Cholera is an infection of the small intestine that causes a large amount of watery diarrhea.
Alternative Names
V. cholerae
Causes, incidence, and risk factors
Cholera is caused by the bacterium Vibrio cholerae. The bacteria releases a toxin that causes increased release of water from cells in the intestines, which produces severe diarrhea.
Cholera occurs in places with poor sanitation, crowding, war, and famine. Common locations for cholera include:
Africa
Asia
India
Mexico
South and Central America
People get the infection by eating or drinking contaminated food or water.
A type of vibrio bacteria also has been associated with shellfish, especially raw oysters.
Risk factors include:
Exposure to contaminated or untreated drinking water
Living in or traveling to areas where there is cholera
The goal of treatment is to replace fluid and electrolytes lost through diarrhea. Depending on your condition, you may be given fluids by mouth or through a vein (intravenous, or IV). Antibiotics may shorten the time you feel ill. Antibiotics that may be used include tetracycline or doxycline.
The World Health Organization (WHO) has developed an oral rehydration solution that is cheaper and easier to use than the typical IV fluid. This solution is now being used internationally.
Expectations (prognosis)
Severe dehydration can cause death. Given adequate fluids, most people will make a full recovery.
Complications
Severe dehydration
Death
Calling your health care provider
Call your health care provider if :
You develop severe watery diarrhea
You have signs of dehydration, including:
Dry mouth
Dry skin
"Glassy" eyes
Lethargy
No tears
Rapid pulse
Reduced or no urine
Sunken eyes
Thirst
Unusual sleepiness or tiredness
Prevention
The U.S. Centers for Disease Control and Prevention does not recommend cholera vaccines for most travelers. (Such a vaccine is not available in the United States.)
Travelers should always take precautions with food and drinking water, even if vaccinated.
When outbreaks of cholera occur, efforts should be directed toward establishing clean water, food, and sanitation, because vaccination is not very effective in managing outbreaks.
References
DuPont HL. Approach to the patient with suspected enteric infection. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed.Philadelphia, Pa: Saunders Elsevier; 2011:chap 291.
Semrad CE. Approach to the patient with diarrhea and malabsorption.In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa:Saunders Elsevier; 2011:chap142.
Giannella RA. Infectious enteritis and proctocolitis and bacterial food poisoning. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 107.
Review Date:
5/30/2012
Reviewed By:
Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
