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Travellers’ Diarrhea/Cholera Vaccine (Liquid)
What is cholera?
• Cholera is a waterborne bacterial infection of the
intestines.
• It is spread by eating or drinking food or water
contaminated with human feces. It can lead to severe
diarrhea and dehydration.
• Approximately 90% of episodes of cholera are mild-to-
moderate in severity and are indistinguishable from other
causes of traveller's diarrhea.
• If left untreated up to 50% of infected people will die.
With appropriate treatment, the death rate is 1%.
What is travellers’ diarrhea?
• Diarrhea is the most common medical problem affecting
travellers to developing countries. It is caused by a
variety of micro-organisms, including enterotoxigenic E.coli
(ETEC) bacteria.
• Both ETEC and cholera are an important cause of
traveller's diarrhea.
• It is spread by eating or drinking food or water
contaminated with human feces.
• Traveller's diarrhea usually begins suddenly and stops on
its own within 1-5 days.
• Up to 50% of travellers can expect to have at least one
episode of acute diarrhea during a two-week stay with
20% being confined to bed for a day.
What does ETEC/cholera vaccine
contain?
• ETEC/cholera vaccine contains sodium hydrogen
carbonate and phosphate, citric acid, sodium carbonate,
saccharin sodium, sodium citrate, raspberry flavour and
formalin.
• The stopper of the vial does not contain latex.
Who should receive this vaccine?
Travellers 2 years and older:
• staying in endemic areas for a prolonged period of time,
without access to medical care
• who have the greatest risk of complications from diarrhea
(e.g. diabetes, chronic kidney failure, congestive heart
failure and any inflammatory bowel conditions)
• with an increased risk of acquiring travellers’ diarrhea
(e.g. gastric hypochlorhydria and young children > 2
years)
• who have a suppressed immune system (e.g. HIV
infection)
• with a history of repeated severe travellers’ diarrhea
• who cannot be sick for even a short period of time (e.g.
elite athletes, business or political leaders)
Who should not receive ETEC/cholera vaccine?
• Children under two years of age (effectiveness is
unknown).
• Pregnant women, except on the advice of a physician.
• People with a life threatening allergy to any of the vaccine
components.
• Anyone with moderate to severe illness may have to delay
immunization.
When should the vaccine be given?
• For ETEC diarrhea protection, for adults and children > 2
years: 2 doses, 1-6 weeks apart
• For cholera protection:
- for children 2-6 years, series of three doses, 1-6 weeks
apart
- for adults and children > 6 years, series of two doses,
1-6 weeks apart
• You must avoid food and drink one hour before and one
hour after taking this vaccine.
• If more than 6 weeks elapse between the doses, restart
the initial series.
• Separate this vaccine and encapsulated oral typhoid
vaccine by at least 8 hours.
How is the vaccine given?
• Store in the refrigerator until use. Do not freeze.
• The vaccine may be stored at room temperature for up to
two weeks on one occasion only.
• Dissolve the buffer in 150 ml (5 oz) of water (2 - 27
degrees C).
• For children 2-6 years, pour away half of the buffer/water
solution.
• Shake the vaccine vial and add the vaccine to the buffer
solution. Stir slowly and drink immediately.
How effective is the vaccine?
• Overall, will prevent 1/4 of all cases of travellers' diarrhea.
• Between 64 - 100% of people will be protected against
cholera. This vaccine does not protect against Cholera
0139 Bengal strain found in Southeast Asia.
• 50 - 67% will enjoy moderate, short-term protection
against travellers' diarrhea.
• Protection begins approximately one week following
the initial series.
How long does the protection last?
If risk continues:
• For ETEC diarrhea protection:
- booster every 3 months.
• For cholera protection:
- (children 2-6 years) booster every 6 months
- (children >6 years and adults) booster every 2 years
• Restart series if no booster within past 5 years.
What might be felt after
receiving the vaccine?
Uncommon (Between 1/1,000 to less than 1/100)
- headache, abdominal pain, stomach gurgling (gas), diarrhea.
Rare (Between 1/10,000 to less than 1/1,000)
- decreased appetite, dizziness, nausea, vomiting, fever, respiratory symptoms.
Very Rare (less than 1/10,000, isolated reports)
- dehydration, drowsiness, fainting, sore throat, indigestion, sweating, joint pain, fatigue, blood disorders, hives, allergic symptoms (itching, difficulty breathing).
For more information, call the International Travel Centre at:
(306) 655-4780.
©2008, Saskatoon Health Region. Reproduced only by permission.
(Updated January 4, 2010)
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