Cholera

Cholera is a disease, characterised by profuse, watery diarrhoea, caused by certain toxin-producing forms of the bacteria called Vibrio cholera. Cholera is transmitted by ingesting (eating and drinking) contaminated water or food. It is common in many low-income countries and is largely linked to poverty, bad sanitation and poor access to clean drinking water.

The risk of cholera for most travellers is extremely low. Activities that may increase risk include drinking untreated water or eating poorly cooked food (particularly seafood) in areas where outbreaks are occurring. Travellers living in unsanitary conditions, including humanitarian workers in disaster/refugee areas, are also at risk.

Cholera can be mild or occur without symptoms in healthy individuals. Symptoms include sudden, profuse, watery diarrhoea with associated nausea and vomiting. If untreated, cholera can rapidly lead to serious dehydration and shock; fifty percent of those with serious complications, die. With quick and effective treatment, risk of dying is less than one percent.

Prevention

Travellers can reduce their risk of being ill from cholera by ensuring good personal hygiene and following advice on preventing food and water spread diseases.

Cholera vaccine

In the United Kingdom (UK), an oral (drink), inactivated cholera vaccine called Dukoral® is available and protects against V. cholerae serogroup O1. This vaccine is not needed by most travellers; it is recommended for those whose activities or medical history put them at increased risk, including:

  • 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. (i.e. for those who do not fit into the above groups, but are still considered at higher risk).

Vaxchora (a live, oral cholera vaccine for prevention of cholera disease in adults and children aged 2 years and older) was granted UK marketing authorisation (licensed) in 2020. The UK Joint Committee on Vaccination and Immunisation (JCVI) are in the process of reviewing the product information. Recommendations on the use of this vaccine will be published in due course.

Vaccine schedule (Dukoral)

Age range Schedule Duration of protection
Adults and children from 6 years Two doses with an interval of at least 1 week but less than 6 weeks between them* 2 years
Age 2 to below 6 years Three doses with an interval of at least 1 week but less than 6 weeks between them* 6 months
*If more than 6 weeks have elapsed between doses the primary course should be restarted. 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.

Resources

First published : 09 October 2019 Last updated : 06 July 2023

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Recent Cholera Outbreaks

17 April 2024

Cholera in Comoros

As of 14 April 2024, a total of 1,484 cholera cases, with 38 deaths (representing a 2.5% case mortality rate) have been reported since this cholera outbreak was declared on 2 February 2024. The three islands have reported cases, with most from Anjouan island.

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Take usual precautions

24 January 2024

Cholera in Zambia

As of 20 January 2024, the World Health Organization has reported rapid expansion of the cholera outbreak in Zambia. A total of 10,887 cases and 432 deaths have been reported since this outbreak started in October 2023. Cases have been reported in nine of the country's 10 provinces, with Lusaka, Central and Eastern worst affected and Lusaka district described as the outbreak epicentre.

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Take usual precautions

17 January 2024

Cholera in Zimbabwe

As of 10 January 2024, a total of 16,815 suspected cholera cases, 2,019 confirmed cases, 67 confirmed deaths and 308 suspected deaths have been reported. In the first week of January, a total of 1,473 new suspected cases were reported. All 10 provinces have reported cases, but three provinces (Harare, Manicaland, and Masvingo) account for approximately 90% of all reported cases.

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Take usual precautions

15 November 2023

Cholera in Haiti

As of 1 November 2023, a total of 69,992 (4,080 confirmed) cholera cases, with 1,054 deaths and 65,738 hospital admissions, have been reported in Haiti since September 2022.

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Take usual precautions