The Centers for Disease Control and Prevention (CDC) has finalized its recommendation regarding use of the cholera vaccine for adults who travel to areas of active cholera transmission.

Vaxchora is a single-dose, live oral cholera vaccine that was approved by the US Food and Drug Administration (FDA) in 2016 for preventing cholera caused by serogroup O1. The vaccine is approved for use in adults between 18 and 64 years of age and is the only FDA-approved cholera vaccine available in the US.

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The CDC defines an area of active cholera transmission as one within a country where cholera is regularly found or where a cholera epidemic is ongoing, which includes areas with cholera activity within the past year prone to a cholera epidemic. The agency’s recommendation does not include areas where cases have been rarely reported.

The following areas currently have active transmission of cholera:

  • Africa: Benin, Burundi, Cameroon, Central African Republic, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Malawi, Mozambique, Nigeria, Somalia, South Sudan, Tanzania, Uganda, Zambia
  • Asia: Afghanistan, Bangladesh, India, Iraq, Malaysia, Myanmar, Thailand, Yemen
  • Americas: Dominican Republic, Haiti

Cholera, an acute, diarrheal illness caused by infection of the bacteria Vibrio cholera, is spread by drinking water or eating food that is contaminated with cholera bacteria. Severe cholera is characterized by large amounts of watery diarrhea, along with nausea and vomiting. Rehydration is the key to treating patients with cholera, according to the CDC. Antibiotics can shorten the length of illness and help prevent loss of fluids in patients with cholera.

“Although cholera is rare, it can kill people quickly if it is not treated,” stated the CDC. “All travelers going to areas with cholera should use and drink safe water, cook food thoroughly, and wash hands properly to prevent cholera infection. Travelers who develop severe diarrhea should seek medical attention, particularly therapy to restore lost fluids, as soon as possible.”


  1. Centers for Disease Control and Prevention. CDC finalizes vaccine recommendation for adults traveling to areas with cholera [press release]. Published May 11, 2017. Accessed May 31, 2017.
  2. Centers for Disease Control and Prevention. Cholera. Updated February 2017. Accessed May 31, 2017. 
  3. Wong KK, Burdette E, Mahon BE, Mintz ED, Ryan ET, Reingold AL. Recommendations of the Advisory Committee on Immunization Practices for use of cholera vaccine. MMWR Morb Mortal Wkly Rep. 2017;66:482-485. doi:10.15585/mmwr.mm6618a6