Two young women travelling together carrying their luggage.

This acute infection can cause severe diarrhoea and vomiting, leading to rapid dehydration and in some cases death. While it’s rare for travellers to pick up the infection, it’s still important to take precautions when travelling to high-risk areas.

Did you know?

  • There are between 2 and 6 cases of cholera in Australia each year, almost always in people who have travelled to countries where cholera is common.1
  • Around the world, there are an estimated 2.9 million cases and 95,000 deaths from cholera each year2.
two travelling partners riding their bicycles past an Asian temple.

What is it?

Cholera is a bacterial infection of the intestine caused by the Vibrio cholerae bacteria. The disease is endemic in about 50 countries, particularly Africa, South Asia and Southeast Asia.

The infection is transmitted via food and water that has been contaminated with the cholera-causing bacteria. This usually occurs in areas where hygiene and the quality of drinking water are poor.

What are the symptoms?

Most people infected with cholera do not develop any symptoms.

For those who do develop symptoms, most will experience mild diarrhoea. Some people, though, will develop severe symptoms with a sudden onset of excessive watery diarrhoea and vomiting. This can lead to a rapid loss of body fluids, causing serious dehydration and potentially death.

This is not a full list of symptoms that can occur following cholera infection. If you feel unwell while travelling or when you return home, make sure you see a doctor as soon as possible.

How is it spread?

Infection most commonly occurs from consuming food or drinks that have been contaminated with the cholera bacteria – such as water, ice, seafood, fruits and uncooked vegetables or leftover food that has not been properly reheated.

The bacteria can occur naturally, or it can be introduced to food or water from the faeces of an infected person.

Who is at risk?

The risk of cholera infection in travellers is generally very low, even in countries where cholera is common. The risk increases if you: 

  • work in disaster situations and refugee camps
  • have a condition such as inflammatory bowel disease, impaired immunity or major heart disease.

To help reduce your risk of cholera infection:

  • only drink and use safe, clean water (sealed bottled water or boiled water), even for things like brushing teeth
  • don’t put ice in drinks unless you know it’s from safe water
  • wash hands often using soap and safe, clean water
  • avoid eating food kept at room temperature for several hours
  • avoid uncooked food, including salads and fruit that cannot be peeled, and seafood
  • thoroughly boil or cook food and drinks.

An easy way to remember it: if you can’t boil it, cook it or peel it, forget it.

Other people may be at risk of cholera infection. Please speak to your doctor if you have any concerns about cholera infection.

Who should be vaccinated?

  • As the risk of cholera infection is quite low, Australian health authorities rarely recommend that Australian travellers receive the cholera vaccine. However, it may be recommended if you fall into a higher risk category (see ‘Who is at risk’ section).

    Speak to your doctor for more information.

Treatment

To prevent severe dehydration and potential death, it’s vital that a cholera infection is treated quickly. Treatment for mild cholera usually involves oral rehydration solutions to replace fluids and salts lost through diarrhoea and vomiting – it’s advised that travellers carry such solutions in case of cholera infection. More serious cases may need intravenous fluids and antibiotics.

Important information

It is important to plan ahead and see your doctor at least 6 to 8 weeks before you travel to discuss immunisation and travel health.

Some side effects may be experienced following immunisation. Please discuss any side effects or concerns with your doctor.

References

  1. Australian Technical Advisory Group on Immunisation. The Australian Immunisation Handbook 10th Edition (2018 update). Australian Government Department of Health. https://immunisationhandbook.health.gov.au/vaccine-preventable-diseases/cholera (accessed September 2018)
  2. Centers for Disease Control and Prevention (CDC); Cholera. Available at: https://www.cdc.gov/cholera/general/index.html (accessed September 2018).

AUS/VAC/0084/18 Date of Approval: November 2018