Key facts
- Cholera is an infectious disease that can kill within hours if left untreated.(1) Cholera is caused by ingesting water or food contaminated with Vibrio cholerae bacteria.(1)
- The disease is endemic in Africa, Asia and Central and South America and is prevalent in areas where there is poor sanitation.(2,4)
- It is estimated that every year, there are roughly 1.3 to 4.0 million cases, and 21,000 to 143,000 deaths per year worldwide due to cholera.(1)
- Symptomatic cholera is shown by watery diarrhea, vomiting and dehydration. Although the disease often has a mild progression, without treatment Cholera can lead to death.(1,2)
- Cholera is a treatable disease.(1) A multifaceted approach which also includes the administration of oral cholera vaccines is key to control cholera, and to reduce deaths.(6)
What is cholera?
Cholera is an acute diarrheal infection that can kill within hours if left untreated.(1) Cholera is caused by ingesting water or food that has been contaminated with Vibrio cholerae bacteria.(1) Cholera is most likely to occur and spread in places with inadequate water treatment, poor sanitation, and inadequate hygiene.(2)
Video CholeraWhere does cholera occur?
Cholera is endemic to many parts of the world, which are popular traveller destinations, including Africa, Asia, South America, and Central America.(3-5) Cholera is most likely to occur and spread in places with inadequate water treatment, poor sanitation, and inadequate hygiene.(2) Cholera bacteria can also live in the environment in brackish rivers and coastal waters. Shellfish eaten raw have been a source of infection.(2)
Which travellers are at risk of contracting cholera?
- Travellers visiting places with poor sanitation are at greatest risk of contracting cholera.(1,2)
- An increased risk of infection is associated with travellers likely to be in close contact with the local population (including travellers visiting friends and relatives, and expatriates), emergency relief workers, health-care and military personnel, and travellers to areas with a high risk of infection or with insufficient access to medical facilities, such as backpackers.(5)
- The infection is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk factor for becoming ill. Most people infected with V. cholerae do not develop any symptoms, although the bacteria are present in their faeces for 1-10 days after infection and are shed back into the environment, potentially infecting other people.(1)
What are the symptoms of cholera?
Most people infected with V. cholerae are asymptomatic. However, the bacteria are present in their faeces for 1-10 days after infection and are shed back into the environment, potentially infecting other people.(1) Approximately 10% of infected people will develop severe symptoms such as watery diarrhea, vomiting, and leg cramps.(2) In these people, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.(2)
How is cholera treated?
Treatment for cholera involves rehydration following the loss of fluids from diarrhea. Patients can be treated with prompt administration of oral rehydration solution, which is a mixture of sugar, salts and water.(1,2) Severe cases may require rapid administration of intravenous fluids and antibiotics may also be administered to shorten the length of diarrhea episodes and to decrease the excretion of V. cholerae bacteria.(1) With early and proper treatment, the case fatality rate should remain below 1%.(1,2) Any person who develops severe diarrhea and vomiting in countries where cholera occurs should seek medical attention immediately.(1)
References
- World Health Organization. Cholera. Factsheet. Online available: https://www.who.int/en/news-room/fact-sheets/detail/cholera (Last accessed December 2021)
- Centers for Disease Control and Prevention. Cholera. General Information. Online available: https://www.cdc.gov/cholera/general/ (Last accessed December 2021)
- World Health Organization. Countries reporting cholera, 2010-2015. September 2016. Online available: http://gamapserver.who.int/mapLibrary/Files/Maps/Global_Cholera_2010_2015.png (Last accessed December 2021)
- Steffen R. Epidemiology of Traveler’s Diarrhea. Clin Infect Dis 2005:41(S8);S536–40.
- Zuckerman JN, Rombo L, Fisch A. The true burden and risk of cholera: implications for prevention and control. Lancet Infect Dis 2007; 7: 521–530.
- World Health Organization. ENDING CHOLERA A GLOBAL ROADMAP TO 2030. Online available: https://www.who.int/cholera/publications/global-roadmap.pdf (Last accessed December 2021)
