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Worried About Cholera? Here's What You Need to Know

Worried About Cholera? Here's What You Need to Know

Cholera is an infectious disease caused by bacteria in contaminated water. It causes severe diarrhea which leads to dehydration. This disease may be fatal within hours if left untreated.

There have been several cholera outbreaks and pandemics in the last 200 years. The risk for outbreaks is highest when people are forced to live in unsanitized, crowded conditions. Outbreaks can occur during a war, natural disasters, or in places where there are bad cases of poverty. In these situations, people typically don’t have access to safe water and food, and adequate sanitation.

In recent years, modern water treatment has effectively eliminated cholera in developed countries. But there are still threats for it in Southeast Asia, Haiti, and Africa.

What are the causes of cholera?

Cholera infection is caused by exposure to Vibrio cholerae or the cholera bacterium. This produces toxins in the small intestine that cause the body to discharge large amounts of water. This will lead to diarrhea and a rapid loss of electrolytes (fluids and salts).

Not all infected patients show symptoms and become ill, but can still pass the bacteria on in their stool, contaminating water supplies and food. The bacterium can be found in contaminated food and water supplies such as:

Surface or well water

Public wells are constant sources of wide-ranging outbreaks of this disease. People living in unsanitized, congested conditions are at a higher risk of contamination.

Raw vegetables and fruits

Unpeeled and raw vegetables and fruits can be a sources of infection, especially in places where there were recent cases. Contaminated irrigation water or uncomposted fertilizers can contaminate the produce.


Rice and millet grains cooked in contaminated water can grow the cholera bacterium after being kept at room temperature for several hours.


Eating undercooked or raw seafood from infected areas can expose you to the disease.

Signs and symptoms of cholera

People who are exposed to the bacterium do not become ill instantly and may not even be aware they are infected. But for 7-14 days, they will shed the bacteria in their stool and can still affect others through contaminated water.

After a few days of infection, symptoms may include:


Cholera can cause sudden diarrhea resulting in threatening fluid loss of about one liter per hour. The diarrhea caused by the disease has a pale, milky appearance resembling water used to rinse rice.

Nausea and vomiting

This occurs in the early stage of cholera and can last for hours.


Mild to severe dehydration can develop within the first few hours of the diarrhea and vomiting. Signs and symptoms of cholera dehydration may include:

  • Dry mouth and sunken eyes
  • Irritability and fatigue
  • Dry and shriveled skin
  • Extreme thirst
  • Little to no urinating
  • Irregular heartbeat and low blood pressure

Dehydration can lead to electrolyte imbalance. Electrolyte imbalance is a quick loss of the minerals that can be found in your blood, resulting in an imbalance of fluids in your body. The symptoms of electrolyte imbalance are muscle cramps and shock. Severe hypovolemic shock occurs when there is low blood volume resulting in a drop in the amount of oxygen and blood pressure and can be fatal if not treated immediately.

Risk Factors

Everyone is prone to cholera infection. However, infants who are breastfed by mothers who survived the disease get immunity to the disease.

There are certain factors that can make you more vulnerable to the disease:

  • Poor sanitary conditions. The bacterium thrives in places where there is poor sanitation and untreated water supplies. These conditions are common in impoverished countries, refugee camps, areas affected by famine, or during war or natural disasters.
  • Household exposure. You are most likely to get infected when you live with someone who is infected with the disease.
  • Eating raw or uncooked shellfish. Shellfish caught from contaminated waters can increase the risk of infection.
  • Type O blood. People with type O blood are most likely to develop cholera compared with people with other blood types. The reasons are still unknown.
  • Reduced or nonexistent stomach acid. Stomach acid can serve as a defense against cholera because the bacterium cannot survive in an acidic environment. People with low stomach acid levels are at a greater risk of cholera including:
  • Children and older adults
  • People who take antacids, proton pump inhibitors, and H-2 blockers

Prevention, diagnosis, and treatment of cholera

Traveling to areas with known cholera cases increases your chance of contracting the disease.

Following these safety precautions and guidelines can lower or prevent the risk of infection:

  • Frequent handwashing with soap and water
  • Making sure your drinking water is safe
  • Eating freshly cooked and hot meals only
  • Avoiding raw or undercooked seafood
  • Staying away from fruits and vegetables that can’t be peeled (such as grapes and berries)

Doctors can confirm cases of cholera by identifying the bacteria in a stool sample. Quick and correct diagnosis allows early medical interventions, decreasing death tolls, and providing probable outbreak control.

Cholera is fatal and requires immediate medical attention and treatment such as:

  • Rehydration. This means using a simple rehydration solution and oral rehydration salts to replace lost fluids and electrolytes. Untreated dehydration leads to death.
  • Intravenous fluids. Patients with severe dehydration may need intravenous fluids.
  • Antibiotics. Often used to reduce and shorten diarrhea that is related to cholera.
  • Zinc Supplements. This helps decrease and shorten diarrhea in children infected with cholera. Zinc helps boost the immune system, which, in turn, reduce the duration of diarrhea.

A number of countries offer oral cholera vaccines, especially if you are traveling to areas affected by cholera. Consult your doctor for more information about these vaccines.

Key takeaway

Cases of cholera still occur throughout the world. Although there are food and water safety guidelines, risks of contamination and infection are still high. If you are experiencing signs and symptoms of cholera, especially if it includes diarrhea and dehydration, you should contact your doctor or go to the nearest hospital immediately. Stay well hydrated and get help immediately to avoid infecting other people, and lower the risk of a potential cholera outbreak.

Learn about Other Bacterial Infections here.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Cholera – WHO | World Health Organization, https://www.who.int/news-room/fact-sheets/detail/cholera

Accessed April 19, 2021

Cholera – Symptoms and causes – Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/cholera/symptoms-causes/syc-20355287

Accessed April 19, 2021

Cholera – Diagnosis and treatment – Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/cholera/diagnosis-treatment/drc-20355293

Accessed April 20, 2021

Diagnosis and Detection | Cholera | CDC, https://www.cdc.gov/cholera/diagnosis.html

Accessed April 20, 2021

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Written by Lhay Ann Boctoy Updated 5 days ago
Fact Checked by Hello Doctor Medical Panel