Cholera

What is it

Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae¹. It is most often spread by drinking water or eating food that has been contaminated¹. Cholera occurs most commonly in regions where there is inadequate sanitation, poor hygiene, overcrowding and a lack of safe food and water. prevalence is highest in developing countries including parts of Africa, Asia, and Central and South America¹.

What are the symptoms

Most infected people do not show any symptoms^1,2.
For those that do develop symptoms, it takes between 12 hours to 5 days for symptoms to appear after ingesting contaminated food or water².
Among people who develop symptoms, the majority have mild to moderate cases².

In mild to moderate cases, symptoms include¹:

Diarrhea, with or without vomiting

In more severe cases, symptoms include¹:

Leg cramps, nausea, vomiting and frequent watery diarrhea
Can lead to severe dehydration and even death within hours if not treated promptly.

Who is at risk

Most travellers are at very low risk if they practice good personal hygiene and safe food and water precautions, even in countries where cholera outbreaks are being reported². Travellers at higher risk include those visiting, working or living in areas with limited access to safe food, water and proper sanitation, or to areas where outbreaks are occurring¹.

How is it spread

The bacteria can be found in the feces of an infected person which can be transmitted to others who consume food and water contaminated with the bacteria¹. Cholera is prevalent in areas with poorly treated sewage and drinking water¹.

Undercooked or raw seafood can be contaminated by water containing the bacteria, or if it’s handled by an infected person¹.

How is it prevented

Consult a healthcare provider or visit a travel health clinic preferably six weeks before you travel to an area where cholera occurs.

Given the current availability of oral cholera vaccine, these vaccines should be used in areas with endemic cholera, in humanitarian crises with high risk of cholera, and during cholera outbreaks. The vaccines should always be used in conjunction with other cholera

prevention and control strategies²:

Practice safe food and water precautions¹.
Wash hands frequently with soap under warm water for at least 20 seconds before eating, preparing food, and after using the bathroom or changing diapers¹.
- Use alcohol-based hand sanitizer if water is not available
Travellers at higher risk (those in areas with limited access to clean water and food and/or with poor sanitation) may benefit from vaccination^1,3.
Monitor your health and carry oral rehydration salts¹.
- If you develop severe diarrhea and/or vomiting, seek medical attention immediately.
  - Drink fluids and use oral rehydration salts to prevent dehydration.
  - Infants, young children, the elderly and those with underlying health conditions are at greatest risk of dehydration.

How is it treated

Cholera is an easily treatable disease; the majority of people can be treated successfully through prompt administration of oral rehydration solution (ORS)². Adults may require up to 6 liters of ors to treat moderate dehydration on the first day².

The most important treatment is to stay hydrated¹.

If a person with symptoms is treated promptly, the illness is rarely fatal¹. In severe cholera cases, antibiotics can help shorten the length of the illness¹. Severely dehydrated patients require rapid administration of intravenous fluids in addition to ORS². Medical advice is recommended for the onset of symptoms. for further information regarding cholera and immunization, please speak with your healthcare provider.

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