Cholera is an intestinal bacterial infection that spreads through contaminated water. It can cause severe diarrhea and dehydration.
It’s not just the residents of these areas who are affected during an outbreak. Visitors can be at risk for catching the disease as well, the Centers for Disease Control and Prevention (CDC) warns.
Although most cases aren't severe and can be treated, the condition can lead to death for those who don't get the proper care.
Signs and Symptoms of Cholera
- Nausea and vomiting
- Sleepiness or lethargy
- Muscle cramps
- Rapid pulse
- Electrolyte imbalance
- Excessive thirst and low urine output
- Dry skin, dry mucous membrane (such as inside the nose or eyelids), and dry mouth
Those who experience cholera dehydration typically have symptoms such as irritability, fatigue, sunken eyes, dry mouth, extreme thirst, and dry and shriveled skin, as well as lack of urination, reduced blood pressure, and irregular heartbeat.
In addition, cholera-related dehydration can cause an electrolyte imbalance, or a rapid loss of vital minerals in your blood. People with an electrolyte imbalance may experience muscle cramps due to reduced levels of sodium, chloride, and potassium in the blood, along with hypovolemic shock caused by dangerous drops in blood pressure and oxygen flow.
Causes and Risk Factors of Cholera
Research suggests the following may increase your risk:
- Poor sanitary conditions
- Reduced stomach acid
- Type O blood
- Household exposure
How Is Cholera Diagnosed
An early diagnosis can lead to faster treatment and isolation of infected individuals, which can help control outbreaks.
Prognosis of Cholera
Duration of Cholera
Treatment and Medication Options for Cholera
Treatment for the infection focuses on restoring fluids and salts lost through diarrhea (or vomiting).
The fluid replacement typically recommended is a WHO-developed rehydration solution called oral rehydration salts (ORS). ORS is available as a powder that can be combined with boiled or bottled water. As long as it’s mixed with clean water, it’s designed to be consumed in large amounts in order to provide full rehydration.
Medication Options for Cholera
Alternative and Complementary Therapies
Plant-extract formulations may eventually be helpful in easing symptoms, in conjunction with established treatments, but it's important to note that this approach shouldn’t be used in place of rehydration therapy or antibiotics.
Prevention of Cholera
- Drink only beverages that are bottled, canned, boiled, or chemically treated, and avoid tap water, fountain drinks, and ice cubes.
- Wash your hands often with soap and (clean) water, or use a hand cleanser with at least 60 percent alcohol — especially before eating or preparing food and after using the bathroom.
- Eat prepackaged food or food that's freshly cooked and served hot.
- Don't eat raw or uncooked shellfish, including sushi.
- Avoid dairy foods.
- Use bottled, boiled, or chemically treated water to brush your teeth, prepare food, wash dishes, and make ice.
If you’re planning on traveling to areas with active cholera transmission, talk to your doctor about this vaccine.
No cholera vaccine is 100 percent protective, though, and vaccination against cholera isn’t a substitute for standard prevention and control measures.
Complications of Cholera
Although most cases of cholera are mild — particularly if treated — the infection can be fatal.
Those with the most severe illness lose large amounts of fluids and electrolytes quickly, causing death within hours.
In less-extreme situations, people who can’t get treated right away can die of dehydration and shock hours to days after their symptoms first appear.
- Low blood sugar (hypoglycemia)
- Reduced potassium levels
- Kidney failure
In addition, severe diarrhea causes people with cholera to lose large quantities of essential minerals the body needs, including potassium. Reduced potassium levels can interfere with heart and nerve function and be life-threatening.
Research and Statistics: Who Gets Cholera?
Related Conditions of Cholera
The bacteria that cause cholera have, at least to date, not been linked with other health conditions. But cholera’s symptoms may mimic those of other conditions, including:
Unlike cholera, traveler’s diarrhea is rarely life-threatening, but if nothing else, it can make for a very unpleasant trip.
Dehydration causes dry mouth, fatigue, dizziness, headache, and muscle cramps. You may also urinate less often than you normally do, or have dark urine.
Resources We Love
World Health Organization (WHO)
Within the United Nations system, the WHO is the authority on international health. Their website provides a comprehensive look at cholera — what it is, how it spreads, and how to prevent it — as well as news on cholera outbreaks and vaccinations.
Centers for Disease Control and Prevention (CDC)
In addition to covering all the basics of cholera, the CDC provides the latest statistics and data on the disease, insight into their own efforts to investigate and combat outbreaks, and helpful information for travelers.
A highly trusted source for Everyday Health editors, the Mayo Clinic offers clear, straightforward info on cholera and its potential complications and what to do if you believe you've been exposed to it.
Additional reporting by Brian P. Dunleavy.
Editorial Sources and Fact-Checking
- Cholera. Mayo Clinic. February 1, 2020.
- General Information: Cholera. Centers for Disease Control and Prevention (CDC). August 5, 2020.
- Cholera. World Health Organization. January 17, 2019.
- Cholera. National Institute of Allergy and Infectious Diseases. May 12, 2016.
- Fanous M, King KC. Cholera. StatPearls. June 6, 2020.
- Cholera. National Organization of Rare Disorders. 2009.
- Technical Note: Use of Antibiotics for the Treatment and Control of Cholera. World Health Organization. May 2018.
- Komiazyk M, Palczewska M, et al. Neutralization of Cholera Toxin by Rosaceae Family Plant Extracts. BMC Complementary and Alternative Medicine. June 20, 2019.
- Travelers' Diarrhea. CDC. October 8, 2019.
- Dehydration. MedlinePlus. April 15, 2016.