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Cholera

Pronounced: KOL-eh-ra

Definition

Cholera is an infectious disease that affects the intestinal tract.

Causes    TOP

Cholera is caused by a specific bacteria. This bacterium releases 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 proper sewage disposal.

Small Intestines

Small intestines
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Risk Factors    TOP

Cholera is more common in children 2-5 years of age. Other factors that increase your chance of cholera include:

  • Living or traveling in areas where cholera is present
  • Eating contaminated food or fluids
  • Eating raw or undercooked shellfish
  • Having blood group O
  • Having a weakened immune system
  • Having low levels of stomach acid

Symptoms    TOP

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

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

The severity of symptoms ranges from mild, short-lived diarrhea to shock and death due to extreme fluid loss. Most symptoms occur 1-3 days after exposure.

Diagnosis    TOP

You will be asked 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    TOP

Fluid Replacement

The first priority in treating cholera is to replace fluids and electrolytes lost through diarrhea. In severe cases, dehydration can be fatal if it is not treated right away. Hydration solutions can be given orally or through an IV.

Antibiotics

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

Prevention    TOP

Cholera Vaccine

Although it is not available in the US or Canada, a cholera vaccine is available in areas where cholera is common. Currently, these areas include parts of these countries and continents:

  • Asia
  • Africa
  • India
  • South America
  • Central America

If you will be visiting a country where cholera is present, you may be advised to receive the vaccination when you arrive at your destination.

Careful Eating Habits

You can prevent cholera by avoiding contaminated food and fluids in areas where cholera occurs.

When traveling in areas where cholera is common, you are advised to:

  • Drink only bottled or boiled water
  • 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

CANADIAN RESOURCES:

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References:

Cholera. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Updated October 18, 2013. Accessed June 19, 2014.
Cholera. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115474/Cholera. Updated June 28, 2016. Accessed September 29, 2016.
Cholera: 2010. 2011 Weekly Epidemiological Record. Jul 29;86(31):325-39. Available at
...(Click grey area to select URL)
Accessed June 19, 2014.
Farmer P, Almazor CP, Bahnsen ET, 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, LaRocque RC, et al. Blood group, immunity, and risk of infection with vibrio cholerae in an area of endemity. Infect Immun. 2005;73(11):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, Nair GB, Siddique AK. Cholera. Lancet. 2004;363(9404):223-233.
Last reviewed May 2016 by David Horn, MD
Last Updated: 6/19/2014

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