05 February 2013

How can cholera be prevented?

Vaccination is available, but preventive measures like the provision of safe drinking water and sanitation are more effective.

 Travellers to endemic areas who follow the usual tourist itinerary and observe the recommended safety precautions regarding safe drinking water and food have minimal risk of contracting cholera.

Although there is a vaccine for cholera, it offers only limited immunity and the jury is out about whether or not travellers should be vaccinated. Most international organizations, such as the Centers for Disease Control (CDC) and the World Health Organisation, do not recommend cholera vaccination for travel.

During cholera epidemics, vaccination may be a short-term intervention, whilst long-term interventions such as provision of safe drinking water and sanitation are put into place.

Newer oral cholera vaccines have been developed that are more reliable than the injected form. These vaccines, however, don’t offer complete protection against the disease, and protection lasts about 2 years after immunisation. However, travellers to an endemic area with a significantly increased risk, such as relief/aid workers, or immunocompromised individuals may benefit from immunization, particularly if they are visiting rural areas.

Regretfully, none of the current vaccines have the necessary combination of high efficacy, long duration of protection, simplicity of administration and low cost to make mass vaccination viable in cholera areas.

(Previously reviewed by Professor Willem Sturm, Head of the Medical Microbiology and Infectious Diseases department at the Nelson Mandela School of Medicine in Durban)

(Reviewed by Dr Miscka Moodley, Microbiologist, UCT, March 2011)


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