Cholera & traveler's diarrhea

The cholera vaccine also reduces the risk of traveler's diarrhea while traveling.

Traveller's diarrhoea


Is the most frequent illness on the journey – and can mean many lost holiday days.

There are a number of things you can do to reduce your risk of becoming infected.

Hand hygiene is important and it is a good idea to have hand sanitizer with you if water and soap are not available. 

It's also important to pay attention to what you eat and drink when traveling, as contaminated food and water can be a big problem.

In general, it is safe to eat well-cooked food served hot, fruit that you can peel yourself - such as bananas and oranges - and pasteurized dairy products.

Unopened bottled or canned beverages, as well as beverages made with boiled water and served hot, such as tea and coffee, are also usually safe to drink.

Foods and drinks that should be avoided as they may be contaminated:

  • salads, fruits and vegetables that are not prepared 

  • food, e.g. buffet, that has been left outside without being covered

  • unpasteurized dairy products

  • food containing raw eggs

  • raw or undercooked meat, fish or shellfish, including oysters

  • food from street kitchens 

  • ice cream and ice cubes

How do you get vaccinated against cholera and traveler's diarrhea?

The cholera vaccine is called Dukoral and has a protection duration of two years after two doses of the vaccine. Children between the ages of two and six should have three doses. 

The second vaccination must be given at least one week after the first dose of the cholera vaccine and no later than 6 weeks after.

You must have your last cholera vaccine at least one week before departure, and you must therefore start the vaccination program no later than 2 weeks before departure. 

Unlike most vaccines, which are injections, the cholera vaccine is a drinkable vaccine. 

You must not eat or drink an hour before and an hour after receiving the cholera vaccine, as this can affect the effectiveness of the vaccine.

The cholera vaccine, Dukoral®, provides up to 60% protection against traveler's diarrhea caused by E.coli (ETEC).

It is the most frequent cause of traveler's diarrhea. Overall, it is estimated that E.coli (ETEC) is the cause of around 30-40% of cases of traveller's diarrhoea. If 60% of these cases can be prevented by vaccination, this corresponds to Dukoral providing protection against traveler's diarrhea of approx. 20%.

It can be expected that the cover against traveler's diarrhea is 2 – 3 months.


Cholera is an acute diarrheal disease caused by the cholera bacterium Vibrio cholerae. Cholera is spread via contaminated food and water and can quickly lead to large epidemics, especially in countries with poor sanitary conditions. The primary symptom of severe cholera is acute watery diarrhea as well as nausea and vomiting.


Where are you at risk of becoming infected with cholera?

Cholera is most often transmitted via contaminated water.

Cholera bacteria can survive for a long time in water.

Cholera is rarely transmitted directly from person to person.

In which areas is Cholera found?

Cholera is most common in low-income countries in Asia, Africa and Latin America. In humanitarian disasters in particular, there is a risk of cholera outbreaks.

What symptoms can be seen in Cholera?

The cholera bacterium produces a toxin which causes the intestine to secrete large amounts of water and salt.

As a result, cholera symptoms include:

  • sudden, severe and frequent watery diarrhea

  • lack of fluid

  • low blood pressure

  • vomiting

The incubation period is between twelve hours and five days.

What treatment is available for Cholera?

The most important thing during treatment against cholera is to prevent severe dehydration and displacement of electrolytes. The treatment takes place by adding large amounts of fluid, first through a drip if you are severely dehydrated, and then through regular fluid intake.

In addition to cholera treatment using fluids, you can treat with antibiotics to shorten the period of diarrhea. People with a mild course of the disease do not need antibiotics for cholera treatment. 

How is cholera prevented?

There are many ways to prevent cholera, including by vaccination.

For effective cholera prevention when traveling in risk areas, it is recommended that you:

  • drinking clean water

  • cook fish and shellfish thoroughly

  • good hand hygiene

  • know the early signs of cholera, so that cholera treatment can be started quickly