Cholera Dukoral vaccine

Cholera is no longer routinely recommended for international travel. The Department of Health has advised that in rare circumstances where an unofficial demand be anticipated, confirmation of non requirement of cholera vaccine may be given on official note paper, signed and stamped by a medical practitioner.

The old type cholera vaccine which was given by injection offers poor protection against the disease and is no longer recommended for use by the Department of Health or the World Health Organization.

The vaccine may be considered for the following:

• People working in areas where there are known cholera outbreaks (e.g. aid workers).
• Travellers staying for long periods in known high risk areas and/or where close contact with locals is likely, and who do not have access to medical care.
• Travellers to risk areas who have an underlying gastrointestinal disease or immune suppression.

The vaccine is taken as a raspberry flavoured drink and can be used in adults and children over 2 years. It is not currently licensed in the UK for travellers diarrhoea.
The standard primary course of vaccination with Dukoral against cholera consists of 2 doses for adults and children from 6 years of age. Children 2 to 6 years of age should receive 3 doses. Doses are to be administered at intervals of at least one week. If more than 6 weeks have elapsed between doses, the primary immunization course should be re-started.

For continuous protection against cholera a single booster dose is recommended after 2 years for adults and children from 6 years of age, and after 6 months for children aged 2 to 6 years. No clinical efficacy data has been generated on repeat booster dosing. However, immunological data suggest that if up to 2 years have elapsed since the last vaccination a single booster dose should be given. If more than 2 years have elapsed since the last vaccination the primary course should be repeated.