• Cause: Vibrio cholerae
• Transmission: Ingestion of contaminated water or food (esp. street food, seafood)
• Symptoms: Profuse watery diarrhea (“rice water stools”), vomiting, dehydration, shock
• Incubation: Hours to 5 days
• Mortality: Can exceed 50% if untreated; <1% with rehydration

Cholera Seasonality in Asia

Region	Peak Cholera Season
South Asia	Pre- and post-monsoon (e.g. April–June and Sept–Nov)
Southeast Asia	Rainy season (May–October, depending on location)
Endemic zones	Can have year-round transmission, especially near rivers, during flooding or disasters

Prevention Without Vaccination

• Drink only bottled or purified water
• Eat well-cooked food, avoid raw seafood and street salads
• Hand hygiene: soap and water or alcohol-based sanitiser
• Use boiled water for brushing teeth

Who Should Consider Vaccination?

Australian guidelines (per ATAGI & Australian Immunisation Handbook) suggest cholera vaccination for:

• Humanitarian or disaster-relief workers
• Travellers to areas with active outbreaks, poor sanitation, or limited access to health care
• Individuals with underlying conditions (immunosuppression, low stomach acid)
• Military or aid workers in refugee camps or flood zones

Routine tourists in Asia generally have low risk if sticking to well-maintained accommodation with safe food and water.

Available Vaccine in Australia

Vaccine Name	Type	Dosing	Duration of Protection
Dukoral®	Oral, inactivated	2 doses (≥6 years, including adults) Dose 1: ≥ 2 weeks before travel Dose 2: ≥ 1 week after dose 1 and ≥ 1 week before travel If > 6 weeks between doses, restart series 3 doses (2–6 years) Dose 1: ≥ 3 weeks before travel Dose 2: ≥ 1 week after dose 1 Dose 3: ≥ 1 week after dose 2 and ≥ 1 week before travel If > 6 weeks between any, restart series	Children 2–6 years: ~6 months Adults & ≥6 years: ~2 years