Outbreaks and Updates Travel Health

Cholera Updates: Iraq and Vietnam

Iraq and Vietnam seem to have the unfortunate position of “top cholera hotspots” according to ProMed’s new diarrheal and cholera updates.

I was just asked a question, from a traveler going to Vietnam, about advice and safety. For knowledge of traveler’s diarrhea, you can visit the Adventure Doc Traveler’s Diarrhea Page.

ProMed stated that Iraq is facing a “Health Catastrophe” in Baghdad. Cholera cases continue to soar, mostly in the eastern part of the city. Poor sanitation is cited as the biggest factor to overcoming this outbreak. A November report form the UN stated 4569 new cases for the year and 22 deaths, all from cholera. Sanitation, clean drinking water, hand washing and prompt recognition of diarrhea followed by copius oral rehydration are the cornerstones to combating cholera.

Another on-going epidemic with 1941 cases of acute diarrhea in northern provinces of Vietnam, of which 261 tested positive for cholera.

“According to Nguyen Tran Hien, director of the National Institute of Hygiene and Epidemiology, the results from tests on vegetables and water from areas where cases of cholera were identified found no sign of the cholera bacterium.” Source: Promed Mail.

Ha Tay and Ha Noi provinces are hardest hit.  Ha Tay, being a large producer of food products for the country, is in a prime spot for transmitting the disease all over the country.

Government inspectors are currently assesing the sitituation and giving out hand sanitizer and latex gloves to citizens in the hardest hit provinces.

The cholera vaccine is currently marketed by:
Dukoral ®
SBL Vaccin AB,
SE-105 21 Stockholm, Sweden
telephone +46-8-7351000,
e-mail: info@sblvaccines.se
website: http://www.sblvaccines.se

Although the CDC does not advise the vaccine for routine travelers. See more on the CDC cholera page. Previous vaccines have been notorious for causing intussusception in children. Intussusception is a cause for abdominal pain and bowel obstruction. This occurs, most commonly, when the bowel/intestine “telescopes” into itself, similiar to closing a spyglass. E-medicine has a great article about it.



  1. Good question! I use PRO-Med Mail as a resource and have not seen much in the way of updates and outbreaks from Vietnam, in the last 2-3 months.

    I believe that this lack of information is a good sign and that the cholera issue has died down. This doesn’t mean that “standard precautions” for prevention of diarrheal illness can be avoided.

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