TABLE OF CONTENTS
- What is Cholera?
- Causes of Cholera
- Risk Factors for Cholera
- Symptoms of Cholera
- Diagnosing Cholera
- Treatment for Cholera
- Complications of Cholera
- Preventing Cholera
- When to See a Doctor
What is Cholera?
Cholera is an infectious disease caused by bacteria, typically spread through contaminated water. It leads to severe diarrhea and dehydration. Without prompt treatment, cholera can become fatal within hours even in individuals who were previously healthy.
According to the World Health Organization (WHO), there are an estimated 1.3 to 4 million cholera cases worldwide each year, resulting in 21,000 to 143,000 deaths.
Countries affected by war, poverty, and natural disasters are at the highest risk for cholera outbreaks, as these conditions often force people to live in densely populated areas without proper sanitation.
Causes of Cholera
Cholera is caused by a bacterium called Vibrio cholerae. The deadly effects of the disease stem from a toxin produced by the bacteria in the small intestine.
This toxin triggers the body to release large amounts of water, resulting in diarrhea and a rapid loss of fluids and electrolytes.
In some individuals, the cholera bacteria may not cause illness, but they can still shed the bacteria through their stool, potentially contaminating food and water supplies.
Contaminated water is the main source of cholera infection. The bacteria may be found in:
- Surface Water or Well Water: Contaminated public wells are often linked to large-scale cholera outbreaks. People living in overcrowded conditions without adequate sanitation are especially vulnerable.
- Seafood: Eating raw or undercooked seafood, especially shellfish from contaminated waters, can lead to infection.
- Raw Fruits and Vegetables: Unpeeled raw produce is a common source of infection in areas where cholera is prevalent. In developing countries, unprocessed manure or irrigation with untreated sewage may contaminate crops.
- Grains: In cholera-endemic areas, grains such as rice can become contaminated if left at room temperature overnight, allowing bacteria to grow.
Risk Factors for Cholera
Anyone can get cholera, except for breastfed infants who gain temporary immunity from mothers previously infected with cholera.
However, certain factors increase vulnerability or the severity of symptoms:
- Poor Sanitation. Cholera thrives in environments lacking proper sanitation, including access to clean water. Refugee camps, impoverished areas, and regions affected by war or disasters are particularly at risk.
- Low or Absent Stomach Acid. Cholera bacteria can survive acidic environments, and stomach acid normally helps prevent infection. People with low stomach acid such as children and older adults are more susceptible.
- Household Exposure. The risk increases for those living with an infected person.
- People with blood type O are twice as likely to develop cholera compared to other blood types.
- While industrialized countries rarely face large outbreaks, consuming contaminated shellfish significantly raises the risk.
Symptoms of Cholera
Most people infected with cholera show no symptoms or only mild to moderate symptoms. Common symptoms include:
- Sudden onset of diarrhea
- Nausea
- Vomiting
- Mild to severe dehydration
Severe dehydration from cholera may cause:
- Fatigue
- Irritability
- Sunken eyes
- Dry mouth
- Wrinkled skin
- Intense thirst
- Reduced urine output
- Irregular heartbeat
- Low blood pressure
Dehydration may lead to a loss of minerals in the blood, causing electrolyte imbalances. The first sign of this is often severe muscle cramps. Eventually, electrolyte imbalance can lead to shock.
In children, symptoms are generally similar to those in adults, but may also include:
- Extreme drowsiness
- Fever
- Seizures
- Coma
Diagnosing Cholera
To confirm a diagnosis, a doctor will need a stool sample or may perform a rectal swab. The sample is then analyzed in a lab to identify the V. cholerae bacteria.
Treatment for Cholera
Common treatments for cholera include:
- Oral rehydration salts (ORS)
- Other electrolyte solutions
- Intravenous (IV) fluid replacement
- Antibiotics
- Zinc supplements
These treatments help replenish fluids and rehydrate the body, as well as reduce the duration of diarrhea.
Complications of Cholera
Cholera can become life-threatening very quickly. In the most severe cases, rapid loss of fluids and electrolytes can result in death within hours.
Without timely treatment, individuals may die from dehydration and shock within hours to days after the first symptoms appear.
While severe dehydration and shock are the most dangerous complications, other issues can include:
- Low blood sugar (hypoglycemia)
- Low potassium levels
- Kidney failure
Preventing Cholera
Preventive measures include:
- Frequent handwashing with soap and clean water, specifically after using the toilet and before handling food. When water isn’t available, use alcohol-based hand sanitizers.
- Drinking safe water, such as bottled water or boiled water.
- Avoiding ice unless it’s made from safe water.
- Eating thoroughly cooked, hot food. Avoid street food that may be unhygienic.
- Choosing fruits and vegetables that can be peeled, such as bananas, oranges, and avocados.
- Receiving the cholera vaccine, where available. However, the vaccine is only offered in some countries.
When to See a Doctor
If home care and preventive steps fail, consult a doctor immediately. Seek medical attention right away if you or someone you know shows symptoms of cholera.
Don’t hesitate to contact our English-speaking doctor directly from your smartphone using the Halodoc app. Doctors are available 24 hours to answer your questions.
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References:
Mayo Clinic. Accessed in 2025. Cholera.
WebMD. Accessed in 2025. Cholera.
Healthline. Accessed in 2025. Cholera.
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