Prevention and control of cholera outbreaks: WHO policy and recommendations
The use of the parenteral cholera vaccine has never been recommended by WHO due to its low protective efficacy and the high occurrence of severe adverse reactions. An internationally licensed oral cholera vaccine (OCV) is currently available on the market in limited stocks and is suitable for travellers. This vaccine was proven safe and effective and is available for individuals aged two years and above. It is administered in two doses 10-15 days apart and given in 150 ml of safe water. Its public health use in mass vaccination campaigns is relatively recent. WHO official recommendations for its use in complex emergencies have been issued, and state that:
- OCV should always be used as an additional public health tool and should not replace usually recommended control measures such as improved water supplies, adequate sanitation and health education. It needs also to be linked to strengthened surveillance and early warning.
- The current internationally available prequalified vaccine is not recommended once a cholera outbreak has started due to its 2-dose regimen and the time required to reach protective efficacy, high cost and the heavy logistics associated with its use.