Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae. An estimated 3-5 million cases and over 100,000 deaths occur each year around the world. The infection is often mild or without symptoms, but can sometimes be severe. Approximately one in 10 (5-10%) infected persons will have severe disease characterized by profuse watery diarrhea, vomiting, and leg cramps. In these people, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.
Cholera is rare in the United States and other industrialized nations. However, globally, cholera cases have increased steadily since 2005 and the disease still occurs in many places including Africa, Southeast Asia, and Haiti.
A person can get cholera by drinking water or eating food contaminated with the cholera bacterium. Large epidemics are often related to fecal contamination of water supplies or street vended foods. The disease is occasionally spread through eating raw or undercooked shellfish that are naturally contaminated.
The FDA recently approved a single-dose live oral cholera vaccine called Vaxchora (lyophilized CVD 103-HgR) in the United States. The Advisory Committee on Immunization Practices (ACIP) voted to approve the vaccine for adults 18 – 64 years old who are traveling to an area of active cholera transmission.
- An area of active cholera transmission is defined as a province, state, or other administrative subdivision within a country where cholera infections may be reported regularly (endemic) or where a cholera outbreak is occurring (epidemic), and includes areas with cholera activity within the past year.
- The vaccine is not regularly recommended for most travelers from the United States, as most travelers do not visit areas with active cholera transmission.
- No country or territory currently requires vaccination against cholera as a condition for entry.
Vaxchora has been reported to reduce the chance of severe diarrhea in people by 90% at 10 days after vaccination and by 80% at 3 months after vaccination. The safety and effectiveness of Vaxchora in pregnant or breastfeeding women is not yet known, and it is also not known how long protection lasts beyond 3 – 6 months after getting the vaccine. Side effects from Vaxchora are uncommon and may include tiredness, headache, abdominal pain, nausea and vomiting, lack of appetite, and diarrhea.
The manufacturer of the cholera vaccine has temporarily stopped making and selling this vaccine. The cholera vaccine may be in limited supply or unavailable. Check TRAVAX for updates.
Source: Centers for Disease Control and Prevention