Cholera is an uncommon bacterial infection of the intestine which causes profuse and watery diarrhoea. Cholera is usually transmitted by eating and drinking food and water contaminated by human excreta. Shellfish obtained from contaminated water has been responsible for outbreaks.
The infection is often mild and without symptoms but can sometimes be life threatening. It occurs in many developing countries with poor hygiene and sanitation, and is particularly high risk in war zones, refugee camps, and in areas suffering from natural disasters.
The best protection is to avoid contaminated food and water. Drink bottled, boiled or treated water. Avoid leafy uncooked vegetables, salads and buffets. Ensure foods are well cooked and served hot, especially shellfish.
The currently available oral vaccine is approximately 85% effective in preventing and reducing the severity of cholera. It is thought it could provide additional partial protection against a strain of E. coli (a bacterium that commonly causes diarrhea), and may theoretically reduce the overall risk of travellers' diarrhoea by a small amount. For adults and children over 6 years of age, 2 sachets of vaccine are given orally, about a week apart. Children under 6 years of age require 3 doses. Adults and children > 6 years who are at ongoing risk should receive a single booster dose up to 2 years after completion of the primary course.
Cholera vaccination is recommended for all travellers at high risk of infection, e.g: those working in refugee camps, disaster zones, health care workers in developing countries, travelling to areas with recent cholera outbreaks.
There is no longer any 'official' requirement for cholera vaccination for arriving travellers to any country, but some border officials may request evidence of vaccination. Please discuss this with your Travel Medicine Doctor.
Cholera can sometimes be a severe infection, requiring hospitalisation for antibiotics and intravenous fluid replacement. Children are particularly prone to serious illness from cholera infection, which can sometimes be life threatening.
For treatment of E. coli infection, please see our information sheet on Travellers' Diarrhoea.