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The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water. The infection is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk factor for becoming ill.
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About 1.3 billion people are at risk of cholera in countries...
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Cholera is an acute, diarrheal illness caused by infection...
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Most people exposed to the cholera bacterium (Vibrio cholerae) don't become ill and don't know they've been infected. But because they shed cholera bacteria in their stool for seven to 14 days, they can still infect others through contaminated water.
Most cases of cholera that cause symptoms cause mild or moderate diarrhea that's often hard to tell apart from diarrhea caused by other problems. Others develop more-serious signs and symptoms of cholera, usually within a few days of infection.
Symptoms of cholera infection can include:
•Diarrhea. Cholera-related diarrhea comes on suddenly and can quickly cause dangerous fluid loss — as much as a quart (about 1 liter) an hour. Diarrhea due to cholera often has a pale, milky appearance that resembles water in which rice has been rinsed.
•Nausea and vomiting. Vomiting occurs especially in the early stages of cholera and can last for hours.
•Dehydration. Dehydration can develop within hours after cholera symptoms start and range from mild to severe. A loss of 10% or more of body weight indicates severe dehydration.
The risk of cholera is slight in industrialized nations. Even in areas where it exists you're not likely to become infected if you follow food safety recommendations. Still, cases of cholera occur throughout the world. If you develop severe diarrhea after visiting an area with active cholera, see your doctor.
If you have diarrhea, especially severe diarrhea, and think you might have been exposed to cholera, seek treatment right away. Severe dehydration is a medical emergency that requires immediate care.
A bacterium called Vibrio cholerae causes cholera infection. The deadly effects of the disease are the result of a toxin the bacteria produces in the small intestine. The toxin causes the body to secrete enormous amounts of water, leading to diarrhea and a rapid loss of fluids and salts (electrolytes).
Cholera bacteria might not cause illness in all people who are exposed to them, but they still pass the bacteria in their stool, which can contaminate food and water supplies.
Contaminated water supplies are the main source of cholera infection. The bacterium can be found in:
•Surface or well water. Contaminated public wells are frequent sources of large-scale cholera outbreaks. People living in crowded conditions without adequate sanitation are especially at risk.
•Seafood. Eating raw or undercooked seafood, especially shellfish, that comes from certain places can expose you to cholera bacteria. Most recent cases of cholera in the United States have been traced to seafood from the Gulf of Mexico.
•Raw fruits and vegetables. Raw, unpeeled fruits and vegetables are a frequent source of cholera infection in areas where there's cholera. In developing countries, uncomposted manure fertilizers or irrigation water containing raw sewage can contaminate produce in the field.
Everyone is susceptible to cholera, with the exception of infants who get immunity from nursing mothers who have previously had cholera. Still, certain factors can make you more vulnerable to the disease or more likely to have severe signs and symptoms.
Risk factors for cholera include:
•Poor sanitary conditions. Cholera is more likely to flourish in situations where a sanitary environment — including a safe water supply — is difficult to maintain. Such conditions are common to refugee camps, impoverished countries, and areas afflicted by famine, war or natural disasters.
•Reduced or nonexistent stomach acid. Cholera bacteria can't survive in an acidic environment, and ordinary stomach acid often serves as a defense against infection. But people with low levels of stomach acid — such as children, older adults, and people who take antacids, H-2 blockers or proton pump inhibitors — lack this protection, so they're at greater risk of cholera.
•Household exposure. You're at increased risk of cholera if you live with someone who has the disease.
•Type O blood. For reasons that aren't entirely clear, people with type O blood are twice as likely to develop cholera compared with people with other blood types.
Cholera can quickly become fatal. In the most severe cases, the rapid loss of large amounts of fluids and electrolytes can lead to death within hours. In less extreme situations, people who don't receive treatment can die of dehydration and shock hours to days after cholera symptoms first appear.
Although shock and severe dehydration are the worst complications of cholera, other problems can occur, such as:
•Low blood sugar (hypoglycemia). Dangerously low levels of blood sugar (glucose) — the body's main energy source — can occur when people become too ill to eat. Children are at greatest risk of this complication, which can cause seizures, unconsciousness and even death.
•Low potassium levels. People with cholera lose large quantities of minerals, including potassium, in their stools. Very low potassium levels interfere with heart and nerve function and are life-threatening.
Cholera is rare in the United States with the few cases related to travel outside the U.S. or to contaminated and improperly cooked seafood from the Gulf Coast waters.
If you're traveling to areas known to have cholera, your risk of contracting the disease is extremely low if you follow these precautions:
•Wash your hands with soap and water frequently, especially after using the toilet and before handling food. Rub soapy, wet hands together for at least 15 seconds before rinsing. If soap and water aren't available, use an alcohol-based hand sanitizer.
•Drink only safe water, including bottled water or water you've boiled or disinfected yourself. Use bottled water even to brush your teeth.
Hot beverages are generally safe, as are canned or bottled drinks, but wipe the outside before you open them. Don't add ice to your drinks unless you made it yourself using safe water.
•Eat food that's completely cooked and hot and avoid street vendor food, if possible. If you do buy a meal from a street vendor, make sure it's cooked in your presence and served hot.
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Dec 11, 2023 · Cholera is a disease of poverty affecting people with inadequate access to safe water and basic sanitation. Conflict, unplanned urbanization and climate change all increase the risk of cholera. Researchers have estimated that each year there are 1.3 to 4.0 million cases of cholera, and 21 000 to 143 000 deaths worldwide due to cholera (1).
Mar 28, 2022 · Poor Environmental Conditions. Because cholera is primarily spread through contaminated food and water, lacking access to safe water and sanitation, as well as proper waste management, can increase the chances of an outbreak happening if someone with cholera enters the area.
May 23, 2023 · Introduction. Cholera is an acute secretory diarrheal illness caused by the bacteria Vibrio cholerae. It is estimated to cause upwards of four million cases per year, worldwide. High-volume fluid loss with electrolyte derangements that can progress to hypovolemic shock and ultimately death characterizes this gastrointestinal disease.
Apr 30, 2021 · People infected with these bacteria can spread disease through their feces (also called stool or poop). They do so when infected feces get into the water system. If the water isn’t properly sanitized (cleaned), people using the water to drink, cook and wash risk exposure.
