Cholera is an important public health problem globally and results in an estimated 2.9 million cases of disease and 95,000 deaths annually. Cholera is endemic in Malaysia with incidence rate ranged between 0.01-0.8 per 100,000 population in the last five years (2014-2019). High incidence rates in 2015 and 2018 were due to outbreaks which occurred in Sabah with 235 and 163 cases reported in the respective years. It is an acute enteric infection caused by the ingestion of the bacterium Vibrio cholerae O1 or O139. The disease is transmitted through the faecal-oral route and through ingestion of contaminated water or food. It can cause severe diarrhoea with or without vomiting. Death can occur in a few hours due to dehydration, electrolyte imbalance, acidosis, shock, hypoglycaemia and renal failure.

Cholera is treated with oral rehydration salts, intravenous fluids and other supportive measures. Appropriate antibiotics may be given to severe cases to diminish the duration of diarrhoea, reduce the volume of rehydration fluids needed and shorten the duration of Vibrio excretion. It is controlled from spreading by public health measures and prevented by good hygiene, good sanitation and clean water supply.

The use of vaccines has now been advocated as an additional measure of lowering the risk of acquiring and transmitting the infection. However, the vaccine should not be used to treat a cholera infection. No adverse effects have been noted in pregnant women or the immunocompromised who were given the vaccine. However, it should only be used if the benefit outweighs the risk.