Cholera
Cholera is a disease, characterised by profuse, watery diarrhoea, caused by certain toxin-producing forms of the bacteria called Vibrio cholerae. Cholera is transmitted by ingesting (eating and drinking) contaminated water or food. It is common in many low-income countries and is largely linked to poverty, bad sanitation and poor access to clean drinking water.
The risk of cholera for most travellers is extremely low. Activities that may increase risk include drinking untreated water or eating poorly cooked food (particularly seafood) in areas where outbreaks are occurring. Travellers living in unsanitary conditions, including humanitarian workers in disaster/refugee areas, are also at risk.
Cholera can be mild or occur without symptoms in healthy individuals. Symptoms include sudden, profuse, watery diarrhoea with associated nausea and vomiting. If untreated, cholera can rapidly lead to serious dehydration and shock; fifty percent of those with serious complications, die. With quick and effective treatment, risk of dying is less than one percent.
Prevention
Travellers can reduce their risk of being ill from cholera by ensuring good personal hygiene and following advice on preventing food and water spread diseases.
Cholera vaccines
In the United Kingdom (UK) cholera vaccination is not recommended for most travellers. It is only advised for travellers whose activities or medical history put them at increased risk, including:
- Aid workers.
- Those going to areas of cholera outbreaks who have limited access to safe water and medical care.
- Those for whom vaccination is considered potentially beneficial (i.e. for those who do not fit into the above groups, but are still considered at higher risk).
There are two cholera vaccines available in the UK: Dukoral® and Vaxchora®.
Dukoral® is an oral (drink), inactivated cholera vaccine that protects against V. cholerae serogroup O1.
Vaccine schedule (Dukoral)
| Age range | Schedule | Duration of protection |
| Adults and children from 6 years | Two doses with an interval of at least 1 week but less than 6 weeks between them* | 2 years |
| Age 2 to below 6 years | Three doses with an interval of at least 1 week but less than 6 weeks between them* | 6 months |
*If more than 6 weeks have elapsed between doses the primary course should be restarted. If more than 2 years (or 6 months for children aged 2 to below 6 years of age) has elapsed since the last dose of vaccine, the primary course should be repeated.
Further information about Dukoral® can be found in the Summary of Product Characteristics (SPC).
Vaxchora® is also an oral (drink) cholera vaccine that protects against V. cholerae serogroup O1.
Vaxchora® is a live vaccine (it contains live attenuated cholera bacteria) and is contraindicated for anyone who is immunosuppressed. See the cholera chapter of Immunisation against infectious disease (also known as 'the Green Book'), for further details.
Vaccine schedule (Vaxchora)
| Age range | Schedule | Duration of protection |
| Adults and children from 2 years of age** | A single oral dose should be administered at least 10 days prior to potential exposure to V. cholerae O1 | No data are available on revaccination interval |
**The safety and efficacy of Vaxchora® in children less than 2 years has not been established.
Further information about Vaxchora® can be found in the Summary of Product Characteristics (SPC).
Resources
- More detailed information can be found in our cholera factsheet
- UKHSA: Immunisation against infectious disease. Cholera
- UKHSA: Guidance. The diagnosis, management and epidemiology of cholera
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Recent News on Cholera
Country Information updates: cholera
NaTHNaC has reviewed the country-specific cholera information and vaccine recommendations for United Kingdom (UK) travellers on the TravelHealthPro website
Updated: 20 November 2025Cholera cases reported in the United Kingdom and Germany linked to Ethiopia
Information for travellers and health professionals
Updated: 07 March 2025Updated cholera 'green book' chapter published
The cholera chapter in the 'green book' (Immunisation against infectious disease) has been updated
Updated: 01 August 2024Cholera vaccine shortage: advice for health professionals
Cholera cases increase worldwide, with shortages of cholera vaccine reported
Updated: 05 March 2024Recent Cholera Outbreaks
Cholera in Zambia
As of 14 October 2026, a total of 909 cases, including 149 confirmed cases and 25 deaths, have been reported in Zambia since the cholera outbreak was declared on 28 July 2026. Cases have been reported across 12 districts in five provinces with the highest number of cases reported in Lusaka (457 cases) and Chibombo (221 cases) districts. Please see our Topics in Brief article for further details on cholera.
