Cholera

Pronounced: KOL-eh-ra

• Definition • Causes • Risk Factors • Symptoms • Diagnosis • Treatment • Prevention

Definition

Cholera is an infectious disease that affects the intestinal tract. It is rare today in developed countries. However, it has caused severe epidemics in the past. It continues to be a major public health problem throughout the world in underdeveloped countries. If left untreated, it may cause death within hours.

Causes

Cholera is caused by the bacterium Vibrio cholera. This bacterium secretes a toxin that causes rapid loss of fluids from the small intestines. Cholera is spread by ingesting food or water contaminated by fecal waste. It is common in countries that lack adequate sewage disposal.

Small Intestines

Risk Factors

Factors that increase your risk of getting cholera include:

Eating contaminated food or fluids
Eating raw or undercooked shellfish
Living or traveling in areas where cholera is present
Having blood group O—nine-fold increase in risk
Having a compromised immune system
Having low levels of stomach acid

Symptoms

Symptoms of cholera begin quickly and can be severe. They include:

Sudden onset of painless, watery diarrhea without blood or pus
Vomiting
Dehydration
Thirst
Muscle cramps

The severity of symptoms ranges from mild, short-lived diarrhea to shock and death due to extreme fluid loss. Most symptoms occur one to three days after exposure.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. It is important to tell your doctor about any recent travel to areas where cholera is common. If cholera is suspected, stool and blood samples will be tested.

Treatment

Fluid Replacement

The first priority in treating cholera is to replace fluids and electrolytes lost through diarrhea. In severe cases, uncorrected dehydration can be fatal. Hydration solutions can be given orally or through an IV.

Antibiotics

Antibiotic medications may help shorten the course of the disease. They may also be given to the people you live with to prevent them from becoming ill.

Prevention

Careful Eating Habits

You can prevent cholera by avoiding contaminated food and fluids in areas where cholera occurs. Currently, these areas include parts of these countries and continents:

Asia
Africa
India
South America
Central America

When traveling in these areas, you are advised to:

Eat only well-cooked foods that are served hot
Avoid all raw or undercooked shellfish
Avoid salads
Avoid raw vegetables that you have not peeled yourself
Carry oral rehydration solution (ORS) and know how to use it if you develop severe diarrhea

RESOURCES:

Centers for Disease Control and Prevention
http://www.cdc.gov

World Health Organization
http://www.who.int/en

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca

Manitoba Health
Communicable Disease Control Unit
http://www.gov.mb.ca/health/publichealth/cdc/index.html

REFERENCES:

Cholera. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/cholera/index.html. Updated May 3, 2012. Accessed January 7, 2013.

Cholera. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated October 9, 2012. Accessed January 7, 2013.

Farmer P, Almazor CP, et al. Meeting cholera's challenge to Haiti and the world: a joint statement on cholera prevention and care. PLoS Negl Trop Dis. 2011;5(5):e1145.

Harris JB, Khan AI, et al. Blood group, immunity, and risk of infection with vibrio cholerae in an area of endemity. Infection and Immunity. 2005;73:7422-7427.

Ryan ET. The cholera pandemic, still with us after half a century: time to rethink. PLoS Negl Trop Dis. 2011;5(1):e1003.

Sack DA, Sack RB, et al. Cholera. Lancet. 2004;363:223-233.

World Health Organization, Cholera: 2010. 2011 Weekly Epidemiological Record. Jul 29;86(31):325-39. Available at http://www.who.int/wer/2011/wer8631.pdf. Accessed January 7, 2013.

Last reviewed November 2012 by Michael Woods, MD
Last Updated: 11/26/2012