CDC Cholera Information for Travelers

      Cholera Information for Travelers
      (Updated October 25, 2000)

          Please see the Destinations section for recommendations for specific 
            countries.


    Cholera is an acute intestinal infection. Cholera occurs in many of the 
    developing countries of Africa and Asia, where sanitary conditions are 
    less than optimal. Most recently, cholera outbreaks have occurred in parts 
    of Latin America.
    Most infected persons have no symptoms or only mild diarrhea. However, 
    persons with severe disease can die within a few hours after onset due to 
    loss of fluid and salts through profuse diarrhea and, to a lesser extent, 
    through vomiting.
    Only a few cases of cholera have occurred among non-travelers in the 
    United States since 1973. Even with foreign travel, the risk of infection 
    to the U.S. traveler is very low, especially for those who follow the 
    usual tourist itineraries and stay in standard accommodations. Worldwide 
    cholera activity is characterized by occasional epidemics in developing 
    countries.
    The organism that causes the illness is named Vibrio cholerae type O:1 or 
    O:139. During epidemics, it is spread by ingestion of food or water 
    contaminated directly or indirectly by feces or vomit from infected 
    persons. Diagnosis is made by culturing the bacteria from the stool of a 
    patient and confirming that the organism produces toxin.
    The best protection is to avoid consuming food or water that may be 
    contaminated with feces or vomit from infected persons. The organism can 
    grow well in some foods, such as rice, but it will not grow or survive in 
    very acidic foods, including carbonated beverages, and is killed by heat.
    Treatment for cholera involves rehydration with oral rehydration solution 
    or, in the most severe cases, with intravenous solutions until the patient 
    is able to ingest fluids. Treatment with antibiotics (usually tetracycline 
    or doxycycline) will decrease the duration of illness and the excretion of 
    live cholera bacteria and will decrease the volume of fluid lost but is 
    not necessary for successful treatment.
    Cholera Vaccine Information
    At the present time, the manufacture and sale of the only licensed cholera 
    vaccine in the United States (Wyeth-Ayerst) has been discontinued. It has 
    not been recommended for travelers because of the brief and incomplete 
    immunity if offers. No cholera vaccination requirements exist for entry or 
      exit in any country.
      Two recently developed vaccines for cholera are licensed and available in       other countries (DukoralŪ, Biotec AB and MutacolŪ, Berna). Both vaccines 
      appear to provide a somewhat better immunity and fewer side-effects than 
      the previously available vaccine. However, neither of these two vaccines 
      is recommended for travelers nor are they available in the United States. 
      Further information on these vaccines can be obtained from the 
      manufacturers at:
        DukoralŪ
        Active Biotec AB (publ)
        Postal Address: P.O. Box 724, SE-220 07 Lund, Sweden
        Office address: Scheelevagen 22
        Tel: +46 46 19 20 00,
        Fax +46 46 19 20 50
        E-Mail: info@activebiotech.com
        Home page: http://www.activebiotech.com/
        MutacolŪ
        Berna, Switzerland Division
        P.O. Box
        CH-3001 Berne
        Domicile:
        Rehhagstrasse 79e
        CH-3018 Berne
        Tel. +41 31 981 22 11
        Fax +41 31 981 20 66
        E-mail: berna@berna.org
        Home page: http://www.berna.org/