Cholera is an acute diarrhoeal disease caused by the bacterium Vibrio cholera. Toxigenic V. cholerae found in fresh and slightly salty water, often associated with shellfish and aquatic plants.
It is usually associated with poverty, poor sanitation and poor access to clean drinking water. It can also be a major problem affecting those in refugee camps and as a result of natural disasters which disrupt water and sanitation systems.
Globally there are an estimated 1.3 – 4 million cases and an average of 95,000 deaths per year caused by cholera. Rehydration is the main management for treatment.
An effective vaccine is available for travellers whose activities or medical history puts them at increased risk of disease.1
The following is a summary about the disease. For further details speak to your local pharmacist or GP.
Cholera is mainly transmitted through faecal contamination of food or water. Infection mostly occurs from:
Humans are the only known natural host and direct transmission from person to person is uncommon. Large numbers of bacteria are needed to establish infection in those with normal gastric acidity.1
Cholera most commonly occurs in areas without clean water supply or modern sewage system such as parts of Africa and Asia. Countries which account for 80% of all cases reported include:
Countries or areas which have reported outbreaks of cholera between 2010 and 2014 can be found here.2
Risk areas can change therefore it is important to refer to country specific information found here.3
For asymptomatic people (those without symptoms) the infection is mild. They shed the bacteria from between 2 days and 2 weeks.
In other cases, symptoms occur between 2-5 days and include:
However, in many cases it causes severe diarrhoea, sometimes with being sick (vomiting).4
In some cases severe diarrhoea can occur. The volume of fluid lost can be up to 20 litres a day. If not replaced this can quickly lead to serious dehydration and can even be fatal.4
Treatment for cholera include:
Antidiarrhoeal drugs are not recommended.1
For the majority of travellers, the risk of acquiring cholera can be reduced by following advice on food and water hygiene and by ensuring good personal hygiene.1
Do:
For the majority of travellers, the risk of acquiring cholera can be reduced by following advice on food and water hygiene and by ensuring good personal hygiene.1
DO:
DO NOT:
The vaccine is not indicated for most travellers, but can be recommended for those whose activities or medical history puts them at increased risk. This includes:
The cholera vaccine is available as an inactivated oral vaccination and is thiomersal-free. The course of vaccinations should be finished at least 1 week before travel.6
For adults, 2 doses (given 1 to 6 weeks apart) can provide protection for up to 2 years. A reinforcing dose is given after 2 years.
Young children require 3 doses of vaccine to establish effective immunity.6
The vaccine does not provide complete protection. For example, it does not protect against all strains of cholera. Therefore, it is still important to take precautions with food, water and personal hygiene.4
This information is taken from trusted third party websites, NaTHNaC (Travel Health Pro) and EMIS (Patient info) and use of all information has been licenced under the Open Government Licence http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.
Although the materials are being used/replicated under the provisions of the Open Government Licence this in no way represents endorsement of Traveljab.co.uk by NaTHNaC, Emis, Public Health England, the NHS or the Department of Health and Social Care.