Cholera
Last Reviewed: August 2017
What is cholera?
Cholera is a bacterial disease that causes diarrhea (loose stool/poop) and is caused by the bacteria calledVibrio cholerae. Although only a few cases are recognized in the United States each year, many cases are identified each year in portions of Africa, South and Central America, and Southeast Asia.
Who gets cholera?
While cholera is a rare disease in the U.S., people who may be at risk are those traveling to foreign countries where outbreaks are occurring and those who consume raw or undercooked seafood from warm coastal waters that may be exposed to sewage contamination. In both instances, the risk is small. Individuals living in places with inadequate water treatment, poor sanitation, and inadequate hygiene (cleanliness) are at a greater risk for cholera.
How is cholera spread?
The cholera bacteria is passed through feces (poop). It is spread by eating or drinking food or water contaminated by the feces (poop) of an infected person. This occurs more often in underdeveloped countries lacking proper water supplies and sewage disposal. It is not likely that cholera is spread directly from one person to another.
What are the symptoms of cholera and when do they appear?
People infected with cholera may experience mild to severe watery diarrhea (loose stool/poop), vomiting, and dehydration (loss of water in the body causing weakness or dizziness). The symptoms may appear from a few hours to five days after eating or drinking contaminated food or water.
How is cholera diagnosed?
Cholera is diagnosed when the cholera bacteria, Vibrio cholerae, is found in a stool sample or rectal swab.
What is the treatment for cholera?
Cholera can be treated simply and successfully by immediate replacement of the fluid and salts lost through diarrhea (loose stool/poop). Patients can be treated with an oral rehydration solution, a prepackaged mixture of sugar and salts mixed with water in large amounts. This solution is used throughout the world to treat diarrhea. Severe cases also require intravenous fluid replacement. With prompt rehydration, less than 1% of cholera patients die.
Antibiotics shorten the course and diminish the severity of the illness, but they are not as important as receiving rehydration. Persons who develop severe diarrhea and vomiting in countries where cholera occurs should seek medical attention promptly.
Does past infection with cholera make a person immune?
People can be reinfected with cholera if they are exposed to the bacteria again.
Is there a vaccine for cholera?
The FDA recently approved a single-dose live oral cholera vaccine called Vaxchora (lyophilized CVD 103-HgR) for adults 18 – 64 years old who are traveling to an area of active cholera transmission with toxigenic Vibrio cholerae O1 (the bacteria strain that most commonly causes cholera). The vaccine is not routinely recommended for most travelers from the United States, as most people do not visit areas of active cholera transmission. Two other oral inactivated (or non-live cholera vaccines), Dukoral® and ShanChol®, exist but these vaccines are not available in the U.S. No cholera vaccine is 100% protective and vaccination against cholera is not a substitute for standard prevention and control measures.
How can the spread of cholera be prevented?
The single most important preventive measure is to avoid consuming uncooked foods or water in foreign countries where cholera occurs unless they are known to be safe or have been properly treated (for example, sealed bottled, boiled, or chemically treated water). In addition, it is important to wash your hands often with soap and clean water or an alcohol based hand cleanser, particularly before you eat or prepare foods and after using the bathroom.
