The concept of a shrinking globe is a 21st century reality. It is now easier than ever to reach destinations far and wide in a matter of hours. Nearly 72 million U.S. citizens jetted off to international destinations in 2016 — an eight percent increase over 2015. While easy access to world travel offers incredible experiences, travelers have to be aware of infectious diseases. Some examples include malaria, typhoid, yellow fever, Zika and cholera — the latter of which is in the midst of a 50-year global pandemic and will leave its mark on current history.

The devastating effects of the current cholera pandemic can be seen in recent outbreaks. In 2010, the cholera outbreak in Haiti affected over 665,000 people and claimed over 8,000 lives. In 2016, after Hurricane Matthew, cholera struck Haiti again, causing the second outbreak in six years. Currently, there is a large pandemic in Yemen where an alarming 500,000 people have been affected to date, and over 1,900 people died between April and July this year. The International Committee of the Red Cross predicts that 600,000 Yemenis could contract cholera before the end of the year, which would be one in every 45 people.

“There are more than 8 million U.S. travelers per year going to countries, which may include areas affected by cholera.”

Many travelers believe the risk of encountering infectious diseases is low. However, travelers should recognize that diseases, such as cholera, are not limited to countries reported in the news headlines. Cholera is estimated to be endemic in over 60 countries worldwide, particularly in Africa, Asia and the Caribbean. In fact, five of the top 20 U.S. international travel destinations — India, Philippines, Dominican Republic, Jamaica and parts of China — are considered to be cholera endemic. There are more than 8 million U.S. travelers per year going to countries, which may include areas affected by cholera.

“In the last 7 to 10 years, we’ve seen more cholera outbreaks around the world,” said Scott Morcott, M.D., FAAFP, medical director of Passport Health in Chicago & Wisconsin and family practice physician at Advocate Condell Medical Center and Northwestern Lake Forest Hospital. “At Passport Health, we often see travelers who are traveling to areas where there are concerns about cholera, for example, Dominican Republic, Haiti, Africa or parts of Asia. It is important that travelers who are going to a country where cholera is actively transmitted speak to an expert in travel health before their trip.”

What is cholera?

Cholera is an intestinal infection, transmitted via contaminated food and water. Cholera may cause fever, diarrhea, vomiting, painful cramping and dehydration. In severe cases, patients pass large amounts of diarrhea (up to one liter per hour), which causes rapid dehydration and can lead to death if left untreated.

Cholera and climate change

The impact climate change may have on outbreaks has caught the attention of scientists. Recent studies demonstrate that unusually high air temperatures and excessive rainfall create environmental conditions ideal for bacterial growth. Flooding due to high volumes of rainfall can spread bacteria to regions not previously affected with cholera. This leaves the future frequency of cholera outbreaks uncertain. 

It could happen to you

Travelers often have a false sense of security when visiting exotic destinations, but anyone is at risk of contracting cholera if exposed. It’s not as uncommon as you think. There are an estimated 3 million cases of cholera worldwide every year in endemic areas.

How can I protect myself?

Here are a few ways to help prevent contracting cholera while traveling:

  • Drink bottled water and make sure the cap is sealed.
  • Avoid raw or undercooked seafood.
  • Peel and wash raw fruits and vegetables.
  • Avoid ice in your drinks, as ice cubes are often made with tap water.

However, it isn’t always easy to follow precautions, such as these. In fact, in a study of 662 travelers, 98 percent did not comply with recommended safe food and water precautions. Recently the Center for Disease Control and Prevention recommended that adults planning to travel to an area of active cholera transmission get a vaccination to help protect from cholera.

To ensure you remember your next trip for all of the right reasons, contact your health care professional for advice at least two weeks prior to departure.