When planning a big trip no matter where it is around the world, there’s always a few things you want to make sure your remember before you depart. Do you need travel insurance? Do you need an international driver’s license? Did you plan all the details? And lastly, do you need any vaccines for where you’re going?
That’s where Dukoral comes in. There’s the region specific vaccines like yellow fever and and malaria but there’s also this vaccine that is said to prevent travellers diarrhea which can occur in high probability in almost half of world. So the question is, does Dukoral work or not? Is this a fancy marketing scheme or is it effective to combat what’s known as travellers’ diarrhea?
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What is Dukoral and why do you need it?
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.
Here is another illustration of countries around the world that are considered to be high-risk according to 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.
How do you buy Dukoral?
Dukoral is a prescription-based vaccination and so you’ll need a doctor to write a prescription in order for you to pick up your doses from your local pharmacy.
Even in Canada, this is not something that’s covered by our universal health care. In the case of the company that I worked for at the time, their private health care plan covered this prescription 100% which was a nice bonus. However, when I changed companies later on, I only had partial coverage so it really depends on what the policy is for elective medication.
How do you take Dukoral?
What I like about Dukoral is that it’s easy to take on your own once you have it. For full immunization, it requires 2 doses taken at least 1 week apart but can be up to 6 weeks. The second dose should be at least 1 week before leaving your home country.
For children 2-6 years old, they have to take 3 doses. The first dose is 3 weeks prior to travel, second dose, 2 weeks prior, and final dose, 1 week before departure.
Dukoral comes with two sachets of powder that almost looks like Kool-Aid except white. You mix it with 5 oz (150 mL) of water and it fizzes up. To me it tastes kind of like gin and tonic and reminds me a lot of what Emergen-C is like. I’ll just say it’s not disgusting.
By taking this vaccine, you’re protected for 3 whole months.
If it’s you’ve taken Dukoral within the last 3 months to 5 years, one single dose will renew your protection. This is what’s called a booster 1 week before trip departure.
If you’re interested in reading more information about the vaccine itself, make sure to head over to the Dukoral home page.
Does Dukoral Work?
I first used Dukoral in 2012 on a big trip to Asia. As part of my annual check up I asked my doctor whether I needed anything prior to heading out especially in the South East Asia region. Turned out I didn’t need anything for malaria despite the trekking we were going to do Chiang Mai but what I didn’t expect was when he recommended Dukoral. Since then I’ve used Dukoral for my trip to Ethiopia, trekking the Inca Trail in Peru, and safari in South Africa. Let’s just say I’ve become a regular user.
So this is the main reason why you’re here which is to answer whether it’s worth it to pay for this vaccine.
Travel case studies
Now take this as a grain of salt because I’ve heard so many conflicting stories about Dukoral effectiveness but in looking at my big trips, I’ve never had any serious stomach issues save for in Ethiopia.
In the cases where I didn’t get sick, it could mean that I was just really lucky and never encountered any bad foods. Alternatively, Dukoral did its part and protected me from e-coli and cholera.
In the cases where I did get sick, the thing is that you can still get diarrhea from other forms of bacteria and overall uncleanliness in the preparation and handling of food.
That time I got sick from not taking Dukoral
I then have another story where I didn’t take Dukoral on a 7 day itinerary to South Korea, I experienced some serious food poisoning and I was out of commission for at least two days.
So what does all of this mean?
From a scientific perspective, you’d be able to say that all of these data points are inconclusive and unfortunately that will be the case when you’re talking about something like diarrhea when travelling.
At the end of the day, Dukoral only protects you from E. Coli and cholera which are the most common causes of diarrhea but there are also parasites and viruses that can also cause a serious upset stomach.
What I say is that you’re better off being protected for the main causes of diarrhea than to be not protected at all. Yes, you can certainly be smart travellers and avoid drinking unclean tap water, street food, and make sure you use hand sanitizer, but sometimes you just can’t control.
The key for me is that there’s no side effect for taking Dukoral before you travel other than the cost behind it. So what is there to lose when you’re travelling to a high-risk area?
Conclusion
Despite not being able to make you invincible to travellers’ diarrhea, I still give Dukoral my two thumbs up. You’re going to get protection from the most common causes and for me, that’s enough to convince me that I should take it for every trip I make to a region that has high potential for getting serious stomach troubles.
I know it’s not conclusive but I hope this answers the question of whether “Dukoral works or not”.
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Just to confirm that Dukoral is available without prescription. However, if you have a drug plan, they will probably only reimburse you if you purchased it with a prescription. In this case, have you family doctor write one up for you.
Four of us traveled in India for a month. We all took Dukoral and no one got sick. So I’m a believer!
Thanks for sharing your experiences! Good to know that you can get it without prescription. Just curious, where are you from as that might be relevant for others?
On September 28/19 we took our second dose of Dukoral before going to Cuba on October 5/19.
We are heading back to Cuba in January 3/20 -JUST over the 3 month mark. Do we need a booster dose? Unfortunately one week before our January 3 departure we will be in Florida. Is it possible to get Dukoral in the US without a prescription!
Thanks!
Hey Terry! Excited for your upcoming trip! Now in terms of getting Dukoral, you can actually get it in Canada before you go by heading over to a travel clinic. This would apply if you’re in the US as well.
Thanks Will but doesn’t it have to be refrigerated and wouldn’t we need the booster one week before we head to Cuba? My concern is if we get it here in Canada before we leave on December 20 it will be unrefrigerated on the plane to Florida.
Sorry to be a pest! It’s been many years since we travelled!
Thanks so much
Hi Terry, this isn’t a guarantee but you can ask the flight attendant to give you a bag of ice. That’s probably the best you’ll be able to do.
