What is cholera? How did it originate?
Cholera is a bacterial infection that causes diarrhoea, which can lead to dehydration and in some cases, death. You can catch it from consuming contaminated food or drink.
Cholera is thought to have originated in the Ganges delta in India in the 19th century, and has since spread across continents, causing pandemics that have killed millions.
The risk of a cholera epidemic is high in countries or areas where people live in crowded areas without adequate sanitation.
What are the symptoms of cholera?
Symptoms can appear a few hours or up to five days after being infected, and may be mild to severe. They include watery diarrhoea and vomiting. These symptoms can lead to dehydration, which can be fatal in a matter of hours if not treated.
How is cholera transmitted?
Cholera is spread by consuming food or drinks contaminated with the bacterium Vibrio choleraem, which is mainly found in regions, namely Africa and Asia, where there is a lack of a clean water supply or sanitation system.
You can contract cholera from:
- drinking unclean water,
- eating food that has been in unclean water, particularly shellfish,
- eating food handled by a person infected with cholera.
What is the transmission seasonality?
Cholera usually occurs in places with poor sanitation, particularly after a disaster or conflict has disrupted sanitation systems. Outbreaks may also be linked to heavy rainfall which can spread dirty water, contaminating water supplies.
What are the infected areas in the world?
Cholera occurs in places with poor sanitation, including areas of recent disasters or war. It can be found in parts of sub-Saharan Africa, the Middle East, south and southeast Asia, and Central America and the Caribbean.
What is a cholera certificate?
A cholera certificate proves you have received vaccination against cholera.
Is cholera curable?
The main treatment for cholera is fluid replacement, to combat dehydration. In severe cases, antibiotics may be prescribed.
How to prevent cholera?
Practising good hygiene habits can help prevent you catching cholera when you travel.
- wash your hands with soap and water often, especially after using the bathroom or before preparing food and eating
- drink tap water only if it has been boiled, or bottled water
- use boiled or bottled water to brush your teeth.
- ice cream and ice in drinks
- uncooked fruit and vegetables (including salads), unless you are sure they were washed in boiled or bottled water
- shellfish and seafood.
How long before a trip do you have to get the cholera vaccine?
You need to have had both doses of the cholera vaccine at least a week before travelling to be protected.
Who should get the cholera vaccine?
The cholera vaccine is recommended by the Society of Infectious Disease Singapore if:
- you plan to travel to an area where cholera is common, and you won’t have access to medical care
- you work in aid or disaster relief and will travel to a place where a cholera outbreak is likely.
Who should not get the cholera vaccine?
You should not get vaccinated if you have had a severe allergic reaction to the vaccine before, or are allergic to formaldyhyde or any of the vaccine’s ingredients.
The vaccine is not suitable of people with impaired immune response, or acute gastro-intestinal illness.
If you fall into any of the following categories, you should consult your GP to determine if the vaccine is suitable for you:
- You are acutely ill
- You are pregnant or breastfeeding
- You are scheduled to receive the yellow fever vaccine on the same day or within three weeks of receiving the cholera vaccine
If you are pregnant or breastfeeding, the vaccine is only recommended if the risk of catching cholera is high.
What is the minimum age requirement for the cholera vaccine?
Cholera vaccines are available to individuals aged 2 years and over.
What is the effectiveness of the cholera vaccine?
While the vaccine offers protection, it is not complete and it does not protect against all strains of the disease. So you should still be careful about what you eat or drink when you travel to a cholera-affected place.
What are the side effects of the cholera vaccine?
Side-effects from the cholera vaccine are uncommon, and around 1 percent of people receiving the vaccine experience some stomach pain, diarrhoea or nausea for a short time after.
How is the vaccine given?
The vaccine is given as a drink. Adults receive 2 doses, given 1 to 6 weeks apart, which provides protection for up to 2 years.
How long does it last for?
The initial vaccine for adults lasts for two years, and a booster dose is needed to extend protection after this time. Children aged 2 to 6 years old need a booster after 6 months.
When and where was the last outbreak of cholera?
The most recent outbreak of cholera was in Somalia on 2018 and is ongoing. A major outbreak in war-torn Yemen began in 2016 and continued into 2018.