Cholera Immunisation

Cholera is an illness cased by a bacterium called Vibrio cholerae. The illness can be mild but in many cases it causes severe diarrhoea which can quickly lead to serious dehydration, and can be fatal. Cholera is usually caught from drinking infected water or eating infected shell-fish.

The worst affected areas are the Indian subcontinent, the Far East, Africa, and South America.

The most important part of prevention is to be very careful about personal, food and water hygiene. This is most important in areas where sanitation is poor, and where there is a risk of catching cholera. You should avoid drinking any water that is untreated and be very careful what you eat. This not only applies to cholera, but to all sorts of water-borne infections found in areas of poor sanitation.

A new vaccine (Dukoral) became available in the UK in 2004. It is not indicated for most travellers. It may be advised for certain people travelling to places where cholera is prevalent. Your doctor or nurse will advise if you should consider having this vaccine. Examples of people who are likely to be advised to have this vaccine include:

• People going to work in an area of a known cholera outbreaks. For example, aid workers, health workers, etc, who will be working in emergency relief camps where cholera has broken out.
• People planing to stay a long time in an area where cholera is high risk. Especially to areas where there is limited access to medical care.

The vaccine

The oral vaccine comes in sachets which are dissolved in a drink. It can be used by adults and children aged two years and over. You should not eat or drink anything for an hour before and after taking a dose of vaccine (to make sure it is absorbed fully from your gut).

The course of immunisation is two doses for people over six years old, and three doses for children two to six years old. Each dose is given at least one week apart, but no later than six weeks apart. The course of immunisation should be finished at least one week before potentially coming into contact with cholera (ie one week before travel).

A booster dose is needed to maintain protection. This is after two years for people over six years old, and after six months for children two to six years old.

Note: the vaccine does not provide complete protection. For example, it does not protect against all strains of cholera. Therefore, it is still important that you are careful in what you eat and drink in the usual way.

Further information

Health Advice for Travellers.
All travellers going abroad are advised to get this booklet by the Department of Health. You can get a free copy:

• From main post offices, or
• By writing, phoning, faxing or emailing the Department of Health (allow 10 days to get it).

  Department of Health, PO Box 777, London, SE1 6XH
  Telephone: 08701 555455    Fax: 01623 724524    Email doh@prolog.uk.com

• Or view the content on the web www.dh.gov.uk/PolicyAndGuidance/HealthAdviceForTravellers/fs/en

Health Information for Overseas Travel (The Yellow Book)
www.archive.official-documents.co.uk/document/doh/hinfo/index.htm
From the Department of Health. Aimed at health professionals but of interest to all.

Patient UK Travel Health Page
www.patient.co.uk/showdoc/38/
Has a comprehensive list of links to UK websites on travel health.

© EMIS and PIP 2005   Updated: April 2005   Review Date: October 2006   CHIQ Accredited