Cholera - A traveller's guide
What is cholera?
Cholera is a diarrhoeal infection that is a problem particularly in developing countries, where sanitation is poor. Countries in Africa report most of the cholera cases, but new outbreaks can occur all over the world so it is important to get up-to-date advice before you travel.
The cholera bacteria are passed in the bowel motions of an infected person, which is why it is important to wash your hands after going to the toilet. In developing countries drinking water can be contaminated with the bacteria.
Fruit, vegetables and uncooked food washed in contaminated water can cause infection. Shellfish can be infected if it comes from sea where sewage is a problem. Cooked food is safe, but can be contaminated if it has been handled by someone with the bacteria.
Cholera symptoms?
About 75% of people who are infected with cholera don’t develop any symptoms. However the bacteria stay in their faeces for 7-14 days, potentially infecting other people. When people show symptoms they can begin very suddenly – sometimes within just two hours of eating or drinking infected water or food. In healthy travellers cholera is usually mild and diarrhoea may be the only symptom. In severe cases, cholera symptoms can include:
- Watery diarrhoea
- Needing to go to the toilet repeatedly
- Severe dehydration
Severe dehydration can lead to kidney failure and death. Cholera affects adults and children. In severe cases it can kill within hours. People with low immunity are at greater risk if they become infected with cholera. In countries where medical care is available quickly, rehydration is a highly effective and life-saving treatment.
What to do if you think you’ve got cholera
You should seek immediate medical attention if you notice any of the signs and symptoms of severe cholera.
If a MASTA travel health nurse has told you that cholera vaccination is recommended for you, there is no doubt that your travel plans put you at risk from cholera.
If they say you should consider cholera vaccination you need to weigh-up the risk and cost of the vaccine against the potential risk of cholera. Many people prefer to take no chances with their health.
MASTA travel health nurse advice is based on:
- Up-to-date information on whether cholera is a problem in the place you are travelling to
- Your chance of coming into contact with cholera
- The medical facilities available if you were to become infected
- The duration of your stay
All travel vaccination recommendations can change because of disease outbreaks and seasonal variations, but MASTA nurses have access to daily updates and are specialists in travel health services.
How is Cholera Vaccination Given?
Cholera vaccination is given as a liquid to drink, rather than an injection. You will be asked not to eat or drink for an hour before and after receiving it. Adults need two doses, at least a week apart with a further week before travel. Children between two and six years of age need three doses - so they need the first dose at least three weeks before travelling.
Adults and children seven years and older can have a booster after 2 years (six months for children aged two to six). A MASTA nurse will make sure you know when you need to return and keep a record of vaccine(s) you need.
If you have made your travel plans late and have less than two weeks before you travel, contact your MASTA Travel Clinic immediately. They may be able to recommend an alternative, based on the time available.
Cholera protection: summary of action to be taken
Get cholera vaccination at least two weeks before you travel (3 weeks for children 2-6 years of age)
Be extra careful about hand washing before eating and after you have used the toilet
Only drink water you know to be safe: From a sealed bottle or treated using a good quality filter, tablets or boiling
Avoid raw food especially salad or uncooked shellfish. Food that is served hot and freshly cooked is safer
Carry rehydration sachets