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a.k.a Colin

Horrible bug guilty of causing diarrhoea, vomiting and severe dehydration in people travelling to South and Central America, Africa and Asia. Beware of infected food and water.

Key Fact

Cholera is difficult to distinguish from travellers’ diarrhoea.1 Approximately 20% of travellers are confined to bed for 1–2 days with travellers’ diarrhoea and 40% have to change their travel plans.2

disease risk map

How do people catch these diseases?

Mostly from food or water that has been contaminated with faeces containing the viruses or bacteria which cause these diseases.5,6

Which countries are affected?

Travellers’ diarrhoea is common in all of Central and South America, Africa, Russia, the Middle East and Asia (see map). Visitors to certain countries in these areas are also at risk from cholera (see map).3,4

What are the symptoms?

Watery diarrhoea, nausea and vomiting.6 Stomach cramps are also common in cases of cholera.7

How serious is the disease?

Most cases of travellers’ diarrhoea clear up within a few days. Dehydration is a risk in severe cases,5 so it’s important to keep drinking clean water. Electrolyte supplements may help.

Cholera is a severe and potentially fatal bacterial infection that requires urgent treatment to prevent dehydration. You’ll need to be treated with antibiotics.5

Can I reduce the chances of catching these diseases?

You can take the following precautions to help reduce your risk of infection:

  • Visit your nearest convenient pharmacy or specialist travel health clinic for a risk assessment before your trip
  • Avoid eating raw or undercooked meat, seafood, fish, fruit or vegetables.7 Choose freshly-cooked food that’s served piping hot or fruit that you peel yourself
  • Avoid ice and stick to fizzy drinks in sealed bottles or cans, or freshly boiled hot drinks7
  • Wash your hands frequently, especially before eating and after using the toilet8
  • Avoid unsanitary living conditions to reduce your risk of cholera infection9


1. Health Protection Agency. Foreign travel-associated illness: a focus on travellers’ diarrhoea. 2010 report. Available online: http://webarchive.nationalarchives.gov.uk/20140714112805/http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1287146380314 (Last accessed September 2017)

2. Ericsson CD. Travelers’ diarrhea. Epidemiology, prevention, and self treatment. Infect Dis Clin North Am 1998;12:285–303

3. World Health Organization. Countries reporting cholera, 2010-2015. September 2016. Available online: http://gamapserver.who.int/
mapLibrary/Files/Maps/Global_Cholera_2010_2015.png (Last accessed September 2017)

4. Steffen R. Epidemiology of Traveler’s Diarrhea. Clin Infect Dis 2005:41(S8);S536–40.

5. World Health Organization. Factsheet. Cholera. August 2017. Available online: http://www.who.int/mediacentre/factsheets/fs107/en/# (Last accessed September 2017)

6. Centers for Disease Control and Prevention. Yellow Book 2018. Chapter 2 The Pre-Travel Consultation. Self-Treatable Conditions. Travelers’ Diarrhea. June 2017. Available online: https://wwwnc.cdc.gov/travel/yellowbook/2018/the-pre-travel-consultation/travelers-diarrhea (Last accessed September 2017)

7. NHS Choices. Conditions. Cholera. December 2015. Available online: http://www.nhs.uk/conditions/cholera/Pages/Definition.aspx (Last accessed September 2017)

8. Fit for Travel. Disease Prevention Advice. Cholera. Available online: http://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/cholera.aspx (Last accessed September 2017)

9. TravelHealthPro. Diseases in Brief. Cholera. Available online: https://travelhealthpro.org.uk/disease/32/cholera (Last accessed September 2017)


UK/TRA/0817/0171a September 2017