A Look at Each Vaccine: Cholera Vaccine
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.
What is cholera?
Cholera is a bacterium (Vibrio cholera) that attacks the intestines, causing diarrhea in about 5 percent of those infected. Sometimes quite severe, the diarrhea and subsequent loss of fluids can cause people to go into shock, and die.
How common is cholera?
Each year about 120,000 cases of cholera are reported to the World Health Organization from 50 countries.
How do you catch cholera?
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 virus are found in water, and because shellfish filter hundreds of quarts of water each day in their search for food, shellfish actually catch and concentrate cholera and hepatitis A virus.
Travelers are generally at no risk of cholera if they stay "on the beaten track," use standard tourist accommodations, eat only cooked shellfish and cooked food, and drink bottled water.
Where can you catch cholera?
Cholera is common in the following countries or regions: India, Africa, Indonesia and Iran among others. To learn more about where cholera is occurring consult the World Health Organization information.
How is the cholera vaccine made?
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.
Why do I need a hepatitis A vaccine, but not a cholera vaccine, given that both can be transmitted in contaminated water and shellfish?
Unlike cholera, hepatitis A virus infections do occur in places with standard tourist accommodations. Also, it is frankly easier and less expensive for countries to eliminate the cholera bacteria from water than to eliminate hepatitis A virus from water.
Does the cholera vaccine have side effects?
Side effects are generally mild and include pain or swelling in the area of the shot. Headache, fever and fatigue also may occur.
Do the benefits of the cholera vaccine outweigh its risks?
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 vaccine — in these cases the vaccine's benefits outweigh its risks.
Reviewed by: Paul A. Offit, MD
Date: March 2008
Materials in this section are updated as new information becomes available. Center staff regularly review 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.
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