Cholera
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Cholera

Pronounced: KOL-eh-ra

En Español (Spanish Version)

Definition

Cholera is an infectious disease that affects the intestinal tract. It is rare today in industrialized countries. However, it has caused severe epidemics in the past, and continues to be a major public health problem throughout the world in underdeveloped countries. If left untreated, it may cause death within hours.

Causes

Cholera is caused by the bacterium Vibrio cholera . This bacterium secretes a toxin that causes rapid loss of fluids from the small intestines. Cholera is not spread directly from one person to another. It is spread through food or water contaminated by fecal waste. It is common in countries that lack adequate sewage disposal.

Small Intestines

Small intestines

© 2008 Nucleus Medical Art, Inc.

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition.

Risk factors include:

  • Eating contaminated food or fluids
  • Eating raw or undercooked shellfish
  • Living or traveling in areas where cholera is present
  • Having blood group O—nine-fold increase in risk
  • Having a compromised immune system
  • Having low levels of stomach acid

Symptoms

Symptoms of cholera come on fairly quickly and can be severe. They include:

  • Sudden onset of painless, watery diarrhea without blood or pus
  • Vomiting
  • Dehydration
  • Thirst
  • Muscle cramps

The severity of symptoms ranges from mild, short-lived diarrhea to shock and death due to extreme fluid loss. Most symptoms occur 1 to 3 days after exposure.

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. 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, uncorrected dehydration can be fatal. Hydration solutions can be given orally or through an IV.

Antibiotics

Antibiotic medications help shorten the course of the disease. They may also be given to the people you live with to prevent them from becoming ill.

Prevention

Careful Eating Habits

You can prevent cholera by avoiding contaminated food and fluids in areas where cholera occurs. Currently, these areas include parts of these countries and continents:

  • Asia
  • Africa
  • India
  • South America
  • Central America

When traveling in these areas, you are advised to:

  • 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.

Vaccine

The short-term cholera vaccine that was previously manufactured and sold in the United States is no longer available. Because it offered only brief and inconsistent immunity, this vaccine was not consistently effective. Cholera vaccines that provide somewhat better immunity and fewer side effects are now available in other countries, but are not recommended for travelers and are not licensed in the United States.

RESOURCES:

Centers for Disease Control and Prevention
http://www.cdc.gov

World Health Organization
http://www.who.int/en

CANADIAN RESOURCES:

Communicable Disease Control Unit
http://www.gov.mb.ca/health/publichealth/cdc/index.html

Health Canada
http://www.hc-sc.gc.ca/index_e.html

References:

Cholera. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/cholera_g.htm . Accessed November 10, 2007.

Cholera. DynaMed website. Available at: http://dynamed101.ebscohost.com/Detail.aspx?id=115474 .

Harris JB, Khan AI, LaRocque RC, Dorer DJ, et al. Blood group, immunity, and risk of infection with vibrio cholerae in an area of endemity. Infection and Immunity . 2005;73:7422-7427.

Sack DA, Sack RB, Nair GB, et al. Cholera. Lancet . 2004;363:223-233.



Last reviewed November 2007 by Marcin Chwistek, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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