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Cholera

What is cholera?
Cholera is an infection of the intestines that causes severe diarrhea. It is caused by the bacteria (germs) Vibrio cholerae. Although only a few cases are recognized in the United States each year, cholera is often reported in parts of Central and South America and Africa. In 2010, there was 1 case of cholera reported in a New York City resident.
Who gets cholera?
While cholera is rare in the United States, travelers to foreign countries where outbreaks are occurring may be at risk for infection. People who consume raw or undercooked seafood from warm coastal waters subject to sewage contamination may also be at risk.
How is cholera spread?
Cholera is spread by eating or drinking food or water that has been contaminated by the fecal waste of an infected person. This occurs more often in developing countries with inadequate water supplies and improper sewage disposal.
What are the symptoms of cholera?
People with cholera may experience mild to severe watery diarrhea, vomiting, and dehydration. Fever is usually absent. Approximately five percent of those who become infected will have severe disease characterized by profuse watery diarrhea, vomiting and leg cramps. Without treatment, the disease can be fatal.
How soon after infection do symptoms appear?
The symptoms may appear from six hours to three days after exposure.
How is cholera diagnosed?
Cholera is diagnosed by isolating the bacteria from an infected person's stool (feces).
What is the treatment for cholera?
Because of the rapid dehydration that may result from severe diarrhea, replacement of fluids by mouth or by the intravenous route is critical. Antibiotics, such as ciprofloxacin and tetracycline, are also used to shorten the duration of diarrhea and shedding of the bacteria in the stool (feces). With prompt rehydration, fatalities are less than one percent.
Is there a vaccine for cholera?
Currently, the manufacture and sale of the only licensed cholera vaccine in the United States has been discontinued. It has not been commonly recommended for travelers since if offers only partial protection for a short duration. Two recently developed vaccines for cholera are available in other countries, but neither is recommended for travelers.
How can cholera be prevented?
People traveling to areas where cholera is common can prevent the disease by following simple precautions:

  • Drink bottled water, or boil water for drinking. Avoid tapwater unless it has been boiled or chemically treated with chlorine or iodine.
  • Only eat food that has been thoroughly cooked.
  • Only eat fruits and vegetables that have been thoroughly cooked or that you have peeled yourself.
  • Avoid eating salads.
  • Avoid undercooked or raw fish/shellfish.
  • Avoid eating foods or beverages from street vendors or restaurants that do not look clean.

Last updated March 2012