Do You Need Dukoral for Your Next Trip?
Have you heard about Dukoral? It’s an oral vaccine that prevents traveller’s diarrhea caused by enterotoxigenic coli (ETEC) and cholera. But what are cholera and ETEC? Are you at risk for these diseases? Keep reading to learn more about these diseases and if you need Dukoral on your next trip.
Cholera is an infectious bacterial disease of the small intestine that causes mild to severe watery diarrhea. If left untreated it can lead to dehydration and in severe casescan lead to death. The bacteria are found in fresh and brackish water, and it is usually contracted when drinking contaminated water where the bacteria are naturally found, or when water or food are contaminated by the feces of an infected person. It can also be contracted from fish and shellfish. Cholera is more common in countries with inadequate water treatment, and poor hygiene and sanitation.
Cholera is a risk in 50 countries, mostly in Africa and South and Southeast Asia. Risk to travellers is very low for most healthy travellers. Those at increased risk include people who drink untreated water or do not properly wash hands, or eat raw or undercooked seafood. The risk is also high for aid and refuge workers in areas with a cholera outbreak or after a disaster. There is essentially no cholera risk to travellers who practice safe food and water precautions and good hand hygiene while travelling.
Dukoral is recommended if you are going to an area with an active cholera outbreak, mainly if you are an aid worker. Cholera protection is not routinely needed for Canadian travellers, as most do no visit areas where cholera is a risk. The Dukoral vaccine is 85% effective against cholera and provides protection for 2 years.
Enterotoxigenic coli (ETEC)
ETEC is an infectious bacterial disease that causes watery diarrhea that usually lasts between 1-5 days. ETEC is the most common cause of traveller’s diarrhea. It is usually contracted through food or water contaminated by the feces of an infected person but can also be spread by direct person-to-person contact or swimming in untreated water.
This risk of traveller’s diarrhea caused by ETEC is highest in less developed countries in Central and South America, the Caribbean, Africa, and South Asia. Although traveller’s diarrhea is also common in Southeast Asia, only a small percentage of cases are caused by ETEC.
Dukoral is up to 67% effective to prevent traveller’s diarrhea caused by ETEC. It does not prevent traveller’s diarrhea caused by other organisms. Protection against ETEC lasts for 3 months after taking Dukoral. Travellers wishing to protect themselves against traveller’s diarrhea caused by ETEC can take Dukoral. It is also important to practice safe food and water precautions on your trip, even after taking Dukoral.
The Public Health Agency of Canada recommends Dukoral for prevention of ETEC for travellers at high risk of health complications or serious inconvenience from traveller’s diarrhea:
- Those for whom a brief illness cannot be tolerated (i.e., elite athletes, some business or political travellers).
- Those with increased susceptibility to traveller’s diarrhea due to certain medical conditions (speak to your health care provider), or young children > 2 years of age.
- Those who are immunosuppressed
- Those with chronic illnesses that are at higher risk of serious consequences from traveller’s diarrhea (e.g., kidney failure, congestive heart failure, insulin dependent diabetes, inflammatory bowel disease)
How to Take Dukoral
Dukoral can be taken by adults and children > 2 years of age. It provides protection against cholera for 2 years and against ETEC for 3 months.
Two doses are needed when taking Dukoral for the first time:
- The first dose should be taken no later than 2 weeks before departure
- The second dose should be taken at least 1 week after the 1stdose and at least 1 week before departure
If Dukoral has been taken in the last 3 months to 5 years only a single booster dose is needed:
- The booster dose should be taken at least 1 week prior to departure
For detailed instructions on taking Dukoral visit the Dukoral Canada website.
To purchase the Dukoral vaccine at TravelSafe Clinic simply call us at 604-251-1975 or email us at firstname.lastname@example.org.
TravelSafe Clinical Educator – Kristin Cain, RN, BSc, MSc(A)