Cholera Vaccine

Cholera is a disease that can cause severe diarrhea and vomiting. If it isn't treated quickly, it can lead to dehydration and even death. About 100,000-130,000 people are thought to die from cholera each year, almost all of them in countries where the disease is common.

Cholera is caused by bacteria, and spread through contaminated food or water. It isn't usually spread directly from person to person, but it can be spread through contact with the feces of an infected person.

Cholera is very rare among U.S. citizens. It is a risk mostly to people traveling in countries where the disease is common (mainly Haiti, and parts of Africa, Asia, and the Pacific). It has also occurred in the United States among people eating raw or undercooked seafood from the Gulf Coast.

Being careful about what you eat and drink while traveling, and practicing good personal hygiene, can help prevent waterborne and foodborne diseases, including cholera. For someone who has been infected, rehydration (replacing water and chemicals lost through diarrhea or vomiting) can greatly reduce the chance of dying. Vaccination can reduce the risk of getting sick from cholera.

The cholera vaccine used in the United States is an oral (swallowed) vaccine. Only one dose is needed. Booster doses are not recommended at this time.

Most travelers do not need cholera vaccine. If you are an adult 18 through 64 years old traveling to an area where people are getting infected with cholera, your health care provider might recommend the vaccine for you.

In clinical studies, cholera vaccine was very effective in preventing severe or life-threatening cholera. However, it is not 100% effective against cholera and does not protect from other foodborne or waterborne diseases. Cholera vaccine is not a substitute for being careful about what you eat or drink.

Tell the person who is giving you the vaccine:

• If you have any severe, life-threatening allergies. If you have ever had a life-threatening allergic reaction after a previous dose of any cholera vaccine, or if you have a severe allergy to any ingredient in this vaccine, you should not get the vaccine. Tell your health care provider if you have any severe allergies that you know of. He or she can tell you about the vaccine's ingredients.

• If you are pregnant or breastfeeding. Not much is known about the potential risks of this vaccine for a pregnant or breastfeeding woman. A registry has been set up to learn more about vaccination during pregnancy. If you get the vaccine and later learn you were pregnant at the time, you are encouraged to contact this registry at 1-800-533-5899.

• If you've recently taken antibiotics. Antibiotics taken within 14 days before vaccination may cause the vaccine to not work as well.

• If you are taking antimalaria drugs. Cholera vaccine should not be taken with the antimalarial medication chloroquine (Aralen). It is best to wait at least 10 days after the vaccine to take antimalaria drugs.

Always wash your hands thoroughly after using the bathroom and before preparing or handling food. Cholera vaccine can be shed in feces for at least 7 days.

If you have a mild illness, like a cold, you can probably get the vaccine today. If you are moderately or severely ill, your doctor might recommend waiting until you recover.

What should I look for?

• Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or unusual behavior.

• Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would usually start within a few minutes to a few hours after the vaccination.

What should I do?

• If you think it is a severe allergic reaction or other emergency that can't wait, call 9-1-1 and get to the nearest hospital. Otherwise, call your clinic.

• Afterward, the reaction should be reported to the ''Vaccine Adverse Event Reporting System'' (VAERS). Your doctor should file this report, or you can do it yourself through the VAERS web site at http://www.vaers.hhs.gov, or by calling 1-800-822-7967.

VAERS does not give medical advice.

• Ask your healthcare provider. He or she can give you the vaccine package insert or suggest other sources of information.

• Call your local or state health department.

• Contact the Centers for Disease Control and Prevention (CDC): call 1-800-232-4636 ( 1-800-CDC-INFO) or visit CDC's website at http://www.cdc.gov/cholera/index. html and http://www.cdc.gov/cholera/general/index.html.

Cholera Vaccine Information Statement. U.S. Department of Health and Human Services/Centers for Disease Control and Prevention National Immunization Program. 7/6/2017.