What is Cholera?
A profuse and watery diarrhoeal illness, cholera is caused by infection of the intestine by the Vibrio cholerae bacterium. The infection is often mild and without symptoms, but can be life-threatening.
Where is it found?
Cholera is a public health concern in developing countries worldwide, especially in Africa, South Asia and Latin America.
Risk to travellers
The risk of contracting cholera while travelling in affected areas is thought to be less than 1 in 500,000 if food and water guidelines are followed. Severe cases in travellers from developed countries are rare.
There is no longer an official requirement for cholera vaccination for arriving travellers to any country. Vaccination for cholera is generally only recommended for high-risk travellers (i.e. aid or refugee camp workers, persons planning extended stays in remote rural areas who are in close contact with the local population).
An added advantage of the cholera vaccine, Dukoral, is that it offers some degree of protection against a common diarrhoea-causing bacterium LT-ETEC (enterotoxigenic E Coli).
For most travellers, this oral vaccine is recommended for long-term travellers and for those visiting countries experiencing floods.
What is Cholera Vaccination?
Dukoral - Oral inactivated
2 doses from 7 days to up to 6 weeks apart. Sachet mixed in 150 ml of water then vaccine dose added. No food or drink should be consumed for one hour before and after administration.
Children from 2 years to 6 years of age require 3 doses. The solution is mixed using the sachet and half the liquid is poured away (75ml) before the full vaccine dose is added.
If vaccine doses are given later than the recommended timeframe as noted here, primary immunisation must be repeated.
Level of protection
Provides 60-70% protection against severe cholera for 2 years.
After a primary course, cholera protection lasts for about 2 years. Boost with a single oral dose 2-5 years after primary course for cholera protection. If more than 5 years have passed the full primary course of two doses is required.
Note: Although protection against ETEC diarrhoea is off-label use in Australia, ETEC protection only lasts 3 months. If continuing ETEC protection is required, boosting with a single dose after 3 months is advised.
Possible Side Effects
Occasional nausea, abdominal cramps or diarrhoea.
As with all vaccines, there is a small risk of allergic reactions