Cholera in travellers: a systematic review

Area of Science:

• Infectious Diseases
• Public Health
• Travel Medicine

Background:

• Cholera poses a risk to travelers visiting endemic regions.
• Returning travelers can introduce cholera to non-endemic countries.
• Understanding travel-associated cholera circumstances is crucial for prevention.

Purpose of the Study:

• To systematically review literature on cholera infection circumstances in travelers.
• To assess the potential value of cholera vaccination for traveler prevention.
• To identify data gaps in travel-related cholera risk.

Main Methods:

• Systematic literature review of PubMed and EMBASE databases (1990-2018).
• Inclusion of case reports of cholera or diarrhea in travelers.
• Exclusion of non-cholera diarrhea, animal cases, and non-detailed epidemic reports.

Main Results:

• 156 cases of travel-imported cholera were identified and reviewed.
• Data on traveler type, source country, serogroup, treatment, and outcomes were summarized.
• Inconsistent detail in case reports hindered robust data synthesis.

Conclusions:

• A significant lack of actionable published data exists regarding traveler cholera risk.
• Further research is essential to inform evidence-based prevention strategies, including vaccination.
• Current vaccination recommendations may require modification as more risk data emerges.