US adults traveling to cholera-affected areas can now be vaccinated against the disease.
US adults traveling to cholera-affected areas can now be vaccinated against the disease, as the FDA recently approved Vaxchora, the first immunization available in the United States for cholera prevention.
Cholera, which is caused by the bacteria Vibrio cholerae, isn’t a common cause for concern within US borders. However, it’s a significant global health issue, particularly in areas of Africa, Asia, and Central America. In fact, current outbreaks are reported in the Democratic Republic of the Congo, Kenya, Malawi, Mozambique, Tanzania, and Zambia.
V. cholerae typically causes an acute illness characterized by diarrhea presenting 2 to 3 days following bacterial infection. Although symptoms are often mild, approximately 5% to 10% of infected individuals develop profuse watery diarrhea and vomiting with the potential for subsequent dehydration and associated symptoms of electrolyte imbalance. In those cases, immediate rehydration is required to prevent death and should be considered the mainstay of treatment.
Antibiotic therapy is reserved for severe disease and should only be used in conjunction with rehydration to reduce diarrheal episodes and shorten the disease course. Options include azithromycin, ciprofloxacin, doxycycline, erythromycin, or tetracycline, although clinical guidelines differ on antibiotic treatment recommendations.
Perhaps the best option for cholera is prevention. V. cholerae is most commonly transmitted via the fecal-oral route and is often found in contaminated water and food sources. Additionally, the bacterium can grow in coastal waters. As a result, endemic areas are focusing on hygiene, sanitation, and water treatment as preventive measures.
Travelers to those areas should consider the following precautions to reduce their risk of cholera infection:
Vaxchora is an additional preventive measure for travelers to cholera-affected areas. This live, attenuated vaccine provides activity against V. cholerae serogroup O1, which is 1 of 2 toxigenic groups previously implicated in cholera epidemics.