-of-two-dose-strategy--as-cases-rise-worldwide. Retrieved 9 Nov 2024."},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2019.08.086"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.05615-11"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/mbio.01900-22"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1101\/2021.10.25.21265347"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00470-16"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0218033"},{"key":"e_1_3_5_17_2","unstructured":"World Health Organization. WHO prequalifies new oral simplified vaccine for cholera. Available from: https:\/\/www.who.int\/news\/item\/18-04-2024-who-prequalifies-new-oral-simplified-vaccine-for-cholera. Retrieved 27 May 2024."},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1006\/jmbi.1993.1209"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix1039"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.22-0462"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00037-12"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00647-15"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2021.12.015"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0007057"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30310-7"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed6040192"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.02021-16"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jix253"},{"key":"e_1_3_5_29_2","unstructured":"Luminex. Available from: https:\/\/info.diasorin.com\/en-us\/research\/download-the-xmap-cookbook. Retrieved 15 Jun 2025."},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-57876-0"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1201\/b21966"},{"key":"e_1_3_5_32_2","unstructured":"RStan. Stan. Available from: https:\/\/mc-stan.org\/users\/interfaces\/rstan. Retrieved 27 May 2024."},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v031.i03"},{"key":"e_1_3_5_34_2","unstructured":"Ashkiani S. Dimensionality reduction and data visualization using MDS- SMACOF package in R. Available from: https:\/\/rstudio-pubs-static.s3.amazonaws.com\/246348_b31bca1e4be04bb395825dc6a00de364.html. Retrieved 23 Feb 2022."},{"key":"e_1_3_5_35_2","unstructured":"Wright MN Wager S Probst P. 2020. Ranger: a fast implementation of random forests. R package version 0 12 1"}],"container-title":["mBio"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/mbio.01898-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/mbio.01898-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T14:06:02Z","timestamp":1762956362000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/mbio.01898-25"}},"subtitle":[],"editor":[{"given":"Marleen M.","family":"Kock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,11,12]]},"references-count":34,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11,12]]}},"alternative-id":["10.1128\/mbio.01898-25"],"URL":"https:\/\/doi.org\/10.1128\/mbio.01898-25","relation":{},"ISSN":["2150-7511"],"issn-type":[{"value":"2150-7511","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,12]]},"assertion":[{"value":"2025-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01898-25"}}