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.

While a two-dose oral vaccine named Dukoral has been available in some countries since 1991, the high cost has made it more of a traveler’s vaccine than a realistic option for developing countries that deal with cholera consistently. 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 traveling. You can find her at her website.

Are you unsure of your vaccination history? You are not alone. There are many people who do not know what vaccines they may or may not have had. But that’s okay, because there is something called titer testing. Titer testing is a laboratory blood test that can show what vaccinations you’ve had or what vaccines that you may need to get.

What Exactly Is Titer Testing?

An antibody titer test is used to find the antibodies and the amounts of them in a person’s blood. The number of certain antibodies within the blood will show how strong your body’s immune response is to it. Titer testing will allow your provider to see whether or not you have been infected with an illness, or whether or not a previous vaccination took hold.

Positive And Negative Results

When your results come back from your titer testing, you will either have a positive or a negative result. If your results come back positive, this means that you have either had the vaccine for what your doctor was testing for, or you have been exposed to a pathogen – a microorganism that invades the body (such as an infection) at some point in the past. This means that your body has a good amount of immunity to fight against the illness you were testing for.

If your results come back negative, this means something different. When you test negative, you have no immunity against what your provider was testing for. You may need to get vaccinated or re-vaccinated against the titer that was being tested. Schools and employers may require these vaccinations.

Why Do You Need Titer Testing?

There are various reasons that one would need titer testing. Some of them include:

• You may need a booster shot
• Your doctor does not have your vaccination history available
• Whether or not a vaccine creates a strong enough of an immune response against illness.
• To check if you have an immune disorder

Some of the diseases that a titer test can test for are:

• Rabies
• Measles, Mumps and Rubella
• Chickenpox
• Hepatitis A
• Hepatitis B

There are other illnesses that a titer test can test for, that is just a small list. If you are unsure of your vaccinations, or if you think you may have been exposed to an illness, titer testing is for you. Talk to your healthcare provider to set up the test at your earliest convenience. It is a quick and easy blood test that will allow your doctor to see where you are medically, and to update your vaccination history.

To schedule a titer test, contact one of Passport Health’s flu specialists at .

If you are a frequent traveler 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 travelers assume they are the same disease. They are actually quite a bit different and knowing the difference could potentially save your life.

[Read more…]

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 traveling, look into your destination and the risk of cholera. Travelers 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 traveling from cholera vaccination to travelers’ 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.