Cholera is an acute, diarrheal illness caused by an infection with the bacterium
Vibrio cholerae, in the intestines. The infection is often mild or without symptoms, but sometimes it can be severe. Although cholera can be life-threatening, it is easily prevented and treated.
In the United States, because of advanced water and sanitation systems, cholera is not a major threat. However, everyone, especially travelers, should be aware of how cholera is transmitted and what can be done to prevent it.
Cholera and Vibrio Cholerae
Vibrio cholerae is the type of bacteria that causes cholera. There are two general types of
Vibrio cholerae:
- Vibrio cholerae Serogroup O1
- Vibrio cholerae Serogroup non-O1.
Vibrio cholerae Serogroup O1 is the type of
Vibrio cholerae that most often causes cholera.
Vibrio cholerae Serogroup O139, a
Vibrio cholerae Serogroup non-O1 bacterium, is the other
cause of cholera.
Cholera is usually spread by eating food or drinking water that is contaminated with Vibrio cholerae.
There are two ways that Vibrio cholerae usually gets in water or food:
- Contaminated feces
- Naturally.
Cholera is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk for becoming ill.
Cholera: Incubation Period
When a person becomes infected with the bacteria that cause cholera, the bacteria begin to multiply within the intestines. After 24 to 48 hours, cholera symptoms can occur. The period between becoming infected and the start of cholera symptoms is called the cholera incubation period.
An infection with
Vibrio cholerae is often mild or without cholera symptoms, but sometimes symptoms are severe. Approximately 1 in 20 infected people has severe cholera symptoms. These people may experience a rapid loss of body fluids, leading to dehydration and shock. Without
cholera treatment, death can occur within hours.
In order to make a
cholera diagnosis, the doctor will ask a number of questions and perform a physical exam to look for signs of cholera and fluid loss. If the doctor suspects cholera, he or she will ask for a stool sample. This sample will be examined under a microscope for evidence of
Vibrio cholerae (see Pictures of Cholera).
People who develop severe
diarrhea and vomiting (in countries where cholera occurs) should seek medical attention promptly. When a cholera diagnosis is made, treatment should begin immediately. If treatment is started early, cholera symptoms and complications can be minimized.
Treatments for cholera can include:
- Fluid replacement
- Antibiotics (medicine that can kill the bacteria).
If
cholera treatment is started in a timely manner, and in adequate volumes, the cholera mortality rate is reduced to well under 1 percent. Without proper treatment for cholera, the mortality rate is between 25 and 50 percent.
In the United States, cholera was prevalent in the 1800s, but has been virtually eliminated by modern sewage and water treatment systems. However, as a result of improved transportation, more people from the United States are traveling to parts of Africa, Asia, and Latin America, where epidemic cholera is occurring. For these people,
prevention of cholera involves avoiding contaminated food and water.
At this point, a
cholera vaccine is not recommended for the prevention of cholera.
Since 1817, there have been seven worldwide cholera
pandemics. There is an ongoing global pandemic in Asia, Africa, and Latin America that has lasted for the last four decades. Since 1995, over 80 percent of reported cases of cholera have occurred in Africa.
Cholera has been very rare in industrialized nations for the last 100 years. In the United States, there are zero to five cases per year. Most cholera outbreaks in the United States have occurred in Louisiana and the Gulf of Mexico, from contaminated shellfish.
In 2003, 111,575 cholera cases from 45 countries were reported to the World Health Organization.
Cholera affects more children than adults, and usually occurs during summer and fall months.
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