Should I take Dukoral before my trip?

This time of year we start having more people coming to ask about Dukoral, its effectiveness and if it’s worth the cost. Dukoral is a schedule 2 vaccine which means that you don’t need a prescription to buy it, but sometimes that is best because some insurance plans will cover it if you have a prescription.

What is Dukoral?

Dukorol is a oral vaccine used to prevent travellers diarrhea. It specifically protects against cholera and enterotoxigenic E. Coli also known as ETEC. Cholera is most commonly transmitted through contaminated water and also food. If not treated cholera can cause life threatening dehydration. ETEC is involved in 25-50% of travellers diarrhea cases, however most cases do not require treatment. The majority of the time the symptoms are mild and will clear up on their own without long term consequences.

 

Is it effective for protecting against cholera?

Yes, but cholera isn’t typically found in areas where most visitors travel (for example travelling to 4 and 5 star resorts). Prevention of cholera would be more important to aid workers, or those visiting areas of recent disasters where the sanitation systems or water supplies could have been damaged.

 

How about ETEC?

There isn’t a difference in effect for protecting against ETEC compared to placebo. This means that an equal number of people still experienced travellers diarrhea whether they took the vaccine or not before travelling.

 

Who should take Dukorol?

Travellers who are at high risk of problems from dehydration or infection could consider taking Dukorol before travel. (People taking immunosuppresants, people with certain kidney diseases, those with congestive heart failure). You should talk to your doctor or pharmacist to get more information about this.

 

What other products can be useful for travellers diarrhea?

Some products that may be important to bring with you in case you get sick are

  • oral rehydration salts, or rehydration drinks (examples Gastrolyte, Hydralyte) to prevent dehydration
  • medications to stop or slow nausea or vomiting (example Gravol, Pepto Bismol)
  • medications that can slow down diarrhea (Imodium)
  • antibiotics to have on hand in case of infection

Talk to your pharmacist about what might be right for your situation.

**remember if you are travelling and you are having persistent symptoms, high fevers, abdominal pain, blood when going to the washroom seek medical attention

 

How do I take Dukorol?

Dukoral is taken as 2 doses 1 week apart on an empty stomach. The doses should be stored in the fridge until used. After completing the course, the protection will last 3 months, and as long as it has been less than 5 years from the last dose a booster dose is only required to regain protection for another 3 months.

Let us know if you have further questions! If you’re planning to travel to an at risk area, make sure you speak to your pharmacist or doctor about whether Dukorol is a good choice for you.

 

 

References:

https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-3-cholera-enterotoxigenic-escherichia-coli-travellers-diarrhea-vaccine.html

Scerpella EG, Sanchez JL, Mathewson III JJ, et al. Safety, immunogenicity, and protective efficacy of the whole-cell/recombinant B subunit (WC/rBS) oral cholera vaccine against travelers’ diarrhea. J Travel Med 1995;2(1):22-7.