Cholera

• Introduction
• Recommendations
• Vaccination
• Overview of the Disease
• The Illness
• Treatment

Introduction

Cholera is an infection spread mainly through food and water that can cause acute watery diarrhoea.

Recommendations for Travellers

Prevention is focused on food and water precautions and practising good hand and personal hygiene, particularly in countries where cholera is more common or where outbreaks occur (see individual country pages).

Detailed risk management advice can be found on the following pages:

• Food and Water Precautions
• Water Purification

Vaccination

A vaccine is available to protect against cholera but as the risk to most travellers is very low, it is only recommended in the following circumstances:

• Volunteers/aid workers/medical personnel in disaster relief situations where cholera outbreaks are likely.
• Those travelling to work in slums/refugee camps, areas affected by natural disasters, or countries experiencing cholera outbreaks and where care with food and water is difficult or not possible.

View the:

• Patient Information Leaflet (PIL) for Dukoral
• Patient Guidance Information Vaxchora

Overview of the Disease

Cholera is caused by the bacterium Vibrio cholerae and is usually transmitted via infected water that has been contaminated by faeces and less commonly via food, particularly shellfish.

The disease is found throughout the world particularly in countries where sanitation is poor, particularly parts of Africa, India and South East Asia. The risk of disease for most travellers is low.

The Illness

The incubation period can be 12 hours up to 5 days after exposure.

• 75% of people affected with cholera will have no or mild symptoms and the illness is self limiting.
• In healthy travellers, the illness is most likely to be mild.
• More severe illness is more likely in those who live in poverty and are unable to access safe water and food.
• More severe illness is more likely in those with underlying health problems such as immunosuppression, liver disease or malnutrition.
• In more severe disease, rapid onset of watery diarrhoea and vomiting can lead to extreme dehydration. For severe illness medical attention should be sought urgently as individuals can die quickly if they are not treated promptly with intravenous fluid replacement.

Treatment

Fluid replacement is the mainstay of treatment. Antibiotic therapy may be used in severe illness.

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