Cholera Vaccination: When Do Travellers Need It?
Cholera remains a risk in areas with poor sanitation. Learn whether you need the cholera vaccine for your travels.
Cholera Vaccination: When Do Travellers Need It?
Cholera is an acute diarrhoeal infection that can kill within hours if left untreated. While relatively rare among typical tourists, certain travellers face significant risk and should consider vaccination.
What is Cholera?
Cholera is caused by the bacterium Vibrio cholerae, found in contaminated water and food. It causes severe, watery diarrhoea that can lead to rapid dehydration and death if untreated.
How Cholera Spreads
- Drinking contaminated water
- Eating contaminated food (especially raw/undercooked seafood)
- Poor sanitation environments
- Areas affected by flooding, conflict, or displacement
Symptoms
Cholera can range from asymptomatic to life-threatening:
Mild cases: Mild diarrhoea (most cases)
Severe cases:
- Profuse watery diarrhoea ("rice water" appearance)
- Vomiting
- Rapid dehydration
- Muscle cramps
- Shock (in severe cases)
Severe cholera can cause death within hours without treatment, but is highly treatable with oral rehydration.
Where is Cholera a Risk?
Cholera outbreaks occur in areas with:
- Inadequate water treatment
- Poor sanitation
- Overcrowding
Higher-risk regions:
- Parts of Africa
- South and Southeast Asia
- Haiti and parts of Latin America
- Areas affected by humanitarian crises
Current outbreaks: Check Travel Health Pro for real-time outbreak information.
Who Should Consider Cholera Vaccination?
Cholera vaccination is not routinely recommended for most travellers because:
- Risk is low for tourists staying in standard accommodation
- The vaccine provides only partial protection
- Safe food and water practices are more important
Vaccination IS Recommended For:
- Aid and relief workers going to disaster/conflict zones
- Healthcare workers in cholera-endemic areas
- Travellers to active outbreaks with limited access to medical care
- Those with increased susceptibility (e.g., reduced stomach acid, previous cholera)
Consider Vaccination If:
- Visiting friends/relatives in endemic areas with poor sanitation
- Backpacking in high-risk areas with limited access to safe food/water
- Extended stays in endemic regions
- Travelling during known outbreaks
The Cholera Vaccine (Dukoral)
About the Vaccine
- Type: Oral vaccine (drinkable)
- Doses: 2 doses, 1-6 weeks apart
- Protection begins: About 1 week after second dose
- Duration: Up to 2 years
- Effectiveness: Approximately 85% for first 6 months, decreasing over time
How to Take It
Dukoral is mixed with water and drunk. It must be taken on an empty stomach (no food or drink for 1 hour before and after). The taste is somewhat salty—not unpleasant.
Side Effects
Generally well-tolerated. Possible side effects include:
- Stomach discomfort
- Nausea
- Diarrhoea
- Headache
Bonus Protection
Dukoral also provides some short-term protection against traveller's diarrhoea caused by enterotoxigenic E. coli (ETEC)—a common cause of "Delhi belly" and similar illness.
Prevention is Better Than Cure
Even with vaccination, safe practices are essential:
Food and Water Precautions
- Drink only bottled, boiled, or treated water
- Avoid ice unless made from safe water
- Eat only thoroughly cooked, hot food
- Avoid raw salads and unpeeled fruits
- Skip street food in high-risk areas
- Wash hands frequently
If You Develop Symptoms
Cholera is treatable. If you develop severe diarrhoea:
- Start oral rehydration immediately
- Seek medical attention urgently
- Continue fluids even if vomiting
Do You Need the Cholera Vaccine?
Most tourists don't. But if your itinerary puts you at higher risk, vaccination adds an extra layer of protection.
Our travel health specialists can assess your specific trip and advise whether cholera vaccination is recommended for you.
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Informed travel is safe travel.