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Cholera is an acute bacterial diarrhoeal infection caused by ingestion of contaminated water or food and the greatest risk is in countries where there is poor sanitation and where access to safe drinking water is not guaranteed. In severe cases cholera causes copious watery diarrhoea and extreme dehydration and medical attention should be urgently sought as individuals can die quickly if they are not treated promptly.

Prevention is focused on ensuring safe food and water, particularly in countries where cholera is more common. Food and drink to be wary of include untreated water, ice, shellfish, salads, unwashed fruit and vegetables. Good personal hygiene is also very important.

Dukoral is an effective oral vaccine to protect against cholera. Adults and children over 6 years require 2 doses and younger children from age 2 years require 3 doses. The vaccine is administered at intervals of at least one week and immunisation should ideally be completed at least 1 week prior to potential exposure. For those at ongoing risk a booster dose is required at 2 years and sooner in children under 6 years. Vaccination should be considered for travellers to a country where cholera is present and where they may be unable to take reasonable precautions with food and water, for example, during wars and when working in refugee camps or slum areas. As with all vaccines the clinical staff will advise during the travel consultation on all aspects of the procedure including vaccine dose schedule, contraindications to vaccination, any possible interactions with other vaccines or medications, the range of possible adverse effects from the specific vaccine and any queries. Written product information to retain for reference is also provided.