(BPT) – Each year, travelers from the United States (U.S.) head to popular destinations. And while many have Zika on their mind while traveling, and are aware of the need to bring sunscreen, bug repellant and other travel necessities, many don’t know that cholera may be a bigger threat than they thought and most don’t take the necessary measures to protect themselves from it.

Cholera – an infection that affects the intestinal tract and can cause severe watery diarrhea is currently estimated to be present in over 60 countries, mostly in the Caribbean, Asia and Africa. Of the top 20 international travel destinations for U.S. travelers, five are to cholera-endemic countries, such as the Dominican Republic, Jamaica, China, India and the Philippines. Mild forms of cholera can be mistaken for traveler’s diarrhea, which can leave travelers in an uncomfortable state due to diarrhea, nausea, vomiting and mild to severe dehydration and ruin travel plans. You can get cholera by eating or drinking contaminated food and water.

Every year, millions of people around the world become ill due to cholera. However, fewer cases are reported to health authorities than the global estimates. There are more than 8 million U.S. travelers per year going to countries where cholera is endemic. In recent years, there has also been a re-emergence of cholera in Ecuador, Haiti, Cuba and Mexico. However, despite the recent re-emergence, cholera remains underreported.

Still, plans to go abroad don’t need to be canceled or changed to avoid getting sick. You can protect yourself from cholera (and other food and waterborne illnesses) by drinking clean (filtered or bottled) water, washing hands frequently and eating foods that are from sealed packages or cooked well. However, almost 98 percent of travelers do not comply with these guidelines.

Getting a vaccine before travel may also help to ensure that your travel plans are not inconvenienced by illness. The CDC recommends that adult travelers (ages 18-64) who are going to areas of active cholera transmission get vaccinated for cholera.

If you are traveling abroad to an area where cholera is present, make sure you are prepared by talking to your doctor or pharmacist at least two weeks in advance about getting vaccinated for cholera.