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
- More detailed information can be found in our cholera factsheet
- UKHSA: Immunisation against infectious disease. Cholera
- UKHSA (previously Public Health England): Guidance. The diagnosis, management and epidemiology of cholera
- Further information on Dukoral can be found in the Summary of Product Characteristics (SPC)
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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.
Cholera in Zimbabwe
As of 7 Novemeber 2023, 5,030 suspected cases of cholera and 139 (31 confirmed, 108 suspected) deaths have been reported in 2023. The provinces of Harare and Manicaland have reported most cases.
Cholera in Ethiopia
As of 20 June 2023, a total of 11,407 confirmed cases of cholera have been reported. The current outbreak is among the longest ever in Ethiopia. There are four affected regions Oromia, Somali, SNNP and Sidama.
Cholera in Lebanon
On 11 June 2023, the Ministry of Public Health in Lebanon declared that the cholera outbreak that started in October 2022 is officially over. No new cholera cases have been reported in the country since February 2023. Ongoing monitoring through active surveillance and intensive awareness campaigns will continue.