On 30 September 2026, Zambia's Ministry of Health declared a new cholera outbreak. As of 29 September 2026, there have been 304 cases, of which 62 cases have been laboratory confirmed, with 11 deaths. Cases have been reported in seven districts across five provinces. Please see our Topics in Brief article for further details on cholera.
Source: StateCholera in Nigeria
As of 7 October 2026, a total of 68,152 suspected cholera cases and 394 deaths have been reported in Borno State since this outbreak began in May 2026. All 22 local government areas in Borno have now reported cases. Please see our Topics in Brief article for further details on cholera.
Between 1 May 2026 and 18 June 2026, a total of 13,234 cases of cholera (108 deaths) have been reported across 17 local government areas in Borno State. Please see our Topics in Brief article for further details on cholera.
Source: StateBetween 1 January and 24 December 2025, a total of 22,196 cases of cholera (505 deaths) have been reported in Nigeria. Please see our Topics in Brief article for further details on cholera.
Source: ECDCAs of 28 July 2025, 4,700 cholera cases and 113 deaths have been reported in Nigeria during 2025. Please see our Topics in Brief article for further details on cholera.
Source: WHOFrom 1 January 2024 to 29 September 2024, Nigeria has reported a total of 10,837 cholera cases, and 359 deaths, across 35 states and the Federal Capital Territory.
Source: WHOCholera in South Sudan
As of 26 July, 109,049 cholera cases and 1,716 deaths have been reported across 55 counties in nine states across South Sudan, since the outbreak began in September 2024. This outbreak is the largest in South Sudan since 2011. Please see our Topics in Brief article for further details on cholera.
As of 16 February 2026, a total of 98,372 cholera cases, including 1,624 deaths, have been reported in South Sudan since this outbreak began in September 2024. Cases have been reported in 55 counties, across nine states and all three administrative areas. Please see our Topics in Brief article for further details on cholera.
Source: StateAs of 28 October 2025, a total of 94,549 cases of cholera including 1,567 deaths have been reported since the start of the outbreak. Nine out of ten states have been affected with the majority of cases reported in Rubkona, Juba, Mayom and Aweil West. Please see our Topics in Brief article for further details on cholera.
Source: WHOAs of 3 March 2025, over 57,100 cases of cholera and 1,500 deaths have been reported since the start of the outbreak. Cases have been reported in 88 localities across 12 states. Please see our Topics in Brief article for further details on cholera.
Source: WHOOn 22 January 2025, the World Health Organization reported that the current cholera outbreak in South Sudan has recorded 21,000 cases and 367 deaths. Cases have been reported in 31 out of 80 counties across seven states. Please see our Topics in Brief article for further details on cholera.
Source: WHOAs of 21 December 2024, 4,793 suspected and confirmed cases of cholera, including 47 deaths, have been reported. There has been a 147% increase in case numbers over the previous four week period. Six out of ten states have been affected. Severe flooding and mass displacement of people have worsened the situation. Please see our Topics in Brief article for further details on cholera.
Source: Africa CDCCholera in DRC
As of 11 May 2026, a total of 26,750 cholera cases, with 783 deaths, have been reported in the Democratic Republic of the Congo for 2026. Please see our Topics in Brief article for further details on cholera.
As of 10 December 2025, a total of 67,124 suspected cholera cases (1,939 deaths) have been reported in 12 out of 26 provinces during 2025. Please see our Topics in Brief article for further details on cholera.
Source: Africa CDCBetween 1 January and 31 August 2025, a total of 51,074 suspected cholera cases and 1,539 deaths have been reported across 20 out of 26 provinces. Of the 6,648 samples analysed, 2,866 tested positive for cholera. Localised surges in cases are still causing concern, particularly in Goma (North Kivu), in South Kivu, and in parts of Kinshasa. Please see our Topics in Brief article for further details on cholera.
Source: WHOBetween 12 and 18 July 2025, 1,820 new confirmed cholera cases and 81 deaths were reported in DRC. The total number of cases reported in 2025 are 38,366 cases and 1,007 deaths across 12 out of 26 provinces. Please see our Topics in Brief article for further details on cholera.
Source: Africa CDCBetween 2-8 June 2025, the Democratic Republic of the Congo reported 1,093 suspected cholera cases and 35 deaths, marking a decrease from 1,530 cases and 45 deaths recorded the previous week. Since 1 January 2025, a total of 30,485 suspected cases and 655 deaths have been reported across the country, with half of the 26 provinces reporting cases.
Source: WHO
