Dukoral

How does it work?
Dukoral oral cholera vaccine contains a mixture of inactivated Vibrio cholerae bacteria (the bacteria that cause cholera) and a non-toxic component of the toxin that these bacteria produce. It works by stimulating the body's immune response to the cholera bacteria, without actually causing the disease.

When the body is exposed to foreign organisms such as bacteria, the immune system produces antibodies. These antibodies help the immune system to recognise and kill the foreign organisms. Each foreign organism causes the body to produce a different type of antibody that only recognises that specific invader.

The antibodies formed remain in the body and recognise any future infection with the same organism. This allows the immune system to attack the organism rapidly and so prevent it causing disease. This protection from infections is known as immunity.

Immunity can be produced artificially by giving vaccines. A vaccine is a bacteria, bacterial toxin or virus that has been inactivated or altered in some way so that it does not cause disease. However, because the body recognises the vaccine as a foreign invader, it produces antibodies against it in the same way as it would against the genuine infecting organism. If the body then encounters the genuine infecting organism it is already prepared and can launch an attack against it rapidly.

Each organism stimulates the production of a specific type of antibody, so a different vaccine must be used for each disease. This cholera vaccine produces antibodies against Vibrio cholerae bacteria serogroup 01 and the toxin these bacteria produce, which causes the symptoms of cholera.

This vaccine is taken by mouth. For adults and children over six years of age two doses are needed. Children aged two to six years need three doses. The doses should be taken at least a week apart. (But if more than six weeks are left between doses the course must be started again.) The vaccine course should be finished at least a week before travel to an area where cholera is a risk.

For continued protection a booster dose can be given after two years for adults and children over six years, and after six months for children aged two to six years.

Cholera vaccination is not given routinely in the UK, as the disease is no longer a risk in this country. The vaccine is licensed for people who are travelling to countries where the disease is a risk, according to official recommendations. However, vaccination is not an official requirement for travellers entering any country. The vaccine may be recommended for backpackers and those travelling to situations where the risk of cholera is greatest (eg refugee camps). However, even if you have received this vaccination, you must still take great care with food, water and personal hygiene measures to avoid the disease, since the vaccine does not provide complete protection against cholera.

What is it used for?

Vaccination against cholera in adults and children from two years of age

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