Learn more about Cholera Vaccination and how our travel clinics at Peak Pharmacy can help you travel safely.
About The Vaccine
Vaccine: Cholera (known as Dukoral)
Dose: Primary immunisation is 2 doses separated by at least one week
Route: Oral suspension to be drank
Booster: 1 dose every 2 years. If a booster dose isn’t taken at 2 years the primary course should be repeated
Transmission: Spread through contaminated water in areas where sanitation is poor
What is Cholera?
Cholera is a disease caused by a bacteria known as Vibrio Cholerae that affects your digestive system causing severe watery diarrhoea.
Cholera can be found in many countries around the world but is particularly prevalent in Asia and Africa.
It is estimated that every year there are around 1.3-4 million cases of Cholera, with up to 143000 unnecessary deaths. The diarrhoea caused by cholera can be so severe that death may occur within hours of symptoms starting due to dehydration. The good news is that Cholera doesn’t need to be deadly, and with prompt medical attention, the disease can be easily managed.
How do you get Cholera?
Cholera is spread through contaminated water and is closely linked to inadequate access to sanitary conditions like clean running water. Typically cholera is one of the first diseases to take hold in areas where normal standards of living have been degraded. Examples include areas involved in conflict, natural disasters, refugee camps and peri-urban areas like slums.
What are the symptoms of Cholera?
The infection has a rapid onset, with symptoms appearing as soon as 12 hours after the initial infection, although incubation may take up to 5 days in some cases.
Initial symptoms are large amounts of watery diarrhoea, vomiting, thirty, leg cramps and restlessness. Many individuals will experience only mild illness but around one in ten will develop a severe illness which can be life-threatening.
Thankfully Cholera can be safely managed through the replacement of lost electrolytes using oral rehydration (ORS) sachets, for example, Dioralyte.
The biggest concern with cholera is how rapidly it spreads. Even those who are asymptomatic can spread the virus in their stools for up to 10 days after the initial infection. This means in areas that are densely populated Cholera spreads very quickly and not everyone will be lucky and experience only mild symptoms.
Why am I at risk of getting Cholera?
Cholera is a risk for individuals travelling to countries that are known to have outbreaks of Cholera, these countries are known as cholera-endemic countries. Your risk of contracting cholera is increased further if visiting areas with a known outbreak or working in areas where standards of sanitation may be poor.
How can I prevent a Cholera infection?
Cholera infections are best prevented through vaccination prior to potential exposure, but some other tips that can help prevent infection by viruses and bacteria spread through the faecal-oral route include:
- Safe drinking water (even for brushing your teeth). Trusted sources of bottled water, Boiled and cooled water, Chlorine treated water or filtered and treated water through products like SafeHydrate from Pyramid Travel.
- Hygiene. Ensure you wash your hands regularly, especially before you eat food and definitely after every trip to the bathroom.
- Beware about the food and drink you consume. Make sure your food is piping hot before eating it, avoid ice in your drinks, avoid salads and only eat fruit that needs to be peeled. Some food like shellfish can be particularly high risk.
For more information, Travel Health Pro have some great fact sheets on food and water safety whilst travelling abroad.
As mentioned earlier Cholera can be prevented through vaccination. Unlike most vaccines, the Cholera vaccine called Dukoral is not an injection it is in fact a drink.
Two doses of the vaccine are drunk at least one week apart with protection lasting 2 years from the date of the last dose.
What side effects could I expect from a Cholera vaccine?
The oral Cholera vaccine is safe and effective; adverse events are infrequent. The cholera vaccine is an inactivated vaccine, this means it cannot cause the disease that we are attempting to protect you against. Typical adverse events are usually limited to:
- Nausea and Vomiting
- Stomach discomfort
- Loose stools and or Diarrhoea
These symptoms will usually resolve within a few days and are the most commonly reported adverse events.
Can I get a Cholera vaccine free from my doctor?
Yes, if really necessary. Cholera vaccines can be provided for free on the NHS but usually only to individuals travelling to very high-risk areas with ongoing outbreaks. It is provided for free as you could become a public health risk to a largely unvaccinated UK population should you bring this lovely illness back off your holiday.
Unfortunately, only your GP surgery can provide the vaccine free of charge, not all surgeries provide travel services and you often need to give your surgery 8 weeks’ notice to get an appointment.