Traveller’s diarrhea prevention while travelling
So prior to my trip last summer, I made sure I went to the doctor…got my annual check up and then I asked him if I needed to get any shots prior to heading out to Asia and in particular South East Asia. I asked about the Malaria thing but even with my research online, it really wasn’t necessary unless you were doing some crazy trekking. I knew Jia and I would only be trekking for one day so the doctor confirmed that it was pretty overkill. Not worth the side effects. What my doctor did recommend was this thing called Dukoral. I had no idea what the heck it was for…
What is Dukoral?
So you guys might be wondering the same thing so I figured i’d explain this piece first. What exactly is Dukoral?
In a nutshell, it’s simply a vaccine you take prior to your travels to help prevent traveller’s diarrhea and cholera while you’re travelling. Traveller’s diarrhea is typically caused by E. Coli.
These are the countries that are known to have cholera cases in the past 10 years.
Countries considered high risk by Dukoral.
From C.Health Canoe
This vaccine works by introducing very small amounts of dead cholera bacteria and nontoxic components of cholera toxin into the body. This allows the body to make antibodies against the bacteria and toxin so that if the bacteria does get into the body and produce the toxin, they are immediately attacked by the body’s own defense system. The cholera toxin is very similar to the toxin produced by ETEC, the bacteria that causes most cases of traveller’s diarrhea. Therefore, the body’s defenses against cholera toxin will also work against the ETEC toxin. It generally takes one week after finishing the first course of immunization for the body’s defenses to develop protection against the bacteria.
This is obviously only available if your doctor writes a prescription for you and you have to consider whether your insurance will cover something like this. Luckily the company I worked with at the time covered 100% of this.
The way it works is you have to take this 2 weeks prior to the start of your travels and is good for 3 months of protection. What I liked about taking Dukoral was that it was extremely easy and was something you could do yourself. A full immunization requires 2 doses taken 1 week apart, with the last dose taken at least 1 week before travel. It comes with a sachet of some powder that looked like Kool-Aid except white and you just mixed it into water. It would fizz up and you drank it just like that. To me it tasted like Gin & Tonic (no disrespect to those Gin & Tonic lovers out there).
The official Dukoral website can be found here.
Was it Effective?
Now this is a bit hard for me to say. I was travelling throughout Asia for 3 months. Check out everywhere I went last summer.
The end result of my travels for 3 months? I never had any stomach issues at all throughout that whole time.
Now this could totally mean that I was lucky and never encountered any bad foods to give me diarrhea but part of me feels like Dukoral may have helped me more than I know. I was definitely not shy about eating street foods all around and was never extremely cautious so that’s gotta say something about the effectiveness of Dukoral.
The only story I can somewhat back up the effectiveness of Dukoral was how I didn’t take Dukoral and got some sort of food poisoning from my trip to Korea earlier this year in February.
I know that’s not really conclusive evidence but I say, why not reduce the chances of getting traveller’s diarrhea if you can?
Conclusion
Thumbs up for Dukoral. If you’re going to a country that is considered high risk and you’re going for 2 weeks or more, just take it. You might as well get yourself covered.
Back in 2011 I took Dukoral, one dose 7 days before my trip to HK, then one dose the night before leaving. Seven days into the trip, I had a long day at the beach in HK, though it was a mild day, I didn’t drink a whole lot of water, maybe 8 glasses that day. Sometime in the evening on the 7th day of the trip, I drank some water from the local water fountain at the community centre, I walked the 20 minutes back to where I was staying. I started feeling still very thirsty, then I noticed my arms getting weaker, legs getting weaker. Thus I sat down and with my relative, told him with limited ability as I was very fatigue and started having claw hands where the hands tighten toward the body like I’m becoming physically challenged. There is a term where all the electrolytes leave the cells and your body starts to not be able to communicate and send electrical signals properly. That was occurring and I suspect it was either the fountain water, which the ER doctor said he drinks it all the time, OR the Dukoral gave me severe dehydration which is one of the listed side effects. When, the gatorade request came back as I sent my relative to the closest 7/11 to get some, I tried to sip it but wanted to throw up. I couldn’t swallow it. I asked him to call the ambulance, by then I was pale white according to my wife who came down to see me sitting near the MTR entrance in front while the ambulance came. By the time the ambulance guys loaded me up, they had to lift me in as I couldn’t move and was barely breathing. After they hooked me up to oxygen, I kept asking for my gatorade to my wife. Then the ambulance guys mentioned, does this guy have mental issues? My wife said no. I heard them so I stopped saying anything more about gatorade. The ambulance wasn’t moving so one experienced staff member asked, “Did you feel like throwing up when you drank it”. I said yes. Then he started the engine immediately and drove me to the hospital. I seen tons of people waiting while I’m in a wheel chair being rolled in, all pale white like a white shirt. The guys asked me do you want your oxygen, I said I’m fine. After they took it off, I had trouble again breathing. I thought crap, I wish I told them I needed it.