Thanks Will! I really appreciate your help and expertise!
You’re very welcome!
https://www.cfp.ca/content/cfp/65/3/171.full.pdf.
Researched article that sees limited use of Dukoral unless a humanitarian worker in limited areas. States it is a marketing campaign and not efficiency of the vaccine.
“ In the context of travel and tropical medicine practice, the evidence-based use of DUKORAL would be infrequent and not considered a priority except for those working within a cholera outbreak region (eg, humanitarian workers).” I’ll attach the link in my next comment.
Thanks for sharing these facts! Always good to see both sides of the argument as I know some people swear by it and others that see it more as a placebo effect type of thing.
This is just my experience, I have travelled to remote India, nepal, remote parts of China, Thailand, Bali,
Kenya and Tanzania you could say I swear by Dukoral. Never had an issue. And I use old school water purifying tablets for my water. The biggest test yet off to Egypt and Jordan soon, Wish me luck.
Thanks for sharing your experiences Rachael!
Just remember ..with Dokoral… the protection from heat-labile toxin producing enterotoxigenic E. coli (LT-producing ETEC ..the major source of Traveler’s Diarrhea) only lasts three months… and then you need to do a booster dose. If you’ve gone five years since your last dose… you need to do the full two dose series all over again.
Protection from Cholera is two years.
Dukoral is available over the counter in Canada, except in Quebec, for prevention of E coli. It is still prescribed for Cholera.
We’ve used it for several trips now – China, Taiwan, Hong Kong, Japan and Mexico and we haven’t run into any issues yet.
That’s definitely new! This must be a new thing because I used to always have to get a prescription for it. Good to know!
I also took Dukoral before a four month trip to Thailand in 2013….(including Chiang Mai and an isolated Lisu tribe village in the mountains north west of Chiang Dao I went with a Thai friend. No hotels, no wifi, no cell phone use. No other westerners there)
I never got sick.. and I ate lots of street food and Lisu tribe food also.
Also took Dukoral before a two month trip to Cambodia in 2017.. including staying for a few days with my driver’s very poor relatives in a poverty stricken village and sharing their food. Again… never got sick.
Just plain luck? I don’t know… but I will always take Dukoral before trips like that.
Funny thing is…(actually not funny at all) was the worst case of food poisoning traveller’s diarrhea I ever got was in modern, first world Toronto, Canada many years ago…. diarrhea and throwing up like crazy…. thought that maybe death would be better…. (Macaroni salad bought at an open air market.)
Dukoral ? ? Yes ! ! Absolutely.
Thank you sharing your experiences! Great to hear a positive experience with Dukoral. I think the lesson is “better safe than sorry”. While it’s never going to be conclusive and some may still get sick but some protection is better than none at all.
Hi,
Thank you for your opinion and experience on Dukoral. Very informative.
I have a question about the timing of the 2 doses.
First dose should be taken 6 weeks before departure?
Second dose: 1 week before departure? Could I take maybe 2 weeks before departure? (Just in case I experience any terrible side effects & can recover a bit before my actual trip?)
Hi Cristina! Timing wise, you’re right take the first dose up to 6 weeks before departure. At that point, space out your second dose at least 1 week later but make sure you do it 2 weeks before departure (the official Dukoral prescription). After that you’re all good!
Thanks Will.
I’m so happy to have found your site plus you are a Canadian as well. :-)
Instructions for taking Dukoral come with the package. Dosing instructions also available on Dukoral’s website.
dukoral.ca
To be safe, I wait even longer after eating than they say before taking a dose. I wait until three hours after eating. And I don’t eat anything for two hours after taking a dose.
In 6 months of traveling in Asia, I credit an almost complete lack of food poisoning to a combination of Dukoral and general food safety/awareness. We avoided tap water, ice, freshly washed veggies, room-temperature food, etc… But we have traveled before and gotten majorly sick. This time, though we can’t prove it, we assume it was the Dukoral that made the difference!
Thanks for sharing your experience! I feel like this is one of those tricky things where if nothing happens, you can pinpoint it on Dukoral but if you do get sick, everyone is going to say Dukoral doesn’t work. What makes it challenging as well that Dukoral protects you from only certain things that can cause the general “food poisoning”. That said, I’m glad you played it smart and used it in combination of savvy and safe travel! Thanks for stopping by :)
Right, and you can’t go back in time to see how it would have been with/without the drug. And great point, too, that it ONLY covers cholera and e-coli. Many things can make you sick! We got intestinal parasites when we were in India. Nothing Dukoral could have prevented. Still, combined with adequate food safety awareness, I think it’s a good safeguard.
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.
I’ve taken the two doses of Dukoral before both my trips to Asia. Followed the instructions exactly.
No side effects from the oral Dukoral vaccine. Might as well have been drinking ordinary clean water.
Also…no traveler’s Diarrhea. 😃
“HK Traveler”’s illness must have been caused by something else.
I’ve known lots of people who have taken Dukoral with no side effects at all.
Dukoral does not protect you against everything out there in the world.
It does not even protect you against all pathogens that can cause Traveler’s Diarrhea and Sickness. It only gives you some protection from Cholera and E.coli ….the most common cause. There are other causes that you can still become infected with.
But eliminating the most common cause by taking your two doses of Dukoral gives you a much higher chance of not getting sick.
I’ll always take my two doses before travel.
HK Traveler’s suggestion of only taking one dose of Dukoral….will not give you proper protection, unless you took your proper two doses of Dukoral within the previous five years.
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.
There are many things that can cause “issues”.
Dukoral only protects you from Cholera and E.coli. (IF you took it properly following the instructions)
If you got some other “bug” or something else other than Cholera or E.coli infection.,.then Dukoral can not protect you.
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??