Cholera is a life-threatening infection causing profuse watery diarrhoea which can lead to complications from dehydration in less than 24 hours. In underdeveloped healthcare settings it has a high mortality rate. It is most commonly caused by a breakdown in water sanitation and hygiene, and outbreaks are usually associated with natural disasters such as earthquakes and flooding. Humanitarian workers are higher risk as well as small children and the elderly. Thought to be rare in general travel, the infection is caused by a bacterium Vibrio Cholera and though treatment with antibiotics can help, it is rapid and efficient fluid replacement that saves lives, something that is not always available in the developing world.
We do sometimes use the Cholera vaccine to protect against travellers’ diarrhoea.
Sudden profuse watery diarrhoea and subsequent dehydration with resulting complications.
Good food, water and hand hygiene practices usually prevents Cholera.
Despite the best efforts E Coli remains a common cause of travellers’ diarrhoa.
There is now a safe and effective vaccine, taken as a drink in two doses a week apart, which provides up to 2 years of protection. However, Cholera fortunately remains (exceedingly) rare in travellers.
The vaccine has some effect on E Coli infection, a very common cause of traveller’s diarrhoea. At highest risk are those who are prone to regular tummy bugs when travelling but also those with pre-existing gut disorders such as Irritable Bowel Syndrome, Inflammatory Bowel Disease and reflux on medication. Young group travellers, business travellers and remote travellers, as well as aid workers are often recommended this vaccine.
E coli protection is short lived, lasting up to 3 months, but can be boosted for further travel within 2 years of the initial doses, with another single dose of vaccine.