Cholera Patient Information Fact Sheet

What is Cholera?
Cholera is a bacterial infection. An estimated 3–5 million cases and over 100,000 resultant deaths occur each year around the world. When illness does occur; more than 90% of episodes are mild or moderate and are difficult to distinguish from other types of travelers' diarrhea. Simple rehydration is the treatment for these cases. Approximately 5% of sufferers develop typical cholera with signs of moderate or severe dehydration. In severe cases, profuse, painless, watery diarrhea (“rice water stools”) can quickly lead to dehydration and death if prompt treatment is not sought.

How do you contract cholera?
The bacteria that causes cholera is called Vibrio cholerae, and is usually spread by food and water contaminated with infected feces. Raw or undercooked seafood from polluted water is a common source of infection. The disease can occur in large-scale epidemics where sanitation facilities have broken down, for example in refugee camps and after natural disasters. Cholera has a typical incubation period of two to three days, but may appear as quickly as within a few hours.

How is cholera prevented?
In general, travelers are at minimal risk from cholera, as they usually avoid the unsanitary conditions where this disease is present. All travelers should take steps to avoid contaminated food and water. Boil or purify all drinking water. Avoid eating undercooked shellfish and seafood. Peel fruits and vegetables before eating.

An oral vaccine for cholera may be recommended for travelers at particular risk, eg, those working in underdeveloped areas, refugee camps or hospitals, those visiting friends and family in areas reporting cases, military personnel in conflict zones, and travelers visiting rural areas currently or recently reporting an outbreak.

Currently, there are two oral vaccines available: Dukoral, which is prequalified by the World Health Organization (WHO), and ShanChol, which is pending qualification. Neither vaccine is available in the U.S. The CDC does not recommend that vaccination replace standard prevention and control measures because the vaccine is a two-dose vaccine, therefore multiple weeks can elapse before persons receiving the vaccine are protected.

How is cholera treated?
Fluid replacement is essential to prevent dehydration. You should aim to drink as much nonalcoholic fluid as it takes to maintain a good output of normal looking urine (this may require consuming as much as six or seven gallons a day). In severe cases, intravenous fluid may be necessary. Antibiotics are an important addition to fluid therapy, as they reduce the volume of fluid loss and the risk of infection spreading to others.

Further information
MASTA Travel Health: www.masta-travel-health.com.
Centers for Disease Control: www.cdc.gov/cholera/general/

Last Reviewed: May 2013