Counting The Cost

Immunisations can now be a significant part of the cost of any trip, so it pays to know the risks you face and whether they’re worth the fees.

- Dr Jane Wilson-Howarth

Your stomach or your wallet? Travellers getting ready for their next big trip inevitably face the big – and sometimes expensive – vaccine question. But there is scope for saving money by knowing more and looking closer at some of the diseases that loom out there…

CHOLERA

Cholera is in the news again because it is killing many in war-torn Yemen. Infection, especially in the malnourished and debilitated, causes a profuse outpouring of bodily fluids, and patients die rapidly from dehydration. But while outbreaks occur in many low-income areas, cholera tends to only strike the poor and hungry.

Years ago, many tropical countries demanded certification that visitors had been immunised against cholera. Research showed, though, that such precautions actually did nothing to control outbreaks and that certification should no longer be demanded.

These days, some private travel clinics offer a cholera vaccine to their clients called Dukoral. This is a blackcurrant-flavoured fizzy drink containing four strains of killed whole cholera bacteria and cholera toxin (in inactivated form). The latter component is the one responsible for the outpouring of fluids from the bowel in sufferers, so blocking attachment of this toxin to the bowel wall is thus protective.