In the U.S., cholera was prevalent in the 1800s; however, the cholera outbreak is still a serious problem in other parts of the world. Cholera is most common in Asia, South Africa, and Latin America. It is most common in places with poor sanitation, war, and crowded places. Cholera is caused by eating food and drinking water contaminated by the bacterium vibrio cholera. It is usually found in food or water contaminated by the feces of an infected person. Cholera is not transmitted directly from person to person.
What is Cholera?
Cholera is an extremely virulent disease caused by ingesting contaminated food and water. It causes severe watery diarrhea. It takes around 12 hours to five days for the symptoms to develop. Cholera affects adults and children and can kill within hours if left untreated. Most people infected with Vibrio cholerae do not develop any symptoms even after the presence of bacteria in their feces for one-ten day. They are shed back into the environment, which affects other people.
What Are the Available Cholera Vaccines?
The cholera vaccine is a live oral vaccine available as CVD 103-HgR or Vaxchora (licensed by US FDA). They were licensed in the United States in 2016. The vaccine is administered as a single dose with buffer salt to neutralize the stomach acid. The Vaxchora vaccine is recommended to be administered eight hours after the dose of the oral typhoid vaccine. Vaxchora has been reported to reduce the chances of severe diarrhea in people. There is a reduction of severe diarrhea by 90 % ten days after vaccination and an 80 % reduction three months after vaccination. The vaccine's effectiveness and protection are not yet known in breastfeeding women. There are three other vaccines available. They are oral inactivated, non-live cholera vaccines. They are Dukoral, Euvichol-Plus, and ShanChol. Two doses of all of these vaccines are required for full protection.
Dukoral vaccine is given to people above two years of age and is administered with a buffer solution that requires 150 ml of clean water for adults. Minimum seven days and not more than six weeks gap should be there between each dose. The children between the ages two-five require a third dose. Dukoral is mainly recommended for travelers as two doses of Dukoral protect against cholera for two years. Shanchol and Euvichol are the same vaccine but are produced by two different brand names. These vaccines do not require a buffer solution for administration, and they are recommended to be given to individuals over the age of one year. There must be a gap of a minimum of two weeks between each dose of this vaccine. Two doses of Shanchol and Euvichol protect against cholera for three years, and a single dose protects for a short period. These vaccines are available for mass vaccinations.
How is Cholera Vaccine Given?
The cholera vaccine is usually given orally as a single dose. The vaccine is powdered and mixed with water before taking it. The best time to receive the vaccine is ten days before travel. After the vaccination, one should wash the hands often, especially after using the restroom or handling food. Seven days after receiving the vaccine, the live cholera bacteria can pass into the feces, so during this time, avoid body fluids from coming in contact with hands and other surfaces. Also, avoid contact with people who have a weak immune system.
Who Should Take the Cholera Vaccine?
The cholera vaccine is not 100 % effective against cholera and does not protect against other food or water-borne diseases. The vaccine is recommended for all travelers traveling to the high-risk area for cholera, between 18-64 years old.
Who Should Not Take the Vaccine?
These people should avoid taking the cholera vaccine:
Those who have been allergic to the cholera vaccine in the past.
People with weak immune systems.
Recently on anti-biotic medications.
Those taking anti-malarial drugs.
People having any other allergies.
What Are the Measures to Be Considered Before Taking the Vaccine?
Before taking the vaccine, the following things should be considered:
Drug Interaction - It is very important that a healthcare provider knows about any other drugs taken that may interact with the vaccine.
Allergies - Talk to a healthcare provider if one has any kind of allergy or have had severe allergic reactions. Also, discuss other allergies like food, dyes, preservatives, or animals.
Pediatric and Geriatric - Safety and efficacy have not yet been established in the pediatric and geriatric age groups.
Breastfeeding - Talk with a healthcare provider and weigh the potential benefits and risks before taking the vaccination while breastfeeding.
What Are the Side Effects of the Cholera vaccine?
Along with benefits, there can be a few unwanted side effects. It may not happen for all, but if they do, they may need medical attention. The common side effects are:
How to Prevent Cholera?
Cholera vaccines offer insufficient protection. Cholera can be prevented by:
Avoid eating uncooked food, especially fish and shellfish.
Avoid water that may be infected.
Vaccination may help protect one from cholera if they travel to cholera-infected areas.
Along with being vaccinated, it is important to be careful about what you eat and drink while traveling and try to practice good hygiene to prevent such diseases.
Avoid eating ice cubes that are not made from bottled water.
Cholera is a global threat to public health. Cholera is highly treatable, so it is important to get treatment immediately.