What Is Cholera?

Cholera shows up in humans as an acute diarrheal illness caused by a bacterium called Vibrio cholerae. Roughly 80% of cholera infections produce mild or even zero symptoms. In the other 20%, people can experience intense bouts of diarrhea, vomiting, and leg cramping. People become infected with cholera after ingesting contaminated food or water. Areas with overcrowding are exceptionally at risk for cholera as the risk of fecal matter contaminating the area’s resources increases.

The most important way to manage and prevent the spread of cholera is to ensure that clean food and water are accessible and have a way to dispose of sewage properly. But, vaccination is also an incredible way that modern medicine has managed to take on the infection.

What Is the Cholera Vaccine?

Cholera vaccines are a way to protect people from contracting the illness. Oral vaccines are readily available and have a 65-85% efficacy. This protection can last anywhere from four months to up to five years. Cholera vaccines have a slightly lower efficacy rate than most vaccines, so they are typically used to control outbreaks instead of more routine vaccination. Data has shown the oral cholera vaccine is safe, and countries experiencing continuous cholera transmission will benefit significantly from implementing it into their health care.

Developing a Vaccine

The plans for a cholera vaccine date back to the 1800’s. Around then, researchers discovered that people who had cholera had protection against additional infections, which suggested some natural immunity. Ferran introduced the first cholera vaccine in 1885. As the healthy community continued to learn about the disease, there became an increasing interest in developing an oral vaccine by the 1980’s.

The Internation Vaccine Institute (IVI) saw the importance of developing the world’s first low-cost cholera vaccine, and they began to work with international partners on creating one. In the early 2000’s, Vietnam, one of the countries in the IVI partnership, had developed its own oral vaccine with some help from technology from Sweden.

To be compliant with the World Health Organization’s requirements for vaccines, IVI reformulated the vaccine. The IVI’s technology was also shared with a manufacturer in India. It was there that clinical trials began to ensure the vaccine was safe to use. In 2009, the vaccine was licensed, and by 2011, it received WHO pre-qualification, a significant victory for IVI and global health.

Vaccination Today

Cholera continues to be an issue for some areas of the world, especially Africa and South Asia. Over the years, adapting the vaccine has done nothing but increase production and access while reducing the price. The battle to end cholera wages on, but the vaccine is on the front lines, keeping our world safe.

From vaccinations to key advice, Passport Health can help you stay safe while abroad. Schedule your appointment today by calling or book your appointment online now.

Written for Passport Health by CJ Darnieder. CJ is a freelance writer and editor in Chicago. He is an avid lover of classical music and stand-up comedy and loves to write both in his spare time.

Chronic Wasting Disease, CWD, is an infectious disease that affects animals in the Cervidae, or deer, family. CWD is always fatal and can affect animals in the wild and in captivity. While this disease is not new, it has spread to 26 U.S. states since its discovery in the 1960’s.

CWD is closely related to Mad Cow Disease. The disease is not caused by a virus or bacteria. CWD is one of a family of diseases called transmissible spongiform encephalopathies. These diseases are the result of a naturally occurring protein, called a prion, that becomes misfolded and thus resists being broken down by the body the way normal proteins are.

The disease has been found in deer, elk, moose, and reindeer in the U.S. and Canada. CWD can be transmitted through direct animal contact, saliva, feces, infected carcasses, and through contaminated soil. Scientists have found evidence of CWD in soil 2 years after the infected animal was removed.

A notable increase in the geographic spread of CWD has taken place in the past two decades. In 2000, CWD was documented in five US states and one Canadian province; in 2010 it was identified in 17 states and two provinces; and in 2019, it was found in 26 states and three provinces. CWD has also been documented in South Korea, Finland, Norway, and Sweden.

The increase in cases of CWD has led to many states to regulate the transportation of deer. The lack of a uniform policy or awareness of existing policies makes it likely that deer infected with CWD are being harvested and transported to areas without current monitoring of the disease.

It is believed that baiting and feeding deer with corn piles, deer blocks, or other attractants can encourage the spread of CWD. Creating common feeding sites for deer can bring outside deer into new communities, risking the spread of CWD.

Currently, there have not been any cases of CWD transmitted to a human. But, laboratory studies have shown that the CWD infective prions can morph into a form that may be infective to humans, and it has been shown that other primates (macaques) can contract the disease by consuming meat from CWD infected deer. It is recommended that humans not consume meat from infected animals.

Written for Passport Health by Brittany Evans. Brittany is a freelance writer and photographer in North Carolina. She has a passion for the outdoors, health information, and travelling. You can find her at her website.

If you are a frequent traveller to tropical and subtropical climates of the world, you’ve most certainly heard of yellow fever. And chances are good you even received a vaccine for yellow fever before you left on your travels.

One disease you may not be familiar with is dengue. As both are mosquito-transmitted diseases, many times travellers assume they are the same disease. They are actually quite a bit different and knowing the difference could potentially save your life.

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Caused by the bacterium Vibrio cholerae, cholera is an acute infectious disease. Cholera is a waterborne disease, with those infected having ingested contaminated water or food. According to the World Health Organization, “researchers have estimated that every year, there are roughly 1.3 to 4.0 million cases” of cholera. For those who contract cholera and only experience mild symptoms, they may not know that they have been infected and in uncomplicated cases, the symptoms resolve themselves within a week. But, the bacteria can remain in their stool for one to two weeks after being infected and can lead to the spread of cholera in their community.

While most people who are infected have mild or no symptoms, about 1 in 10 will develop more severe symptoms. These more serious symptoms include vomiting, muscle cramps, and profuse watery diarrhea. Without treatment, the loss of bodily fluids can lead to severe dehydration and even death.

But how does cholera actually cause such severe diarrhea?

Once a person is infected, the bacteria travel through the body’s digestive system. The bacteria stop their protein production to conserve energy. Those that survive the high acidity in the stomach manage to pass through and go on to the small intestine. It’s here where the bacteria need to restart their protein production so that they can propel themselves through the small intestine’s thick mucus lining using their flagella, the “curly whip-like tails” made through flagellin protein production.

Finally, the bacteria reach their final destination – your small intestine’s intestinal wall. This is where the bacteria thrive and start to do damage to your system. The bacteria no longer need their flagella to move. They switch gears once again and stop producing the flagellin protein. Now attached to your intestinal wall the bacteria start to produce toxic proteins which disrupt your small intestine’s regular functions and cause the small intestine to start to secrete fluid. The intestinal barrier disruption and fluid loss are what lead to the severe watery diarrhea that “often has a pale, milky appearance that resembles water in which rice has been rinsed.”

There are a few different strains of Vibrio cholerae and the severity of the disease differs from strain to strain. But, they can all cause the body to secrete enormous amounts of water, leading to watery diarrhea and rapid loss of fluids and electrolytes. The body’s fluid loss can be as much as one quart per hour depending on the severity of the case. This fluid loss can be treated swiftly through re-hydration. It can also be treated with intravenous fluids, while antibiotics and zinc supplements can aid with cholera-related diarrhea.

People living in high-risk areas for cholera usually develop an immunity to the cholera bacterium. But, travelers should take the necessary steps to avoid infection and cholera induced diarrhea. Before travelling, look into your destination and the risk of cholera. Travellers with plans to hot spots such as South America, Middle East, Asia, and Africa, should check with the Centers for Disease Control to determine areas of endemic cholera and availability of the cholera vaccine.

In addition to being vaccinated, you should wash your hands frequently and take precautions to make sure your food and water consumed are safe and free of contamination. Through these methods of prevention, you may be able to avoid having severe diarrhea caused by cholera.

Passport Health offers a variety of options to help with diarrhea while travelling from cholera vaccination to travellers’ diarrhea kits. Click or tap to schedule your appointment now.

Written for Passport Health by Brianna Malotke. Brianna is a freelance writer and costume designer located in Illinois. She’s an avid coffee drinker and enjoys researching new topics for writing projects. Her site can be found here.

If you travel a lot, you likely have experienced jet lag at some point. Jet lag occurs when people experience sleep problems after travelling long distances. The body’s “internal clock” is affected and causes a feeling of imbalance and increased tiredness. Your body needs time to get used to a new sleep and wake pattern.

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Whether you want to relax, spend time with friends and family, or travel, there is likely to be some form of alcohol present. But, not all alcohol is safe to drink because it may have been tampered with or have an expired shelf life. Thankfully, there are ways you can avoid consuming tainted alcohol.

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If you have plans to visit India, Pakistan, the Caribbean, or certain areas of Central and South America, Africa, and the Middle East, you’ve probably received a recommendation to have a typhoid fever vaccine. Typhoid fever is a bacterial disease with a history dating back to early Greek civilizations. A vaccine was developed in the late 19th century, helping to curb this potentially life-threatening infliction.

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What is typhoid fever?

Typhoid fever is caused by an organism called S. Typhi that stems from a group of organisms called Salmonella. Cases are commonly found in tropical or underdeveloped countries, but these areas can often delay diagnosis due to a lack of resources. In developed countries, diagnosis tends to be difficult, as it is not often the suspect of the patient’s symptoms. If left untreated, typhoid fever can spread through the body and cause organ failure.

The disease has caused many different symptoms throughout history, some being more peculiar than others, including issues with the brain.

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The incredible vistas of Peru are a must-see for a traveller, but a lack of oxygen can keep you from enjoying your trip. Macchu Pichu, a popular destination for tourists, is roughly 8,000 feet above sea level. Hypoxia (a lower-than-normal oxygen concentration in arterial blood) can occur at around 7,874 feet above sea level. But, for many travelling to Macchu Pichu, it’s the colonial-capital city of Cusco that will be the real challenge. Clocking in at over 11,000 feet above sea level, visiting Cusco can be breathtaking – and not necessarily in the way you’d like Keep yourself from losing precious moments to altitude sickness with some easy mitigation techniques.

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Human papillomavirus (HPV) is the most common infection of the reproductive tract for both men and women. Anyone who is sexually active is at risk for contracting HPV. There were about 43 million HPV infections in 2018, many among people in their late teens and early 20’s.

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