Cholera: What It Is, Causes, Symptoms & Treatment

Cholera is a sudden illness that happens when a person swallows food or water containing Vibrio cholerae bacteria. It’s not common in the United States or other developed countries, but affects millions worldwide. Cholera can cause severe diarrhea, dehydration and even death. Clean water and good hygiene are important to prevent it.
Cholera is a sudden illness that happens when a person accidentally ingests (swallows) Vibrio cholerae (V. cholerae) bacteria. When the bacteria infect a person’s intestines, they can cause very bad diarrhea and dehydration. These complications can sometimes lead to death.
Millions of people across the world get cholera infections each year. The bacterial infection usually happens in places without modern systems for sewage and clean water. Examples include undeveloped countries and refugee camps, as well as parts of the Middle East, Asia, South America and Africa.
Cholera outbreaks are more common in warm climates. Outbreaks sometimes happen after natural disasters, like earthquakes and hurricanes. These disasters can damage sewage systems.
Cholera is rare in the United States and other modern, industrialized countries. But Americans should be aware of the disease and its causes, especially if they travel internationally.
Cholera comes from the V. cholerae bacteria. 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.
When a person eats or drinks food or water that contains V. cholerae, the bacteria grow inside them. The bacteria then make the small intestines secrete (leak) fluid, leading to diarrhea.
Cholera usually doesn’t spread directly from person to person, but it can. So it’s important to wash your hands to prevent infection.
Cholera bacteria also live in salty rivers and coastal waters. Some people have gotten cholera from eating raw or undercooked shellfish, though that’s rare.
A cholera infection can be mild, with no symptoms. But about 10% of infected people develop severe symptoms, 12 hours to five days after ingesting the bacteria. These symptoms include:
If you develop any cholera symptoms, immediately contact a healthcare provider. Mild symptoms may go away on their own in a few days. But dehydration can become deadly very quickly. Early treatment can save your life.
Diarrhea and vomiting from cholera can make your body lose large amounts of important substances:
When your body doesn’t have enough of those things, you get dehydrated and may develop:
Untreated, severe dehydration from cholera can lead to:
To test for cholera, a healthcare provider will need a sample of your stool. Often, you will poop into a collection cup or bag. Sometimes, a healthcare provider will insert a swab into your rectum (opening where poop comes out).
The sample gets sent to a laboratory, where experts will look at it under a microscope to identify the bacterium V. cholerae. Some areas where cholera is more common have access to a “dipstick” tool that can rapidly test a stool sample.
The most important part of cholera treatment is preventing or reversing dehydration. Anyone with cholera should immediately replace the fluids and salts they’ve lost. A healthcare provider may prescribe:
Other treatments may include:
V. cholera bacteria usually disappear from the body within two weeks.
People who don’t live in or visit areas with poor sanitation have little chance of getting cholera. But if you’re in an area with cholera cases, certain strategies can help prevent infections:
The U.S. Food and Drug Administration (FDA) has approved one vaccine for cholera (Vaxchora®). It’s for adults ages 18 to 64 who plan to travel to areas with cholera. But the vaccine isn’t recommended very often because most tourists don’t visit places with cholera. Two other cholera vaccines exist but aren’t approved in the United States.
Vaccines aren’t 100% effective, so you should still take care when traveling. Follow precautions with food and water, and wash your hands often.
Cholera may go away on its own in just a few days. But if you have severe symptoms and start to become dehydrated, you need medical attention. You must replace fluids very quickly.
The Centers for Disease Control and Prevention (CDC) has a website where travelers can check for outbreaks of cholera and other diseases (Visit their Travel Health Notices website.)
If you live in an area with cholera or plan to travel to one, make sure you’re careful about the water you drink. Wash your hands and prepare food carefully. The following supplies might help: