What do you think of the Dukoral vaccine against E. coli infection (traveler's diarrhea)?

Hello,

The question is very relevant given the great publicity about Dukoral for preventing traveler's diarrhea. You should know that the main indication for Dukoral is for the prevention of cholera which is caused by certain types of E. Coli. Thus, if you are going to countries where cholera is present, the vaccine may be recommended.

For traveler's diarrhea, the effectiveness of Dukoral is very limited. The Institut national de santé publique du Québec (INSPQ), which makes a lot of recommendations for travelers, has looked into this. It states on their site that:

Nonetheless, the vaccine could be used in some people who have significant health problems and should not get traveler's diarrhea. Also, it could be used in some people (e.g., high-level athletes, diplomats) who cannot afford to get sick, while being aware of its very low efficacy.

The only drug that has shown some efficacy in prevention is Pepto Bismol. However, it must be taken 4 times a day, has side effects (black tongue and stool, nausea, constipation), and is not compatible with many diseases and medications.

In short, if your goal is to prevent traveler's diarrhea in a high-risk country, your best weapon is still food and water precautions. Your pharmacist can also prescribe antibiotics and other diarrhea medications to bring with you on your trip at any time and take as needed.

Note that if you wish to take Dukoral, it can be prescribed by a nurse or doctor. It should be taken at least 2 weeks before leaving in 2 doses. Its effect lasts for 3 months.

Reference: https://www.inspq.qc.ca/sante-voyage/guide/risques/diarrhee-des-voyageurs

True to the word,

Sarah-Yan Chagnon, pharmacist