A brief history
Cholera has caused major epidemics for centuries. Its first recorded pandemic occurred in the 19th century, and the seventh began in South Asia in 1961. Its history shows how closely infectious disease is linked to access to clean water and sanitation.
How does it spread?
The bacterium Vibrio cholerae spreads when people swallow contaminated food or water. Infected people pass the bacteria in their stools, including when they have no symptoms. Disrupted water supplies and poor sanitation can allow outbreaks to spread quickly.
Symptoms and possible complications
Many infections are mild or unnoticed. Severe cholera causes profuse watery diarrhoea and rapid loss of fluid and salts. Life-threatening dehydration can develop within hours, so urgent rehydration and medical care are essential. Vaccination complements safe food, drinking water and hand hygiene.
Where it may be relevant
- Aid or disaster-relief workers with limited access to safe water and sanitation
- Travellers to outbreak settings who may be unable to follow safe food and water precautions
- People staying in remote or high-risk conditions after individual assessment
Dose schedules
The clinician will select the appropriate licensed schedule after reviewing age, health, previous doses and departure date.
Adult and child course
Age 6 years and over
Complete at least one week before possible exposure.
Young-child course
Age 2 to under 6 years
Three doses are used; complete at least one week before exposure.
Who may be eligible
- Most adults and children from the product's licensed minimum age when a specific travel risk is present
- Travellers able to complete the oral course before exposure
Who may not be eligible
- Anyone with a confirmed severe allergic reaction to a previous dose or a vaccine ingredient
- People who are acutely unwell with a significant fever may need vaccination deferred
- Pregnancy, breastfeeding, immune suppression and current medicines must be reviewed individually
- The oral dose may need separating from food, drink and some medicines
- Children require the age-appropriate preparation and schedule
Potential side effects
- Temporary stomach discomfort, nausea or diarrhoea
- Headache or tiredness
- An allergic reaction is possible but uncommon
Important risks and precautions
- A severe allergic reaction is very rare and requires urgent treatment
- Protection is not absolute, so relevant food, water, bite or exposure precautions remain important
- The exact product and schedule must be confirmed during a clinical assessment
Clinical references