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Cholera is a potentially fatal bacterial infection caused by drinking contaminated water or eating food which has been mixed with contaminated water. The infection is spread in areas of poor sanitation, where food and water become contaminated with the faeces (stools) of an infected person. Infection can cause severe diarrhoea and vomiting, which can then lead to dehydration.

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Symptoms tend to develop within a few days of infection, although they can sometimes occur within a few hours. Not everyone who is infected will develop symptoms, but those who do will experience severe watery diarrhoea, nausea and vomiting and stomach cramps. This loss of water can result in severe dehydration which can cause the body to go into shock (due to a sudden huge drop in blood pressure).
In the most severe cases the infection can be fatal.

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Severe Diarrhoea

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Stomach Cramps

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Blood Pressure Drop

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Can Be Fatal

Countries at risk

Cholera occurs in areas of poor sanitation, with poor food and water hygiene. Outbreaks can also occur in areas of natural disasters or war zones due to overcrowding and lack of clean water. Cholera can be found in sub-Saharan Africa, South and South East Asia, the Middle East, central America and the Caribbean. There are 3-5 million cases of cholera worldwide and it is estimated the infection caused between 100,000 to 130,000 deaths in 2010.

Advice for travellers

By following basic precautions you can prevent yourself from catching cholera and travellers diarrhoea.

  • Only drink water that has been recently boiled, or drink from a bottle that is properly sealed.

  • Avoid ice cream and don't have ice in your drinks.

  • Avoid uncooked fruits and vegetables unless you have washed them in safe water or peeled them yourself.

  • Avoid shellfish, seafood or salad. Ensure food is freshly cooked and served hot.

  • Follow good personal hygiene and hand washing rules.


There is a vaccine for cholera which is 85% effective against cholera for a two year period. After this booster doses may be needed if you continue to be at risk. Two doses of the vaccine (Dukoral) is given as a drink, where the vaccination ingredients are mixed with water. All the doses must be taken between one and six weeks apart. Ideally, the vaccinations should be completed at least one week before travelling.

Number of doses

2-6 years - three doses (minimal interval 1 weeks and maximum interval 6 weeks).

Over 6 years- two doses 7 days apart



2-6 years- 6 months if continuing risk

> 6 years:2 year if continuing risk.



Meningitis ACWY For Hajj/Umrah

Meningitis symptoms can develop quickly and they can be difficult to spot as they as similar to symptoms of flu. Infection with meningitis is an emergency and requires admission into a hospital where you will be given antibiotics. All pilgrims to Saudi Arabia for Hajj or Umrah are required to show proof of vaccination in the last three years against meningitis ACWY.


Vaccination is required at least 10 days before you are due to travel and you will also receive a certificate as part of your vaccination.

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