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Cholera


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11 replies to this topic

#1 cheetah80

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Posted 12 May 2014 - 09:49 AM

Hello,

 

I have a bit of a dilemma - after many years of travelling all over the world I have changed the medical clinic which I visit and suddenly I am being recommended Cholera prevention medicine, which I have never been prescribed before.  I usually meticulously follow doctors' advice, but this Cholera thing strikes me as a bit strange.  My boyfriend goes to a different local clinic and is never advised to take it, and I have spoken to a friend abroad doing similar trips and he has never been advised to take this either.  So I just want to know whether any of you take it?  If it helps my destinations for this year will be the Masai Mara, Hwange, Chobe & Mana Pools.  I won't be straying away from the standard tourist trails, and I will not have stays in villages etc.  


Edited by cheetah80, 12 May 2014 - 09:50 AM.


#2 Soukous

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Posted 12 May 2014 - 11:14 AM

Here's the advice given in the UK

 

Cholera

 

Introduction

Cholera is an acute diarrhoeal illness caused by the bacterium Vibrio cholerae. The disease infects the small bowel and causes painless, watery diarrhoea. It is known to only infect humans.

Cholera is usually transmitted via infected water that has been contaminated by faeces and less commonly via food.

The disease is found throughout the world particularly in countries where sanitation is poor particularly parts of Africa, India and South East Asia.

The Illness

The disease causes rapid onset of watery diarrhoea and vomiting. Extreme dehydration can occur due to the affected individual's inability to retain fluids orally. Medical attention should be urgently sought as individuals can die quickly if they are not treated promptly.

Treatment

Antibiotic therapy is required in conjunction with rapid and adequate fluid replacement.

Recommendations for Travellers

Prevention is focused on ensuring safe food and water, particularly in countries where cholera is more common. Food and drink to be wary of include untreated water, ice, shellfish, salads, unwashed fruit and vegetables.

Good personal hygiene is also very important. Individuals should ensure that they wash their hands prior to eating and after visiting the bathroom.

A vaccine called Dukoral is available to protect against cholera. Adults and children over 6 years require 2 doses. The vaccine is administered at intervals of at least one week and immunisation should be completed at least 1 week prior to potential exposure. For those at ongoing risk a booster dose is required at 2 years. The requirements for children under 6 years should be discussed with the GP. Individuals should consider being vaccinated if they are travelling to a country where cholera is present and they will be unable to take reasonable precautions with food and water, for example, during wars and when working in refugee camps or slum areas.


Edited by Soukous, 12 May 2014 - 11:15 AM.

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#3 cheetah80

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Posted 12 May 2014 - 11:57 AM

Thanks @Soukous, I have to double check as from what I understood my doctor said it needs to be taken EVERY 2 years - it is expensive so it makes a difference.  I already have the first round so if a booster will protect me for a longer period I might go for it.  

 

" Individuals should consider being vaccinated if they are travelling to a country where cholera is present and they will be unable to take reasonable precautions with food and water, for example, during wars and when working in refugee camps or slum areas."

 

From the description here it would seem that as I suspected, it is not necessary as I would imagine reasonable precautions are taken in tourist camps and when we self-drive we have an even larger degree of control.

 

My thought is that some doctors think the whole of Africa is a slum infested warzone & just give out vaccinations blindly ... 



#4 Soukous

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Posted 12 May 2014 - 12:14 PM

Cholera is both preventable and treatable.

A> It is highly unlikely you will catch it if you take sensible personal hygiene precautions and drink bottled/filtered water

B> If you think you have symptoms you can easily get treatment.

 

My local GP surgery is pretty paranoid about inoculations and tablets for travel to Africa but they do not seem to consider Cholera as a real risk.

 

One has to allow for a certain amount of arse covering in all this. They are covering themselves aginst the outside possibility that IF your doctor said there was no need for a shot and IF you then contracted Cholera you might then sue them.

 

Oops, does that sound cynical?


Edited by Soukous, 12 May 2014 - 12:15 PM.

"if you think you're too small to make a difference, try spending the night in a closed room with a mosquito."

Martin Dunn FRGS

 

website: www.wildlifephotographyafrica.com

facebook: Wildlife Photography Africa

twitter@wildphotoafrica


#5 madaboutcheetah

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Posted 12 May 2014 - 01:33 PM

@cheetah80 - I don't think you should worry about those 4 locations? You are probably going to Porini etc etc., where bottled water is easily available ...... The quality of the fresh fruit and Veg on safari is fantastic and I enjoy all of it, usually ......


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#6 Whyone?

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Posted 12 May 2014 - 02:29 PM

There most certainly have been Cholera outbreaks in Zim in recent years - we were stopped in Chinhoi and advised not to stop (!!!) because of an ongoing outbreak.  Maybe it is outbreaks such as this (and other more serious ones in Harare) which have flagged the need for precautions to be taken on our medical centers systems?

 

For what it is worth, I have never taken precautions, despite drinking water drawn (and boiled) from the Zambezi.


Edited by Whyone?, 12 May 2014 - 02:30 PM.


#7 cheetah80

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Posted 12 May 2014 - 03:51 PM

Yes I think it is a case of the doctors being overly cautious and not really understanding the nature of the trips - so I just wanted to double check with other advice given before taking decisions as I found it odd that I am being prescribed this Cholera vaccine and my partner isn't!  Thanks for the inputs!  



#8 marg

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Posted 13 May 2014 - 04:40 AM

is your doctor a regular doctor or a travel medicine doctor...this might make the difference in recommendations.



#9 cheetah80

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Posted 13 May 2014 - 09:13 AM

@marg, good point - I went to a regular doctor listed as having Travel Medicine skills, as that's what's available with my health insurance.  They do work off the same database as the more specialized ones I guess - perhaps then the interpretation is more generic & cautious.



#10 JohnR

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Posted 13 May 2014 - 10:43 AM

When I had a job in Naples (Italy) I was told to get a cholera jab before I went and in those days I got a certificate for 6 months. When I got to Naples they laughed and said its protection barely lasted 3 months and was a waste of time. Simple hygiene was enough. The furthest we went was washing salads in a mild bleach solution.

 

Visiting Tanzania in 2005 I was advised by their consulate to have a paper saying I had had a jab which my Doctor ordered and then  wrote a letter as there is now no official document unlike other inoculations.

 

So I would only do it if it was a condition of entry to a country or if I was going to a region with a current outbreak.


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#11 JulieM

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Posted 18 May 2014 - 05:34 AM

The other thing that the Dukoral oral vaccine protects against is traveller's diarrhoea.  It's about 50% protective.  I have taken it in the past for that reason more so than for cholera risk, but then I absolutely detest vomiting and will do anything and pay anything to avoid it if I can!  We took the family to Vietnam a few years back and hubby, myself and my older son took it, but my daughter was only about 5 at the time and I could not get her to drink it - it doesn't taste very nice.  The rest of us were fine, but my daughter got gastro twice during our three week trip!


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#12 JulieM

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Posted 24 August 2014 - 08:15 AM

Scrap my last post - latest research says that Dukoral is in fact NOT protective against traveller's diarrhoea.  My daughter just must have been unlucky and we were lucky.


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