The Basics
What Causes Cholera?
Cholera is an acute diarrheal infection caused by the bacterium Vibrio cholerae. It is primarily spread through the ingestion of food or water contaminated with the faeces of an infected person. It is a fast-acting disease that can cause severe dehydration within hours. While rare in industrialised countries, it remains a significant risk in areas with limited access to clean water and sanitation, such as regions affected by natural disasters or conflict.
Vaccination Overview
The Oral Cholera Vaccine
| Feature | Dukoral® (Inactivated) | Vaxchora® (Live Attenuated) |
| Number of Doses | Adults/Children 6+: 2 doses Children 2–6: 3 doses |
Single Dose |
| When to get it | Complete the final dose 1 week before travel. | Take at least 10 days before travel. |
| Boosters | Adults/6+: Every 2 years Children 2–6: Every 6 months |
Not currently specified (intended for single-trip use). |
| How it is given | A drink mixed with a buffer sachet (to protect from stomach acid). | A single drinkable solution. |
| Suitable Age | 2 years of age and older. | 2 years of age and older. |
Important Administration Rules
How to Take the Vaccine Correctly
For the oral vaccine to work, it must survive the journey through your stomach. To ensure success:
Fasting Rule: Do not eat, drink, or take any other oral medications for 1 hour before and 1 hour after taking the vaccine.
Liquid Choice: Mix the vaccine only with the provided buffer sachet and cool water. Do not use juice or other liquids as they may destroy the vaccine.
Storage: Keep the vaccine in the refrigerator (2°C to 8°C) until you are ready to take it.
Safety & Side Effects
Potential Side Effects
The vaccine is generally very safe because it is not an injection. Most people experience no side effects, but some may report:
Mild Digestive Issues: Occasional nausea, stomach cramps, or mild diarrhoea.
General Symptoms: A headache or a slight fever.
Duration: These symptoms are temporary and usually clear up within 48 hours.
Recognising Symptoms
Symptoms of Cholera
Symptoms can appear anywhere from a few hours to 5 days after infection. While many people have mild symptoms, approximately 1 in 10 will develop severe illness.
“Rice-Water” Stools: Sudden onset of profuse, watery diarrhoea that appears milky or like water used to wash rice.
Vomiting: Often occurs in the early stages and can worsen dehydration.
Leg Cramps: Caused by the rapid loss of salts (electrolytes) from the body.
Severe Dehydration: Rapid heart rate, dry mouth, extreme thirst, and loss of skin elasticity (skin stays up when pinched).
Shock: If untreated, the massive loss of fluids can lead to kidney failure and circulatory collapse.
Additional Precautions
The "Safe Travel" Habits
Vaccination is a powerful tool, but it is not 100% effective. Always follow these “WASH” (Water, Sanitation, and Hygiene) principles:
Safe Water: Drink only bottled, boiled, or chemically treated water. Avoid ice cubes in drinks.
Food Hygiene: Follow the rule: “Boil it, cook it, peel it, or forget it.” Avoid raw shellfish and salads that may have been washed in local water.
Hand Hygiene: Wash hands with soap and safe water frequently, especially before handling food and after using the bathroom.
Oral Rehydration: Always carry Oral Rehydration Salts (ORS) in your travel kit. If diarrhoea starts, begin drinking ORS immediately to replace lost fluids.
FAQ
Does the vaccine protect against "Traveler’s Diarrheal"?
The Dukoral vaccine provides some cross-protection (approx. 60%) against diarrhoea caused by E. coli (ETEC) for about 3 months, though its primary purpose is preventing Cholera.
Do I need a certificate to enter certain countries?
No. Under current International Health Regulations, a Cholera vaccination certificate is not a legal requirement for entry into any country, but it is highly recommended for aid workers in outbreak sones.
Medical Disclaimer
The information provided on this website is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. While we strive to provide accurate health information, it is not a substitute for the professional judgment of a healthcare provider. Always seek the advice of your physician or other qualified health professional with any questions you may have regarding a medical condition or vaccination schedule. Never disregard professional medical advice or delay seeking it because of something you have read on this website.