Sex: F
Vaccine: CHOL, HEPA, IPV, MNQ, TD, TYP
Symptoms: Culture stool negative, Diarrhoea, Nausea
Clinical narrative: Nausea; PERSISTENT DIARRHEA; This spontaneous case (PVX2019-1147) was received from a nurse on 07-May-2019. It describes a 58-year-old female consumer who had persistent diarrhea, after the administration of Vivotif, Vaxchora (company suspects), Hepatitis A, Menactra, Polio vaccine, and Diphtheria, tetanus, and pertussis (Tdap) vaccine (non-company suspects) for a humanitarian trip.  Case report: The consumer took the first dose of Vivotif on 18-Mar-2019. On the same day, she also received other vaccines included Vaxchora, Hepatitis A, Menactra, Polio vaccine, and Diphtheria, tetanus, and pertussis (Tdap) vaccine. On 26-Mar-2019, two days after completion of Vivotif doses, she had diarrhea. Then, she went on her trip and was still having diarrhea. The reporter stated that the consumer potentially got something else while she was on her trip, which was a risk for GI illness.  She had been taking Imodium (loperamide; frequently during the day) for diarrhea.  The consumer was allergic to sulfa drugs. She did not have any medical history of heart, lungs, seizures, immune system disorders, diabetes, kidney disorders, anticancer drugs or treatments, steroids, aspirin therapy, Guillain-Barre syndrome, and any recent reaction to vaccines or blood transfusion.  The consumer's laboratory test included stool culture, which was conducted on 07-May-2019 and the result showed that there was no salmonella or anything like that. The test also confirmed that she did not have cholera.  Action taken with Vivotif, Vaxchora, Hepatitis A, Menactra, Polio vaccine, and Diphtheria, tetanus, and pertussis (Tdap) vaccine was not applicable.  The consumer had not recovered from the event.  The reporter considered the event of persistent diarrhea unrelated to the vaccines.  Company's Comment: In this case, the consumer had persistent diarrhea following the intake of oral Vivotif, Vaxchora (company suspects), Hepatitis A, Menactra, Polio vaccine, and Diphtheria, tetanus, and pertussis (Tdap) vaccine. Based on temporal relation between intake of both vaccine and event, the causality of the event with Vivotif and vaxchora is assessed as possible. Additionally, co-administration of multiple vaccines also provides an alternative explanation for the reported events.  Follow-up information have been extracted from VAERS on 30-Jul-2019.  The consumer experienced additional event of "nausea", while being on oral Vivotif (lot number: 3003241), oral Vaxchora (lot number: 7000011), intramuscular Hepatitis A (lot number: F4EL2), intramuscular Menactra (lot number: U6179AA), intramuscular Polio vaccine (lot number: N1K921M) and intramuscular Adacel (Tdap) (lot number: U6202BA) vaccine.  The consumer had diarrheal episode occurred 1-2 per day, average.  Action taken with Vivotif with respect to the "nausea" was dosage maintained  Action taken with Vaxchora, Hepatitis A, Menactra, Polio, and Adacel with respect to the event "nausea" was unknown.  The consumer had recovered from the event "nausea".  Company's Comment: In this case, the consumer had persistent diarrhea and nausea following the intake of oral Vivotif, Vaxchora (company suspects), Hepatitis A, Menactra, Polio vaccine, and Diphtheria, tetanus, and pertussis (Tdap) vaccine. Based on temporal relation between intake of both vaccine and events, the causality of the events with Vivotif and Vaxchora is assessed as possible. Additionally, co-administration of multiple vaccines also provides an alternative explanation for the reported events.; Sender's Comments: Company's Comment: In this case, the consumer had persistent diarrhea and nausea following the intake of oral Vivotif, Vaxchora (company suspects), Hepatitis A, Menactra, Polio vaccine, and Diphtheria, tetanus, and pertussis (Tdap) vaccine . Based on temporal relation between intake of both vaccine and events, the causality of the events with Vivotif and vaxchora is assessed as possible. Additionally, co-administration of multiple vaccines also provides an alternative explanation for the reported events.