This is assuming the individual is travelling to an area where there is a risk of exposure to infection as a consequence of being in that area [11]. Oral cholera vaccine may also provide some protection against diarrhoea caused by the heat-labile toxin of Escherichia coli E. Dukoral has been given to children between 1 and 2 years of age in immunogenicity and safety studies. However, protective efficacy has not been studied in this age group.
Therefore Dukoral is not recommended for children under 2 years of age [13]. Dukoral is for oral administration: food and drink should be avoided for 1 hour before and 1 hour after vaccination. Oral administration of other medicinal products should also be avoided within 1 hour before and 1 hour after administration of Dukoral [13]. Immunisation should be completed at least 1 week prior to potential exposure to V. The true efficacy of the vaccine in preventing cholera in travellers is not known as risk in this population is too low to be able to carry out efficacy trials.
However, oral cholera vaccine has demonstrated a protective efficacy of between 61 — 86 percent against V cholerae 01 for 4 — 6 months in those living in endemic countries. In children under 6 years of age, protection wanes rapidly after 6 months [3]. The vaccine does not provide protection against V cholerae There are few individuals who would be unable to receive the oral cholera vaccine when indicated.
The most commonly reported adverse events have been mild gastro-intestinal symptoms abdominal pain, cramping, diarrhoea, nausea. Serious adverse events, including a flu-like syndrome, rash and arthralgia are rare [13].
Content Sections. Key Messages Cholera is an acute bacterial disease characterised by profuse watery diarrhoea. Transmission is mainly by ingestion of contaminated food and water; cholera is considered a disease of poverty and is usually associated with poor sanitation and poor access to clean drinking water. Globally there are an estimated 1. Rehydration is the main management for treatment; up to 80 percent of cases can be successfully treated with oral rehydration solution.
The majority of travellers are at low risk of disease: standard food, water and personal hygiene precautions should be observed by all travellers. An effective vaccine is available for travellers whose activities or medical history puts them at increased risk of disease. Overview Cholera is an acute diarrhoeal disease caused by ingestion of food or water contaminated with the Gram — negative bacterium Vibrio cholerae [1].
Risk areas In a total of 1,, cases of cholera including deaths were reported to the World Health Organization WHO from 34 countries [4]. Risk for travellers Cholera does not generally occur in high-income countries where there is access to safe drinking water and improved sanitation facilities.
Cholera in travellers from England, Wales and Northern Ireland Cholera does not occur in the UK - the last indigenous case reported in England and Wales was in [9]. Transmission Cholera is mainly transmitted through faecal contamination of food or water. Signs and symptoms Cholera can be mild or occur without symptoms in healthy individuals. Diagnosis and treatment In extreme cases cholera is one of the most rapidly fatal infectious diseases known [2].
Preventing cholera 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. Vaccine information Availability An oral, inactivated cholera vaccine, Dukoral, is licensed in the UK for protection against infection caused by V. Indications for use of vaccine Country specific information on the risk of cholera can be found on our Country Information pages and Outbreak Surveillance section.
This includes: aid workers those going to areas of cholera outbreaks who have limited access to safe water and medical care those for whom vaccination is considered potentially beneficial Since when WHO removed cholera vaccination from the International Health Regulations, countries no longer require proof of cholera vaccination from travellers as a condition of entry. If more than 2 years or 6 months for children aged 2 to below 6 years of age has elapsed since the last dose of vaccine, the primary course should be repeated [9].
Administration Dukoral is for oral administration: food and drink should be avoided for 1 hour before and 1 hour after vaccination. Efficacy of vaccine The true efficacy of the vaccine in preventing cholera in travellers is not known as risk in this population is too low to be able to carry out efficacy trials. Contraindications There are few individuals who would be unable to receive the oral cholera vaccine when indicated. The vaccine should not be given to those who have had: confirmed anaphylactic reaction to a previous dose of oral cholera vaccine confirmed anaphylactic reaction to formaldehyde or any of the components of the vaccine Adverse events The most commonly reported adverse events have been mild gastro-intestinal symptoms abdominal pain, cramping, diarrhoea, nausea.
