Definition Cholera is an infection of the intestines caused by bacteria called Vibrio cholera. This infection results in large amounts of diarrhoea.
What is going on in the body? A person can develop cholera by eating or drinking contaminated food or water. Cholera occurs in most parts of the world. In Australia, most cases are seen in travellers from other countries, or in people who have eaten food imported from another country. Cholera can cause severe dehydration, which may result in death if the person is not treated.
What are the signs and symptoms of the infection? Symptoms usually start 1 to 3 days after eating or drinking contaminated food or water, and may include:
painless watery diarrhoea, often in very large amounts
What are the causes and risks of the infection? Cholera is caused by eating or drinking contaminated food or water that contains Vibrio cholera bacteria.
What can be done to prevent the infection? Thorough cooking of food can often prevent cholera. Boiling water or treating it with chlorine or iodine is another good way to prevent this infection. Cholera is common in underdeveloped countries that lack clean water supplies. A person who travels to underdeveloped countries should be careful about the food and water consumed.
Good hygiene, especially when preparing food, can help prevent spreading the infection through foods.
How is the infection diagnosed? The diagnosis of cholera begins with a complete medical history and physical examination. Sometimes, the bacteria can be seen in a sample of the stool with a microscope. In other cases, a stool culture is needed. Stool culture involves putting a sample of stool in a special container. This container has a solution in it that allows the Vibrio cholera bacteria to grow. If the organism grows, it can be identified and the diagnosis can be made.
What are the long-term effects of the infection? All the important effects of cholera are due to losing large amounts of water and salt from the diarrhoea. A person can develop life-threatening salt imbalances. Severe dehydration can occur and result in low blood pressure and kidney damage.
In severe cases, shock and even death are possible. Death from cholera is very rare in Australia, but is more common in countries where access to water and medical care is limited.
What are the risks to others? Cholera can be spread from one person to another. This is more likely to occur if the infected person does not have good personal hygiene. A person with diarrhoea from an infection should be extra careful about washing his or her hands.
What are the treatments for the infection? A person with cholera needs large amounts of fluids and salts, called electrolytes, to replace what is lost. Liquid salt solutions can be used if the person is able to drink. Otherwise, fluids and salt can be given through an intravenous line, or IV. An IV is a thin tube that is inserted through the skin and into a person's vein, usually in the hand or forearm. This is often the only treatment that is needed, as the diarrhoea goes away in a few days.
Antibiotics, such as doxycycline and ciprofloxacin, can be used to treat cholera. Though antibiotics are not needed, they can shorten the length of time it takes for symptoms to go away. They also help clear the bacteria from the bowel, which reduces the chance of spread to others.
What are the side effects of the treatments? All antibiotics have possible side effects, including allergic reactions and stomach upset.
What happens after treatment for the infection? In most cholera cases, the diarrhoea goes away and the person starts to feel better within a few days. If treatment is delayed, dehydration can cause complications. These include kidney damage, severe salt imbalances, or even shock. In these cases, the person is usually treated and monitored in a hospital for a short time.
How is the infection monitored? Any new or worsening symptoms should be reported to the doctor.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
