CDC recommends this vaccine for adults who are traveling to areas of active cholera transmission. Areas of active cholera transmission include the districts of Blantyre, Dedza, Dowa, Karonga, Kasungu (last case reported January 2018), Likoma, Lilongwe, Mulanje (last case reported January 2018), Nkhatabay (last case reported January 2018), Rumphi, and Salima in Malawi. Cholera is rare in travelers but can be severe. Certain factors may increase the risk of getting cholera or having severe disease (more information). Avoiding unsafe food and water and washing your hands can also prevent cholera.