World Health Organization. Cholera fact sheet. Cholera vaccines: WHO position paper — August WER 25 August Information: You can check the country information on the TravelHealthPro website.
Do wash your hands with soap and water regularly, especially after using the toilet and before preparing food or eating only drink tap water that's been boiled or bottled water brush your teeth using bottled or boiled water. Information: If you need the cholera vaccine, you may be able to get it for free on the NHS.
Urgent advice: See a doctor if:. You may need treatment to stop you becoming dangerously dehydrated. Since the early 19th century, there have been seven cholera pandemics around the globe, resulting in millions of deaths. A few weeks ago scientists proved that the seventh cholera pandemic which is currently raging in Africa, and has been since originated in Asia, as did the majority of antibiotic-resistant strains of cholera that are isolated on this continent.
There's a saying in French that describes an impossible choice as akin to " choosing between plague and cholera". This wry expression describes a no-win situation, a cruel dilemma. For many, the idea of "plague or cholera" harks back to a bygone era — few people are aware that cholera is actually still a dangerous disease that is rife in every continent. The disease therefore mainly affects developing countries, where hygiene and safe water are severely lacking.
Cholera is caused by ingesting water or food that has been contaminated by the Vibrio cholerae bacterium. The incubation period for the disease can range from a few hours to a few days, after which time the infected person begins to suffer from severe diarrhea and vomiting but no fever.
The death rate is higher among children, elderly people and those with weak immune systems. Treatment primarily involves replacing lost water and electrolytes. Depending on the level of dehydration, patients are rehydrated orally or by intravenous administration. Improvements can be observed after just a few hours and patients recover fully, with no lasting effects, within a few days.
Antibiotic therapy is recommended by WHO only for severe dehydration. Read the Cholera Fact Sheet. The International Committee of the Red Cross has described what is happening in this country as "the world's single largest humanitarian crisis". For a single country, the sheer number of cases that occur in Yemen is staggering; the number reported there in less than a year is equivalent to the total number of cases declared in Haiti since In mainland France, cholera a notifiable disease remains a rare imported disease, and the number of cases is steadily falling.
But cases of cholera are reported by countries in every region of the world , and is endemic in some countries in South Asia. It is also prevalent in Africa and more recently in the Americas, with the island of Hispaniola.
Vibrio cholerae is a highly motile bacterium with modest nutritional requirements whose natural reservoirs are found in humans and in certain cases the environment. The disease is caused by ingesting contaminated water or food.
Man plays both the role of culture medium and means of transport for V. Diarrheal stools, massively contaminated by V.
The incubation period, from a few hours to 5 days, and the healthy carriers, enable the transport of V. The main factors that encourage cholera transmission are socio-economic status and living conditions of populations. Densely concentrated populations in areas with poor hygiene facilitate the emergence and development of cholera outbreaks. Colony of the pathogenic cholera bacterium, Vibrio cholerae, possessing blue areas, indicating the successful artificial fusion of the two chromosomes to result in a single chromosome strain.
Scientists from the Institut Pasteur and the Wellcome Trust Sanger Institute, in collaboration with several international institutions, recently published a landmark study in the journal Science.
They traced the history of cholera outbreaks in Africa, Latin America and the Caribbean over the past 60 years. Their research revealed that the cholera bacterium had been introduced at least 11 times into Africa over a period of 44 years, always from Asia, and that human populations were the main vectors for disease dispersal throughout Africa.
These findings show that cholera was not only introduced into Africa in before subsequently taking up residence there, but is repeatedly introduced on a regular basis. Starting from two prime zones of introduction in West Africa and East Africa, epidemics spread along preferential routes to persistence zones such as the Lake Chad basin or the Great Lakes region. The areas of Africa most susceptible to the introduction of cholera will have to be targeted more specifically in order to stem the cholera waves before they sweep the rest of the continent," point out the researchers.
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