What preventive measures should be advised to patients traveling to areas with known cholera outbreaks?

Patients traveling to areas with known cholera outbreaks should be advised to strictly adhere to preventive measures focusing on safe water, food hygiene, and personal sanitation to reduce infection risk. They should consume only treated or bottled water, avoid ice unless made from safe water, and eat thoroughly cooked food served hot, avoiding raw or undercooked seafood and street food. Frequent handwashing with soap and water, especially before eating and after using the toilet, is essential to prevent transmission. Additionally, cholera vaccination may be recommended for travellers at high risk or those staying in endemic areas for prolonged periods, as oral cholera vaccines have shown effectiveness in reducing disease incidence. Travellers should also be educated on recognising early symptoms of cholera and advised to seek prompt medical care if diarrhoea develops. These combined behavioural and immunisation strategies form the cornerstone of cholera prevention in travel health advice NICE CG84 Ryan & Calderwood 2000 Korzeniewski 2017.