CDC Publishes ACIP Recommendations for Use of Cholera Vaccine in MMWR

The Centers for Disease Control and Prevention (CDC) published Recommendations of the Advisory Committee on Immunization Practices for Use of Cholera Vaccine in the May 12 issue of MMWR. The “Recommendations for Prevention of Severe Cholera Among Travelers” section is reprinted below.

Personal Protective Measures
All travelers to cholera-affected areas should follow safe food and water precautions and proper sanitation and personal hygiene measures as primary strategies to prevent cholera. Travelers who develop severe diarrhea should seek prompt medical attention, particularly fluid replacement therapy.

Use of CVD 103-HgR
CVD 103-HgR is recommended for adult travelers (aged 18–64 years) from the United States to an area of active cholera transmission. An area of active cholera transmission is defined as a province, state, or other administrative subdivision within a country with endemic or epidemic cholera caused by toxigenic 
V. cholerae O1 and includes areas with cholera activity within the last year that are prone to recurrence of cholera epidemics; it does not include areas where only rare imported or sporadic cases have been reported.

The vaccine is not routinely recommended for travelers who are not visiting areas of active cholera transmission. Most travelers from the United States do not visit areas with active cholera transmission (https://wwwnc.cdc.gov/travel).

Booster Doses
At this time, no data exist about the safety and efficacy of booster doses of lyophilized CVD 103-HgR for the prevention of cholera. The duration of protection conferred by the primary dose beyond the evaluated three-month period is unknown. There is no recommendation for use of booster doses at this time.