Cholera

What is cholera?

Cholera is an acute diarrheal illness caused by certain strains of the bacterium Vibrio cholerae.

Who gets cholera?

In the United States, cholera occurs in persons who travel to foreign countries where outbreaks of cholera are occurring and who drink contaminated water and food there, or those who eat raw or undercooked seafood, including seafood from the Gulf of Mexico. The disease is not a threat in the United States and other countries with advanced water and sanitation systems.

How is cholera spread?

People with cholera shed the bacteria in their feces (stool). The disease is not likely to spread directly from one person to another. The main way cholera is spread is when feces from a person with cholera gets into the water and people get sick from swallowing the contaminated water. Food can also be contaminated if it is washed with unclean water or fertilized with sewage or contaminated soil. If shellfish are harvested from water that has been contaminated, people can get sick from eating the shellfish if it is raw or undercooked. Proper water treatment and sanitation minimize the risk of cholera.

What are the symptoms of cholera?

Most people exposed to the cholera bacteria will not develop any symptoms. Symptoms can range from mild to severe and most commonly include profuse watery diarrhea, vomiting, weakness, and leg cramps. In severe cases, when treatment is unavailable or delayed, death can occur within a few hours due to loss of large amounts of fluid. With rapid, proper treatment, people can recover without long-term consequences.

How soon after exposure do symptoms appear?

Symptoms can appear anywhere from six hours to five days after exposure, but usually appear within two to three days after exposure.

How is cholera diagnosed?

Special laboratory testing of a stool sample is needed to confirm that a person has cholera.

What is the treatment for cholera?

Persons with symptoms of cholera should seek medical care immediately. The most important treatment is replacement of fluid lost from the body due to diarrhea. It is very important that special replacement fluids containing the right balance of electrolytes (sodium, chloride, and potassium), sugar and water are used to replace the lost fluids. In severe illness, intravenous (I.V.) fluids might be necessary. Antibiotics are also sometimes used.

How can cholera be prevented?

Safe drinking water and proper sanitation are the keys to cholera prevention. When traveling in countries where cholera is present, eat only thoroughly cooked hot foods or fruits/vegetables that you peel just before eating (e.g., bananas). Use only bottled beverages or water that has been boiled or treated with chlorine for drinking, brushing teeth, or cleaning food preparation surfaces. Thorough hand washing with soap after using the bathroom and before preparing or eating food is always important. Seafood should be cooked thoroughly before it is eaten.

An oral cholera vaccine has been approved for use in the United States in adults 18–64 years of age who are traveling to an area of active cholera transmission. Three other vaccines for cholera have been developed, but they are not available in the United States. Prospective travelers to areas where cholera is common should carefully follow recommendations for obtaining safe food and water at their destination, and seek medical attention promptly if they develop symptoms of cholera.

How can I get more information about cholera?

• If you have concerns about cholera, contact your healthcare provider.
• Call your local health department. A directory of local health departments is located at the VDH Local Health Districts page.
• Visit the Centers for Disease Control and Prevention website at the CDC's page on cholera.

August 2018