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).