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Cholera
What is Cholera?
Cholera is an intestinal illness caused by the bacterium Vibrio cholera. It is rare in the United States because of our superior public water purification systems and sanitary sewer systems. This disease, however, is still common in other parts of the world, including certain parts of Africa, India, and Central and South America.
Who gets Cholera?
Anyone can get cholera, however, individuals that are most at risk are travelers to foreign countries where this disease is an ongoing problem and where drinking water is untreated or sewage treatment facilities are inadequate.
How is Cholera spread?
A person usually becomes infected with cholera by eating food or drinking water contaminated with the cholera bacterium. The bacteria multiply in the intestinal tract, and are passed out of the body through the stool. Spread of cholera can be rapid in areas where there is inadequate treatment of sewage and drinking water.
Cholera bacterium may also live in coastal and estuarine waters (ocean bays) which have been contaminated by sewage containing Vibrio cholera. A few persons in the United States have become ill with cholera after eating raw or undercooked shellfish harvested from the Gulf of Mexico. However, generally the risk of becoming ill with cholera is quite low in the United States.
What are the symptoms of Cholera?
A person may have no symptoms, or may have mild to severe diarrhea, vomiting and dehydration. Fever is usually absent. Approximately one in 20 infected persons has severe disease characterized by profuse watery diarrhea, vomiting and leg cramps. In these persons, rapid loss of body fluids can lead to dehydration and shock. Without immediate hospitalization and restoration of the body fluids, death can occur within hours.
How soon do symptoms appear?
An individual infected with cholera may experience symptoms from 5 hours to 5 days after swallowing food or water contaminated with the cholera bacteria. However, symptoms usually appear within 2 to 3 days.
How is cholera diagnosed?
Cholera is diagnosed primarily by identifying Vibrio cholera bacteria in a stool specimen examined under a microscope. Sometimes the diagnosis is confirmed by blood samples which are tested for Vibrio cholera antibodies.
What is the treatment for cholera?
If an ill individual has prolonged, severe diarrhea and/or vomiting which has resulted in dehydration (a significant loss of body fluids and salts) replacement of these fluids and salts can be urgent. Patients can be treated with oral fluids in most situations, however in more severe cases hospitalization for intravenous (IV) fluids is necessary. A doctor may also prescribe an antibiotic to shorten the duration of diarrhea and diminish the severity of illness.
How long is an infected person infectious to others?
An infected person can pass this illness on to others as long as Vibrio cholera bacteria are being passed in his or her stool. The cholera bacteria usually disappear from the stool a few days after the diarrhea and vomiting have stopped. Occasionally, however, an individual may continue to pass the bacteria in his or her stool for several months following recovery.
Is there a vaccine for cholera? Yes, however it is generally not recommended for routine use. The currently available vaccine is only about 50% effective at preventing illness, and it's effectiveness declines after only 2 to 6 months.
Should an infected person be excluded from work or school?
Individuals with vomiting and diarrhea should remain home from work or school until those symptoms have resolved. It is not necessary to exclude from work or school an individual who has recently recovered from cholera and who may still have cholera bacteria in his or her stool unless that individual has poor personal hygiene. Casual contact with an infected person is generally not a risk for becoming ill. However, anyone with diarrhea should not prepare food for others.
How can cholera be prevented?
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