Washing The Hands That Feed You

Things You Need To Know About Cholera

What is Cholera?

Cholera is an infection of the small intestines that cause a large amount of watery diarrhea, and vomiting as well. It's typically caused by consumption of contaminated food or water. During the 19th century, cholera spread across the world from its original reservoir in the Ganges delta in India. Six pandemics killed millions of people across all continents. The current (seventh) pandemic started in South Asia in 1961, and reached Africa in 1971 and the Americas in 1991. Cholera is now an endemic in many countries.

What Causes Cholera?

Cholera is caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. The short incubation period of two hours to five days, increases the chance of an explosive pattern of outbreaks. The bacteria are present in a persons feces for 7–14 days after infection and are shed back into the environment, potentially infecting other people.


Cholera is an extremely virulent disease. It affects both children and adults and can kill within hours. Cholera transmission is closely linked to inadequate environmental management. Typical at-risk areas include peri-urban slums, where basic infrastructure is not available, as well as camps for internally displaced people or refugees, where minimum requirements of clean water and sanitation are not met. Underdeveloped countries such as Africa are at a higher risk than most. Any disruption of water and sanitation systems, or the displacement of populations to inadequate and overcrowded camps can increase the risk of cholera transmission if the bacteria is present or introduced. For 2011 alone, a total of 589 854 cases were notified from 58 countries, including 7816 deaths. Many more cases were unaccounted for due to limitations in surveillance systems and fear of trade and travel sanctions. The true burden of the disease is estimated to be 3–5 million cases and 100 000–120 000 deaths annually.

Check Your Stool; Symptoms of Cholera

About 75% of people infected with V. cholerae do not develop any symptoms, Among people who develop symptoms, 80% have mild or moderate symptoms, while around 20% develop acute watery diarrhea with severe dehydration. This can lead to death if untreated. People with low immunity – such as malnourished children or people living with HIV – are at a greater risk of death if infected.
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Diagnosing Cholera involves testing a stool sample from a suspected patient. This is difficult to do due to the risk of its chance to spread. Isolation and identification of Vibrio cholerae is the top standard for identifying cholera. Rapid Test kits are available to all state health department labs in the U.S. In areas limited to no lab testind, the Crystal VC dipstick rapid test can provide an early warning to health officials.


Cholera is an easily treatable disease. Up to 80% of people can be treated successfully through the administration of oral rehydration salts. Very severely dehydrated patients require administration of IV fluids. Such patients also require appropriate antibiotics to diminish the duration of diarrhea, reduce the volume of rehydration fluids needed, and shorten the duration of V. cholerae excretion. Mass administration of antibiotics is not recommended, as it has no effect on the spread of cholera and contributes to increasing antimicrobial resistance. In order to ensure timely access to treatment, cholera treatment centers (CTCs) should be set up among the affected populations. With proper treatment, the case fatality rate should remain below 1%.


Once an outbreak is detected, the usual intervention strategy is to reduce deaths by ensuring prompt access to treatment, and to control the spread of the disease by providing safe water, proper sanitation and health education for improved hygiene and safe food handling practices by the community. The provision of safe water and sanitation is a challenge but remains the critical factor, and one of the only ways to really reduce and prevent the impact of cholera.

What your Stool is telling you; Additional facts and Statistics

  • Today, no country requires proof of cholera vaccination as a condition for entry.
  • Cholera is an acute diarrhoeal disease that can kill within hours if left untreated.
  • There are an estimated 3–5 million cholera cases and 100 000–120 000 deaths due to cholera every year.
  • Up to 80% of cases can be successfully treated with oral rehydration salts.

  • Provision of safe water and sanitation is critical in reducing the impact of cholera and other waterborne diseases.