Cholera
What is cholera?
Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae. It is most often spread by drinking water or eating food that has been contaminated.
What is my risk?
Most travellers are at very low risk, if they practise good personal hygiene and safe food and water precautions, even in countries where cholera outbreaks are being reported.
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 occurring.
How is it transmitted?
- The bacteria are found in the stool (feces) of an infected person. It can be spread to other people who consume food and water contaminated with the bacteria, especially in areas where sewage and drinking water are poorly treated.
- Food, particularly undercooked or raw shellfish and fish, can be contaminated by water containing the bacteria or if it is handled by an infected person.
What are the symptoms?
- Most infected people do not show any symptoms.
- Those who do develop symptoms usually have mild to moderate diarrhea, with or without vomiting.
- In more severe cases, symptoms include leg cramps, nausea, vomiting and frequent watery diarrhea, which can lead to severe dehydration and even death if not treated promptly.
Can cholera be treated?
The most important treatment is to stay hydrated.
If a person with symptoms is treated promptly, the illness is rarely fatal. In severe cholera cases, antibiotics can help shorten the length of the illness.
Where is cholera a concern?
- Cholera occurs most commonly in regions of the world where there is inadequate sanitation, poor hygiene, overcrowding and a lack of safe food and water.
- The risk of cholera can increase following disaster situations (for example, earthquakes, hurricanes, civil unrest) due to the disruption of water and sanitation systems and the displacement of populations to overcrowded camps.
- Cholera continues to occur in many developing countries especially where sanitation is poor, including parts of Africa, Asia and to a lesser extent, Central and South America.
- A map of areas reporting outbreaks and imported cases of cholera is available from the World Health Organization (WHO).
Recommendations
Consult a health care provider or visit a travel health clinic preferably six weeks before you travel.
1. Practise safe food and water precautions
- Wash your hands with soap under warm running water for at least 20 seconds as often as possible, including before eating or preparing food and after using the bathroom or changing diapers.
- Use alcohol-based hand sanitizer if soap and water are not available. It’s a good idea to always keep some with you when you travel.
3. Consider getting vaccinated
- Most travellers are at very low risk. Travellers at higher risk (those in areas with limited access to clean water and food and/or with poor sanitation), should discuss with a health care provider the benefits of getting vaccinated before travelling.
4. Monitor your health and carry oral rehydration salts
- If you are travelling to areas where cholera occurs, oral rehydration salts can help to treat dehydration in cases of severe diarrhea. Oral rehydration salts are available at pharmacies.
- 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.
- Cholera, WHO