Traveller’s diarrhea and cholera vaccine

Travel vaccines are recommended for people visiting or working in some countries. It is important to talk to your health care provider or visit a travel clinic at least 6 to 8 weeks before you leave on a trip.

Most travel vaccines are not covered by the provincial Medical Services Plan (MSP), so check with your local travel clinic to find out the cost.

Bring a copy of your immunization records to your medical appointment. Keep a record of any travel vaccines you receive and take it with you on your trip.

What is the traveller’s diarrhea and cholera vaccine?

The vaccine gives you some protection against traveller’s diarrhea and cholera, which are infections caused by 2 types of bacteria.

The vaccine is approved by Health Canada.

Who should get the vaccine?

If you are travelling to or working in Central and South America, the Caribbean, Southeast Asia, Middle East, Africa, and Eastern or Southern Europe, it may be beneficial to get the vaccine. The travel clinic doctor or nurse will advise if you should receive the vaccine. A booster dose may be required if you continue to travel or work in these areas.

Most travellers following the usual tourist itineraries in countries affected by cholera are at extremely low risk of acquiring cholera infection. Travellers' diarrhea is usually a mild and short-term illness. This vaccine is only recommended for those who are the highest risk of infection only. Not all recipients of this vaccine will be fully protected against cholera or travellers' diarrhea.

How is the vaccine given?

Traveller’s diarrhea

Adults and children 2 years of age and older are given 2 doses of the vaccine to take at home by mouth (orally). A booster dose may be required every 3 months. Please note that this vaccine needs to be refrigerated; bringing the vaccine with you in your travels may be a challenge.

Cholera

Adults and children over 6 years of age are given 2 doses of vaccine to take orally at home. A booster dose may be required every 2 years.

Children 2 to 6 years of age are given 3 doses of vaccine to take orally at home. A booster dose may be offered every 6 months.

The vaccine will start offering protection about one week after taking the last dose.

The travel clinic will provide instructions on how to take the vaccine at home. It is important to follow the instructions.

What are the possible reactions after the vaccine?

Reactions are mild and temporary. The most common reactions are stomach pain, diarrhea, nausea and vomiting.

After getting any vaccine there is an extremely rare possibility, less than one in a million of a life-threatening allergic reaction called anaphylaxis. This may include hives, difficulty breathing, or swelling of the throat, tongue or lips. Should this reaction occur, your health care provider is prepared to treat it. Emergency treatment includes administration of epinephrine (adrenaline) and transfer by ambulance to the nearest emergency department. If symptoms develop, call 9-1-1 or the local emergency number.

It is important to always report serious or unexpected reactions to your health care provider.

Who should not get the vaccine?

Speak with a travel clinic doctor or nurse if you:

• Have had a life-threatening reaction to a previous dose of cholera vaccine, or any component of the vaccine including saccharin; or
• Currently have a fever or stomach illness

Children under 2 years of age should not receive the vaccine.

What is traveller’s diarrhea?

Traveller's diarrhea is frequent, loose, or watery bowel movements usually from eating or drinking contaminated foods or fluids. Symptoms may also include stomach cramps, nausea, vomiting, bloating and feeling unwell. Symptoms can begin 14-30 hours after infection and can last 3 to 5 days.

The most common cause of traveller’s diarrhea is food or water contaminated with bacteria called enterotoxigenic E. coli (ETEC). These bacteria are found in the bowel movements (stool) of infected people. People who use the bathroom without proper hand washing can pass the bacteria on to others through food preparation or hand-to-mouth contact. Food can also be contaminated when stool is used as fertilizer, or when contaminated water is used to spray vegetables in market stalls.

What is cholera?

Cholera is a serious and sometimes life-threatening infection caused by the bacteria Vibrio cholerae. People infected may have no symptoms or only mild diarrhea. However, others can develop very severe, watery diarrhea and vomiting. Without treatment, this can lead to severe dehydration and death.

Like ETEC, cholera bacteria are also found in the stool of infected people and the disease is spread in the same way. In addition, cholera bacteria can live in the water of certain coastal areas. The disease can then be spread by eating raw or undercooked seafood and shellfish.

What other precautions can I take when I am travelling?

It is very important to have good personal hygiene and to take food and drink precautions. For more information, please visit HealthLinkBC File #41a Health advice for travellers.

Mature minor consent

It is recommended that parents or guardians and their children discuss consent for immunization. Children under the age of 19, who are able to understand the benefits and possible reactions for each vaccine and the risk of not getting immunized, can legally consent to or refuse immunizations. For more information on mature minor consent please visit HealthLinkBC File #119 The Infants Act, mature minor consent and immunization.

For more information

For a list of travel clinics in B.C., visit the Public Health Agency of Canada:www.canada.ca/en/public-health/services/travel-health/yellow-fever/vaccination-centres-canada-british-columbia.html.

For more information on travel vaccines, please visit HealthLinkBC File #41c Travel immunizations for adults.