What is cholera?

Cholera is an illness caused by infection of the intestine with the vibrio cholerae bacteria. Infection may cause severe diarrhoea and, as a result, dehydration. It is most likely to be found in parts of the world with poor quality water and sanitation.

What are the symptoms of cholera?

Cholera can be mild or severe. Sometimes people do not know they have cholera, although their faeces (poo) can infect others. It usually takes 2-3 days for symptoms to appear but the time can range from a few hours to 5 days.

Mild symptoms are like other gastro illnesses. If the infection is severe, you can become severely dehydrated and may die if not treated.

Symptoms of severe cholera infection may include:

• extreme watery, painless diarrhoea
• vomiting and nausea
• leg or abdominal (tummy) cramps
• feeling very tired
• weakness
• dizziness
• headache
• dry mouth and being very thirsty
• urinating less than normal

What causes cholera?

Cholera is caused by infection by the vibrio cholerae bacteria.

A person can get cholera from drinking water or eating food that has been contaminated with the bacteria. It is also spread by coming into contact with the faeces of someone that is infected, and passing the bacteria into the mouth.

The illness can spread rapidly particularly in areas with unsafe drinking water, poor sanitation and inadequate hygiene. The disease is not likely to spread from person to person; therefore, casual contact with an infected person is not a risk factor for cholera.

You are more likely to contract cholera if travelling to countries with poor sanitation, although the risk is very low. Cholera is found in more than 50 developing countries, mainly in Africa, Haiti, South and Southeast Asia. The risk is higher in urban slums and camps for displaced persons.

How is cholera diagnosed?

Cholera is diagnosed with a stool culture test, when a sample of faeces is examined in the laboratory to look for the bacteria.

How is cholera treated?

The main treatment for cholera is oral rehydration therapy to replace fluid and salts lost through diarrhoea. People with severe dehydration will need intravenous fluids.

Sometimes people with cholera may be given antibiotics.

Can cholera be prevented?

To avoid cholera and other gastro illnesses when you are travelling, it is important to consume safe food and water. Remember: “Boil it, cook it, peel it or forget it”.

You should avoid unpasteurised milk, yoghurt and cheese, raw or undercooked meat and seafood, reheated or cold foods, salads, ice cubes and any food that is contaminated by flies or dirty hands. Make sure all food is covered and that you use clean cutlery and crockery. Always wash your hands or use hand sanitiser before you eat or handle food.

Safe food choices are fruit you can peel, fruit or vegetables cleaned with sterilised water, freshly cooked meals, tinned food or freshly baked bread.

Assume that all water is contaminated. If you cannot get bottled water, then sterilise water by boiling it for at least 5 minutes or using water purification tablets. Assume that ice is also contaminated.

The risk of catching cholera is usually very low, so most travellers do not need to be vaccinated. However, the cholera vaccine is recommended for children aged 2 years and over and adults (such as emergency/relief workers) travelling to areas where there is a high likelihood of exposure to cholera. It is also recommended for people with certain conditions that put them at greater risk of travellers’ diarrhoea, such as poorly controlled diabetes, inflammatory bowel disease, HIV and significant cardiovascular disease.

The cholera vaccine is not routinely recommended for women who are pregnant or breastfeeding, unless their doctor thinks they need it. You should not have the cholera vaccine if you have a fever or a gastro illness — wait until you have recovered.

This table explains how the cholera vaccine is given, it is not on the National Immunisation Program Schedule. Some diseases can be prevented with different vaccines, so talk to your doctor about which one is appropriate for you.

Complications of cholera

Cholera can lead to severe dehydration. Death is rare, but in some people who do not receive medical care, it can be fatal within hours of symptoms starting.

Resources and support

• For more information on cholera, visit the Department of Health’s web page on travel immunisation.
• If you need to know more about cholera, or need advice on what to do next, call healthdirect on 1800 022 222 to speak with a registered nurse, 24 hours, 7 days a week (known as NURSE-ON-CALL in Victoria).