Cholera is an acute diarrhoeal disease caused by the bacterium Vibrio cholerae. The short incubation period ranges from two hours to five days. Some patients may have severe symptoms with sudden onset of profuse diarrhoea with rice-water like and fishy smelling stool, nausea and vomiting. Without prompt treatment, these patients may die from severe dehydration.

It is a condition characterised by a twofold or greater increase in the frequency of unformed bowel movements. The symptoms are fever, colicky abdominal pain, or vomiting. Travelers’ Diarrhea is a clinical syndrome that can result from a variety of intestinal pathogens, including bacterial pathogens and protozoal pathogens.

Travellers' Diarrhea is acquired through ingestion of faecally contaminated food and water. Especially risky foods include raw vegetables, raw meat and raw seafood. The consequences of a disaster – such as disruption of water and sanitation systems can increase the risk of cholera transmission.

Tips for travelers

• Cook food or boil water thoroughly before consumption
• No foods and beverages from unlicensed street vendors
• Avoid eating cold dishes like salads
• Peel fruit by yourself
• No ice for beverages
• If water cannot be boiled, treat water with chlorine or iodine before consumption
• It is suggested taking oral cholera vaccines before the trip for prophylaxis. It offers significant protection against cholera at 84-86% 3-5

For more information about oral cholera vaccine, please consult your primary doctor.

WHO’s view on oral cholera vaccines (Weekly epidemiological record) 6

• Oral cholera vaccines have been developed and proved to be safe, immunogenic and effective. Only 2 of these are currently being marketed internationally.
• WHO has never recommended the use of the parenteral cholera vaccine because of its limited protective efficacy (45% for 3 months) and its unsuitability for public health purposes.
• Oral cholera vaccines are considered an additional means to control cholera, but should not replace conventional control measures. Provision of safe water and sanitation is critical in reducing the impact of cholera and other waterborne diseases.
• With two safe and effective oral cholera vaccines available, immunization should be implemented with other prevention and control strategies in areas where the disease is endemic and in areas at risk for outbreak. Vaccines provide a short-term option for populations living in high-risk areas, while other measures such as improving drinking-water and sanitation take longer to be put in the place to provide sustained control of the disease.
• Oral cholera vaccine have proven to be safe and effective. However, there is a need to scale up the prevention measures in order to avert outbreaks by expanding access to improved sources of drinking-water and improved sanitation to diminish the risks of infection.