There has been a number of Cholera out breaks this year. Obviously the Pakistan floods have brought this to the attention of the media. There have also been outbreaks in India, Nepal, Papua New Guinea and Vietnam, Angola, Nigeria and Kenya, owing to excessive monsoons and flooding.

There is a cholera vaccine available at The Travel Clinic Ltd called Dukoral. This is taken by mouth, two doses with one week apart. We recommend this to travelers going to at-risk areas who may not be able to be able to source well cooked food and/or boiled water.

Cholera infection is caused by contaminated food or water and commonly occurs after floods or disruption to sanitation. Cholera causes a sudden onset of watery diarrhoea often accompanied by vomiting. One can pass as much as 22 liters of diarrhoea in 24 hours. Travellers should always boil water for three minutes prior to drinking or even cleaning teeth with it. Ensuring food is cooked thoroughly is another preventative measure that can reduce risk of transmission.

Most symptomatic cases are hard to distinguish from other illnesses that cause diarrhoea - it is only in one in 10 that have such severe symptoms such as to be admitted to hospital, indeed it may be thought of as a nasty bout of travelers’ diarrhoea.
Treatment includes rehydration salts and drinking lots of water. Severely dehydrated patients may need intravenous fluids. Antibiotics can reduce the spread of the illness.
 

What vaccines do I need?
Staying healthy abroad is not just about having a vaccination or taking a few tablets it's about fully appreciating the associated risks and avoiding them as far as possible, all of which we discuss at The Travel Clinic.
It is impossible to say what vaccines are needed, as it is not known what diseases you will encounter when away. So that is why a risk assessment is required. One needs to know how diseases are spread, before you think about immunising
Travel checklist The main risks for travellers fall into three categories:
1. Vaccine-preventable diseases
2. Insect-borne diseases
3. Gastrointestinal illnesses, such as diarrhoea, which is caused by contaminated food and water
This may be misleading, the major cause of preventable deaths in travellers is injuries.
In any case, preventive measures can reduce the possibility of all these problems -- from making sure one's vaccines are up-to-date to drinking only bottled water.
If business travellers are more at risk than the average traveller, it is because they are less likely to take the necessary precautions.
Traveller's health is mostly common sense - Bugs, Bites and Bowels as written in Dr Jane Wilson-Howarth memorable book who practices here at The Travel Clinic Ltd
http://www.travelclinic.ltd.uk/publications.aspx
While specific health risks may vary, recommended travel precautions include:
• Before the trip, assess the potential health risks for the country the person is visiting. These will vary depending on what parts of the country they will visit, the time of year, and the kind of accommodation they will stay in.
• Ensure that you bring previous records of vaccinations with you

Most children recover well from a bout of chicken pox, It is not usually a life threatening disease. They may be off school for 7-10 days and have up to 250-500 itchy red blisters and spots; they recover well and have just a few scars.
Varicella or chicken pox is highly infectious. It spreads rapidly through households, and is very common with infection of up to 90% of vulnerable individuals who come into contact with the virus

 However occasionally severe complications such as meningitis and pneumonia occur especially as one gets older. The rate of admissions to hospital for treatment of varicella is 900% higher in adults although 90% of are people affected before adolescence.

10-20% of people who had had chickenpox will eventually develop shingles (a condition characterised by numbness, itching, or severe pain that may last for many weeks and may reoccur.

In pregnancy there is a fear of severe damage to the developing baby as well as complications with the mother
It is a course of two vaccines with about 6 weeks between doses

Until recently it was recommended that children should just have one vaccine, with the over twelve years and adults having two injections. The Department of Guidelines were changed in February 2010 so here at The Travel Clinic Ltd we are recalling all children to have their second dose of varicella vaccine
Later this Spring 2010 a vaccination against shingles will be released, the DOH are looking at vaccinating elderly people with the vaccine first as they are extremely vulnerable, this vaccine will be available from The Travel Clinic Ltd as soon as it is released.
 
http://www.patient.co.uk/doctor/Chickenpox-(Varicella).htm is a useful source of information