Dukoral

Indication
Cholera, Protection against cholera in adult & children >2 yr.
Adult Dose
Oral Active immunisation against cholera Adult: For primary vaccination schedule: Given as a suspension (in doses of 3 ml, mixed with sodium hydrogen carbonate solution): 2 doses, at wkly intervals. Complete immunisation 1 wk prior to potential exposure. If >6 wk have elapsed between doses, primary immunisation course should be re-initiated. A single booster dose may be given after 2 yr to maintain protection.
Child Dose
Oral Active immunisation against cholera Child: For primary vaccination schedule: Given as a suspension (in doses of 3 ml, mixed with sodium hydrogen carbonate solution): 2-6 yr: 3 doses, at wkly intervals; >6 yr: 2 doses, at wkly intervals. Complete immunisation 1 wk prior to potential exposure. If >6 wk have elapsed between doses, primary immunisation course should be re-initiated. A single booster dose may be given after 6 mth (2-6 yr) or 2 yr (>6 yr), depending on the age of the patient to maintain protection.
Contraindication
Hypersensitivity. Acute stomach disorder or infection w/ fever (postpone vaccination).
Mode of Action
Cholera vaccine is available as oral preparations containing either live attenuated or inactivated strains. Oral cholera vaccines appear to be more effective than parenteral vaccines. It may be used in adults and children aged ?2 yr who are traveling to areas of risk.
Precaution
Immunisation should be delayed in patients suffering from acute febrile illness or acute GI illness. Not recommended for use in children <2 yr. Limited data on efficacy and safety of the vaccine usage in HIV-infected patients. Additional protective measures should be undertaken as the vaccine does not provide complete protection against cholera infection. Side Effect GI disturbances, headache, dizziness and respiratory symptoms. Fever and malaise, hypersensitivity reactions and neurological symptoms. Interaction Not to be used within 3 wk of immunoglobulin admin. Reduced response may occur in patients who are concurrently receiving immunosuppressant treatment e.g. antineoplastics, corticosteroids at therapeutic doses. Oral, encapsulated typhoid vaccine should not be admin within 8 hr of cholera vaccine admin.