Cholera
Cholera is a disease, characterised by profuse, watery diarrhoea, caused by certain toxin-producing forms of the bacteria called Vibrio cholera. Cholera is transmitted by ingesting (eating and drinking) contaminated water or food. It is common in many low-income countries and is largely linked to poverty, bad sanitation and poor access to clean drinking water.
The risk of cholera for most travellers is extremely low. Activities that may increase risk include drinking untreated water or eating poorly cooked food (particularly seafood) in areas where outbreaks are occurring. Travellers living in unsanitary conditions, including humanitarian workers in disaster/refugee areas, are also at risk.
Cholera can be mild or occur without symptoms in healthy individuals. Symptoms include sudden, profuse, watery diarrhoea with associated nausea and vomiting. If untreated, cholera can rapidly lead to serious dehydration and shock; fifty percent of those with serious complications, die. With quick and effective treatment, risk of dying is less than one percent.
Prevention
Travellers can reduce their risk of being ill from cholera by ensuring good personal hygiene and following advice on preventing food and water spread diseases.
Cholera vaccines
In the United Kingdom (UK) cholera vaccination is not recommended for most travellers. It is only advised for travellers whose activities or medical history put them at increased risk, including:
- Aid workers.
- Those going to areas of cholera outbreaks who have limited access to safe water and medical care.
- Those for whom vaccination is considered potentially beneficial (i.e. for those who do not fit into the above groups, but are still considered at higher risk).
There are two cholera vaccines available in the UK: Dukoral® and Vaxchora®.
Dukoral® is an oral (drink), inactivated cholera vaccine that protects against V. cholerae serogroup O1.
Vaccine schedule (Dukoral)
| Age range | Schedule | Duration of protection |
| Adults and children from 6 years | Two doses with an interval of at least 1 week but less than 6 weeks between them* | 2 years |
| Age 2 to below 6 years | Three doses with an interval of at least 1 week but less than 6 weeks between them* | 6 months |
*If more than 6 weeks have elapsed between doses the primary course should be restarted. If more than 2 years (or 6 months for children aged 2 to below 6 years of age) has elapsed since the last dose of vaccine, the primary course should be repeated.
Further information about Dukoral® can be found in the Summary of Product Characteristics (SPC).
Vaxchora® is also an oral (drink) cholera vaccine that protects against V. cholerae serogroup O1.
Vaxchora® is a live vaccine (it contains live attenuated cholera bacteria) and is contraindicated for anyone who is immunosuppressed. See the cholera chapter of Immunisation against infectious disease (also known as 'the Green Book'), for further details.
Vaccine schedule (Vaxchora)
| Age range | Schedule | Duration of protection |
| Adults and children from 2 years of age** | A single oral dose should be administered at least 10 days prior to potential exposure to V. cholerae O1 | No data are available on revaccination interval |
**The safety and efficacy of Vaxchora® in children less than 2 years has not been established.
Further information about Vaxchora® can be found in the Summary of Product Characteristics (SPC).
Resources
- More detailed information can be found in our cholera factsheet
- UKHSA: Immunisation against infectious disease. Cholera
- UKHSA: Guidance. The diagnosis, management and epidemiology of cholera
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Recent News on Cholera
Cholera cases reported in the United Kingdom and Germany linked to Ethiopia
Information for travellers and health professionals
Updated: 07 March 2025Updated cholera 'green book' chapter published
The cholera chapter in the 'green book' (Immunisation against infectious disease) has been updated
Updated: 01 August 2024Cholera vaccine shortage: advice for health professionals
Cholera cases increase worldwide, with shortages of cholera vaccine reported
Updated: 05 March 2024Cholera: worldwide risk reminder
A reminder of the risks of cholera worldwide and the importance of good food, water and personal hygiene for all travellers
Updated: 22 June 2023Recent Cholera Outbreaks
Cholera in Angola
From 31 December 2024 to 23 March 2025, a total of 8543 cholera cases, with 329 deaths, have now been reported from 15 provinces in Angola. Please see our Topics in Brief article for further details on cholera.
Cholera in South Sudan
As of 3 March 2025, over 57,100 cases of cholera and 1,500 deaths have been reported since the start of the outbreak. Cases have been reported in 88 localities across 12 states. Please see our Topics in Brief article for further details on cholera.
Cholera in UK ex Ethiopia
As of mid February 2025, four cases of cholera have been reported in the UK. Three cases had a history of recent travel to Ethiopia, two to the Amhara region, of these one had visited the holy well at Bermel Giorgis. One case had not travelled outside of the UK but consumed water from the well. Please see our Topics in Brief article for further details on cholera.
Cholera in Germany ex Ethiopia
As of 27 February 2025, three cases of cholera have been reported in Germany. Two of the individuals had travelled to a holy site at Bermel Georgis spring, Amhara western Ethiopia and consumed water from the well. Please see our Topics in Brief article for further details on cholera.
