Health Information - Cholera
Cholera is an acute diarrhoeal disease caused by the intake of contaminated food or water infested by the bacteria Vibrio cholerae. The disease is endemic in many countries. Cholera outbreaks are caused by two serogroups of V. cholerae – O1 and O139.
Transmission
The bacterium that causes it is spread through food and water that has been contaminated by the faeces of an infected person. Symptoms Cholera has a short incubation period of a few hours to 5 days and can lead to death if left untreated. It affects both children and adults. Most infected cases do not develop any symptoms but are infectious for a period of 1 to 10 days. Mild to severe diarrhoea may develop within one to five days after infection. It is painless and watery, often called "rice-water" stools. Vomiting also occurs in most patients. Usually, the symptoms are relatively mild and respond to oral rehydration.
Severe cases of cholera (5-10%) can cause life-threatening dehydration.
Diagnosis
Diagnosis is through isolation and identification of Vibrio cholerae bacteria in a culture of a stool sample or rectal swab.
Treatment
Prompt treatment is very effective and involves oral and/or intravenous fluid replacement depending on the severity of dehydration. Antibiotics are helpful in reducing the volume and duration of diarrhoea.
Vaccine
Oral vaccines are available to prevent cholera, but they are not 100% effective and not available in every country.
Dukoral® (manufactured by SBL Vaccines) is administered to adults and children > 6 years in 2 doses, protection can be expected 1 week after the last dose. For children aged > 2 years and < 6 years require 3 doses. Dukoral® also gives some short-term protection against traveller's diarrhoea caused by ETEC (enterotoxigenic E.Coli).
ShanChol® (manufactured by Shantha Biotec in India) is administered to adults and children > 1 year in 2 doses.
A third oral cholera vaccine Euvichol® (manufactured in South Korea) was approved by the WHO in January 2016.
In June 2016, Vaxchora® (manufactured by PaxVax) was approved by the U.S Food and Drug Administration for the prevention of cholera caused by serogroup 01 in adults aged 18-64 years travelling to cholera-affected areas. It is administered as a single oral dose at least 10 days prior to travel.
Prevention
If visiting an area infected with cholera:
• Consider vaccination if available.
• Select food, water and other beverages carefully.
• Drink only boiled or bottled water, water that has been treated with chlorine or iodine, or carbonated beverages.
• Consider carrying water purification supplies with you.
• Choose food that has been thoroughly cooked while fresh and is served hot.
• Avoid ice, raw fruit, and raw vegetables (including salad). Fruit and vegetables that you peel yourself are safer choices.
• Pay close attention to hygiene. Wash your hands frequently, especially before eating.
Risk to Travellers
Cholera tends to occur in large epidemics, especially in areas where sanitary conditions have deteriorated such as peri-urban slums, refugee camps and war zones. With the exception of health and relief workers, cholera rarely infects travellers who avoid unsanitary conditions.
More information
Reference
Disclaimer: This information has been developed for educational purposes only. It is not a substitute for professional medical advice. Should you have questions or concerns about any topic described here, please consult your healthcare professional.
