Cholera
En Español (Spanish Version)

Definition
Cholera is an infectious disease that affects the intestinal tract.

Causes
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

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Risk Factors
Cholera is more common in children 2-5 years of age. Factors that increase your risk of getting 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
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 one to three days after exposure.

Diagnosis
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
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
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

World Health Organization

CANADIAN RESOURCES:

Public Health Agency of Canada

References:
Cholera. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/cholera/index.html. Updated October 18, 2013. Accessed June 19, 2014.

Cholera. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 16, 2014. Accessed June 19, 2014.

Cholera: 2010. 2011 Weekly Epidemiological Record. Jul 29;86(31):325-39. Available at http://www.who.int/wer/2011/wer8631.pdf. Accessed June 19, 2014.

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.

Last Reviewed June 2014



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