Needless to say, they gave me a bed immediately. I knew I was dying, so I told my wife to get me some salt water IV. I knew I needed electrolytes. I was phasing in and out of a bit and couldn’t respond to words when I wanted to at times. ER doctor came by and said he needs an IV and authorized it. Upon then sticking in the needle and in 20 minutes I was sitting up, and then after the bag was done, they gave another one. After the second one, I needed the bathroom very badly, but couldn’t walk yet. So I asked the nurse, she gave me a container to take a leak into. I filled it all the way up. She said, “Wow, this guy isn’t dehydrated, look at all this fluid.” So the doc came by and after one hour I and third bag of IV, they cranked the speed up on the drip and I walked my way to the bathroom in two hours. All my skin color was back to Asian. I was out of the ER in three hours total and survived. The ER doc asked me how much water I had, I said 9 glasses approx. that day. He said, he doesn’t know what happened to me, but said if you didn’t come here you would have died for sure. I thanked him and took a cab back home right away with my wife.
Summary of the story, I’ve been drinking HK tap water boiled all the time for 7 days so couldn’t be the water from the fountain. My relative sipped it too and nothing happened to him.
In summary
Dukoral if not needed, take only one dose like the pharmacist told me to. Two doses screwed me up good. After the hospital bout, I ended up with big hemorrhoids for the first time in my life a few days later. Had to get my body all back into sync.
I won’t ever take it again. I’d rather have the runs, take some immodium rather than end up with severe dehydration as a result from taking Dukoral. Or if taken, follow the instructions 14 days before trip, then 7 days next dose before trip.
Happy travels and glad I survived the ordeal.
Thank you so much for your detailed story. This is really good to know especially with your first-hand experience. I wonder if it’s something where everybody reacts to it differently but a good word of caution for anyone looking into taking it. From my experience, I’ve taken Dukoral 3-4 times at this point and I’ve been ok and will probably continue to take it.
Whether you take Dukoral or not, you should also consider taking an antibiotic with you on your trip in case you get traveller s diarrhea.
That’s a really good tip! For my trip to Ethiopia, I took Dukoral before the trip BUT it didn’t prevent issues happening later. Luckily I had Cipro which is that antibiotic you’re talking about.
Less than 24 hours after taking the first dose I have experienced both abdominal pain and diarrhea. I hope it doesn’t last long and I hope it actually protects me when on vacation because so far the cure is worse than the disease.
I think it probably was the vaccine. I am from Canada, but moved to China. I am pretty careful and still get stomache issues weekly. I don’t seem to be building an immunity either. Planning on going home for a visit in January and taking the vaccine then.
Hi I used Ducoral in Dec. .2015 more than week before trip I took last dose and 2 days before trip I am getting sick .
Stomach pain and visit to toilet like 6 times already
I went to doctor and he told me no food for 12 h. Should I go on that vacation if I am sick even before trip.
I really regret this product . Never again !
Hey Chris, really sorry to hear about your troubles! Honestly even for me, it’s hard to say if Dukoral is effective or not. I took it again for my trip to Peru and while I was good for most of it, I still had trouble along the Inca Trail. That being said, it could’ve covered me for cholera in Lima/Cusco but could’ve been something else while trekking. I think the biggest thing to note is that this certainly isn’t full protection.
I’m also wondering if you had a reaction to the vaccine when you took it? It’s definitely not normal to get sick from it prior to travelling.
From Canada. Four months in northern Thailand last yeast. Mostly Chiang Mai with trips to Lisu tribal villages deep into the mountains north west of Chiang Dao. Took the two doses of Dukoral before I flew to Thailand. Never got sick even though eating mostly from street food vendors, and tribal food in the villages. (Villages were not “tourist” villages. I was the only westerner there. No souvenir sellers, lived with a family in their home. Had no ideal what I was eating during their Lisu New Year feast.)
Never got sick. Dukoral is supposed to protect against E choli for three months, and against Cholera for two years. But I think it only gives about 80% protection. However, even for those who still get sick, it might be not as bad as for someone who did not take Dukor. And it doesn’t protect against all thing that give you “Delhi Belly”.
But 80% protection is good enough for me. That puts the odds in my favor. I’ll take it before trips to that part of the world each time. It’s better than not taking it and having no protection at all .
Have happy, safe travels.
Hey Robert, thanks so much for your detailed comments. My experience was very similar to you and you’re right, 80% protection is enough for most people and puts the odds in our favor 🙂 Sounds like one epic trip you went on!
didnt work for me!
Hey thanks for the comment! Would love to hear your story. What happened??