Country Information updates: cholera

NaTHNaC has reviewed the country-specific cholera information and vaccine recommendations for United Kingdom (UK) travellers on the TravelHealthPro website

NaTHNaC and the UK Health Security Agency have recently reviewed destination-specific specific cholera information and vaccine guidance to provide up-to-date recommendations for UK travellers and travel health professionals [1-5]. Further information is available about this review.

Cholera is a potentially fatal infection which causes severe diarrhoea. Infection is usually a result of eating or drinking food or water contaminated with cholera bacteria Vibrio cholerae (V. cholerae).

Cholera is no longer a risk in the United Kingdom (UK) but is sometimes reported in returning UK travellers. There are two oral cholera vaccines available in the UK, they are only recommended for certain travellers [6].

Advice for travellers

Before you travel

Check our Country Information pages for the latest guidance on cholera risk at your destination and for specific advice about other health hazards. If you think you are at increased risk of cholera, make an appointment with your GP, practice nurse, travel clinic or a pharmacy to discuss if a cholera vaccine is appropriate for you.

For most travellers, the risk of cholera is very low, with estimates of two to three cases reported per million travellers [6].

For travellers at higher risk, the cholera vaccine can be considered following a full risk assessment by your travel health professional. These travellers include:

• humanitarian aid workers
• people going to areas of cholera outbreaks with limited access to safe water and medical care
• other travellers to cholera risk areas, for whom vaccination is considered potentially beneficial due to their occupation, activities or underlying health problems [6].

The latest news about larger cholera outbreaks is available in our Outbreak Surveillance section.

While you are away

Reduce your risk of illnesses spread by food and water by:

• Following good food and water hygiene advice at all times
• Taking care with your personal hygiene
• Avoiding drinking or rinsing your mouth with any water from freshwater sources, such as springs and wells, including holy water

Seek urgent medical attention locally if you have any symptoms of cholera.

When you return

Get urgent medical advice if you have returned from a country with cholera and you have:

• severe watery diarrhoea and/or vomiting
• signs of dehydration, like feeling very thirsty and/or dark yellow, strong-smelling urine (pee)

Remember – tell the health professional treating you that you recently visited a country with cholera.

Advice for health professionals

Health professionals should check our Country Information pages and advise travellers about their destination specific risk of cholera. Cholera vaccine should be offered to those at increased risk of infection; further information is available in our cholera factsheet.

Health professionals should be alert to the possibility of cholera in returned travellers presenting with a severe watery diarrhoeal illness. Stool samples (or rectal swabs if stool not available) with full clinical and travel histories should be sent to their local microbiology laboratory for testing. Isolates of V. cholerae can be referred for typing by the microbiology laboratory to the UK Health Security Agency Gastrointestinal Bacterial Reference Unit.