The cholera vaccine is generally not required or recommended for travel anywhere in the world, with perhaps a few local exceptions. For some traveling to a specific area within a particular country, local authorities may require that you receive the two-dose vaccine; however, no vaccine for cholera is available in the United States.
Cholera is a bacterium (Vibrio cholera) that attacks the intestines, causing diarrhea in about 5 of every 100 people who are infected. Sometimes quite severe, the diarrhea and subsequent loss of fluids can cause people to go into shock and die.
Each year about 100,000 to 300,000 cases of cholera are reported to the World Health Organization, and about 5,000 to 7,500 people die.
The cholera bacteria may be present in contaminated food, water or shellfish. Shellfish contain cholera for the same reason that they contain hepatitis A virus: because both cholera and hepatitis A viruses are found in water. Because shellfish filter hundreds of quarts of water each day in their search for food, they actually catch and concentrate cholera and hepatitis A viruses.
Travelers are generally at no risk of cholera if they stay "on the beaten path," use standard tourist accommodations, eat only cooked shellfish and cooked food, and drink bottled water.
Cholera is common in several countries or regions of the world. To learn more about where cholera is occurring, consult this interactive map from the World Health Organization (WHO). The World Health Organization offers additional information about cholera on a dedicated Web page that includes information for travelers, outbreak information and statistics.
The cholera vaccine is made by taking the whole cholera bacteria and killing (or inactivating) it with a chemical. Once injected into the body, the killed cholera bacteria cause an immune response against cholera, but, because the bacteria are killed, they don't cause the disease. Unfortunately, the cholera vaccine is only about 50 percent effective at preventing cholera in people who are exposed to the bacteria.
Unlike cholera, hepatitis A virus infections do occur in places with standard tourist accommodations. Also, it is easier and less expensive for countries to eliminate the cholera bacteria from water than to eliminate hepatitis A virus from water.
Side effects are generally mild and include pain or swelling in the area of the shot. Headache, fever and fatigue also may occur.
Although the cholera vaccine does not have serious side effects, it is only about 50 percent effective and people traveling in developing countries are not at high risk of catching cholera if they stay in standard tourist accommodations. So, for most people, the cholera vaccine isn't necessary.
However, people traveling "off the beaten path" in countries where cholera is common and who also engage in high-risk activities such as eating raw or undercooked food (such as shellfish) or drinking unbottled water, should get the cholera vaccine — in these cases the vaccine's benefits outweigh its risks.
|A small number of travelers, but the vaccine is not available in the U.S.|
|Disease Risks||Vaccine Risks|
Reference: Plotkin SA, Orenstein W, and Offit PA. Cholera Vaccines in Vaccines, 6th Edition. 2012, 141-152.
Reviewed by: Paul A. Offit, MD
Date: March 2013
Materials in this section are updated as new information becomes available. The Vaccine Education Center staff regularly reviews materials for accuracy.You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family's personal health. You should not use it to replace any relationship with a physician or other qualified healthcare professional. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult your physician or, in serious cases, seek immediate assistance from emergency personnel.