The Facts on

Heat-Labile Toxin

Producing Enterotoxigenic

E. coli (LT-ETEC) Diarrhea

Just because you can’t pronounce it

doesn’t mean you won’t get it

When should I take DUKORAL®?

Start DUKORAL® at the latest*

Month Day

*for children between 2 and 6 taking DUKORAL®  to prevent cholera, start at least 3 weeks before your departure

DUKORAL® must be started at least 2 weeks before you leave, unless this is a booster dose. Remember to leave enough time before your next trip.

Where can I get DUKORAL®?

What is it?

Enterotoxigenic E. coli (ETEC) is one of the most common causes of diarrhea for travellers to many parts of the world. ETEC produces two toxins: a heat-stable toxin (ST) and/or a heat-labile toxin (LT).

A study showed that those affected lose an average of 3.5 days of vacation time.

Enterotoxigenic E. coli (ETEC)-diarrhea can also spread very easily from person to person.

Annually, enterotoxigenic
E. coli (ETEC) is estimated to cause 200 million diarrheal episodes and approximately 380,000 deaths worldwide.

ETEC is also estimated to cause approximately 8 million episodes of diarrhea during travel each year. 

Overall, 60% of ETEC isolates produce a heat-labile toxin (LT) either LT alone (27%) or the combination of LT and heat-stable toxin (33%).

If you eat food or drink water or ice that is contaminated with
LT-ETEC, you are at risk of getting LT-ETEC diarrhea.

What are the symptoms?

Profuse watery diarrhea

Abdominal cramping

Fever, nausea, vomiting, chills, loss of appetite, headache, muscle aches and bloating

These symptoms can occur 1-3 days after ingesting contaminated food or water.

Am I at risk?

98% of travellers to high-risk areas consumed food or beverages that would put them at risk of diarrhea within the first 3 days of their trip.

If you’re travelling to a high-risk area, you should consider the threat of 
LT-ETEC diarrhea.

How can I protect myself?

You can help protect yourself with DUKORAL®. Before you travel to an at-risk area, ask your healthcare professional if DUKORAL® is right for you.

You should also:


Take care with your food and water choices.

Boil, peel or cook your own food when possible 

Avoid uncooked foods in restaurants, especially shellfish or salads

Drink bottled or boiled water


Wash your hands thoroughly before eating and after using toilet facilities


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Start DUKORAL® at the latest

[ Month Day ]

*for children between 2 and 6 taking DUKORAL®  to prevent cholera, start at least 3 weeks before your departure