Cholera is a serious bacterial disease that usually causes severe diarrhea and dehydration. The disease is typically spread through contaminated water. In severe cases, immediate treatment is necessary because death can occur within hours. This can happen even if you were healthy before you caught it.
Modern sewage and water treatment have effectively eliminated cholera in most countries. It’s still a problem in countries in Asia, Latin America, Africa, India, and the Middle East. Countries affected by war, poverty, and natural disasters have the greatest risk for a cholera outbreak. That’s because these conditions tend to force people to live in crowded areas without proper sanitation.
Cholera is caused by bacteria called Vibrio cholerae. The disease’s deadly effects are the result of a strong toxin known as CTX that is produced by these bacteria in your small intestine. CTX interferes with the normal flow of sodium and chloride when it binds to your intestinal walls. When the bacteria attaches to the small intestine’s walls, your body begins to secrete large amounts of water that lead to diarrhea and rapid loss of fluids and salts.
Contaminated water supplies are the primary source of cholera infection. Uncooked fruits, vegetables, and other foods can also contain the bacteria that cause cholera.
Cholera is not usually passed from person to person through casual contact.
Anyone can become sick with cholera, but a few factors may increase your risk. These risk factors also increase the likelihood that you’ll have a severe case. These include:
- unclean conditions (such as poor sanitation and contaminated water)
- low levels of stomach acid (cholera bacteria cannot live in highly acidic environments)
- sick household members
- type O blood (it’s not clear why this is true, but more people with this blood type seem to be at risk for cholera)
- eating raw shellfish (if the shellfish live in dirty waters where the cholera bacteria live, there is greater chance of becoming ill)
The majority of people exposed to cholera never become ill. In fact, in most cases, you may never know you’ve been exposed. Once you’re infected, you’ll continue to shed cholera bacteria in your stools for seven to 14 days. Cholera usually causes mild to moderate diarrhea, like other illnesses.
One in 10 people who are infected will develop typical symptoms within two to three days after infection.
Common symptoms of cholera include:
- sudden onset of diarrhea
- mild to severe dehydration
The dehydration caused by cholera is usually severe and can cause tiredness, moodiness, sunken eyes, dry mouth, shriveled skin, extreme thirst, reduced urine output, irregular heartbeat, and low blood pressure.
Dehydration may lead to loss of minerals in your blood. This can lead to an electrolyte imbalance. The first sign of an electrolyte imbalance is severe muscle cramps. An electrolyte imbalance can eventually lead to shock.
Children usually have the same cholera symptoms as adults. Children may also experience the following:
- severe drowsiness
Cholera rarely occurs in first world nations. If you follow proper food safety practices, even in affected areas, the risk of infection is minor. Still, cholera continues to occur worldwide. If you develop severe diarrhea after visiting an area with a high rate of cholera, you should see a doctor.
Diagnosis and Treatment
If you have symptoms of cholera, you should contact your doctor. A doctor can confirm that you have cholera by identifying bacteria in a stool sample.
Common methods for treating cholera include:
- oral rehydration salts
- intravenous fluid rehydration
- zinc supplements
These treatments add to the liquid in the body and rehydrate it. They also help reduce the length of time you have diarrhea.
Cholera can be fatal. In severe cases, rapid loss of fluids and electrolytes can cause death in as little as two or three hours. Even in typical cases, if cholera is left untreated, people can die of dehydration and shock in as little as 18 hours.
Shock and severe diarrhea are the most serious complications of cholera. However, other problems may occur, such as:
- low blood sugar
- low potassium levels
- kidney failure
If you’re traveling to an area where cholera is common, your chances of catching the disease are still low if you:
- wash your hands
- drink only bottled or boiled water
- avoid raw food and shellfish
- avoid dairy foods
- eat raw fruits and vegetables that you can peel yourself
Since cholera vaccines don’t work very well and most people have a slim chance of catching cholera, your doctor is not likely to provide you with a vaccination. If you’ve already had the vaccine and are going to be in a country where cholera is a threat, you may need a second dose or booster of the vaccine.