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Cholera

What is Cholera?

Cholera, caused by and infection in the intestine with the Vibrio Cholerae bacterium, is an acute diarrhoeal illness that can result in severe dehydration and death. It is estimated that over 100,000 people die each year around the world from Cholera.

Where is Cholera found?

Cholera is still common in countries with poor lower socio-economic areas such as Africa, Central Europe, Latin America and Asia. This is because of insufficient access to clean water and sanitation facilities that are often found in very poor areas, or refugee camps, or when a natural disaster such as floods, cause a disruption to water and sanitary systems. For example, during the rainy season each year, Cholera becomes particularly problematic in Ghana due to the filth and insanitary situations in the country.

How do you get infected with Cholera?

Cholera infections occur when a person:

  • eats food that has been contaminated (food is usually contaminated by dirty water, unwashed hands or flies)
  • drinks water that has been contaminated by human faeces
  • eats fish or shellfish that has been taken from contaminated water.

It is important to note that the cholera organism can survive for long periods of time in ice and water.

Cholera is not known to spread from person to person. This means that casual contact with an infected person does not put you at risk on contracting the infection.

What are the symptoms of Cholera?

The Cholera infection is often mild or occurs without symptoms. It is estimated that approximately five to 10% of Cholera cases become more severe, with symptoms ranging from nausea, profuse watery diarrhoea, vomiting (and sometimes leg or abdominal cramps) leading to rapid dehydration, electrolytic imbalances and shock. If left untreated, the infected person may die within hours.

In severe cases, the symptoms often start suddenly a few hours to five days after ingesting the Cholera bacterium through contaminated water or food. Both adults and children can be affected.

Even if no symptoms occur, infected people will have the bacterium present in their faeces for up to 10 days and, if shed back into the environment, can potentially infect other people.

If you suspect you, or someone you know, may be infected seek immediate medial advice (especially if you are in or have travelled to countries where Cholera occurs). You should also start using rehydration fluids (ORS) immediately if you have any available and continue to do so whilst travelling to seek medical advice as this could save their life.

How is Cholera diagnosed and treated?

The presence of Cholera is confirmed by testing a stool sample or through a rectal swab in a laboratory.

Cholera can be easily treated by the immediate replacement of the fluid and salts that have been lost through diarrhoea. Depending on the severity of the Cholera infection, oral rehydration, intravenous (IV) fluid replacement and antibiotics may be used during treatment.

Prompt rehydration dramatically reduces the potential of death, with fewer that one percent of patients dying after treatment.

How can I reduce the risk of contracting Cholera?

The risk of contracting Cholera is very low when observing simple precautions such as following proper sanitary practices (even when visiting areas with an epidemic).

When visiting an area where Cholera is, or has occurred, you should:

  • Be careful of what you drink. Drink only bottled, boiled or chemically treated water and canned or bottled drinks (including carbonated drinks). Be careful to ensure the seal of your bottle has not been broken.
    • Avoid tap water, ice cubes and fountain drinks.
    • You can disinfect your own water by:
      • Boiling for one minute, or filter the water
      • Add 2 drops of household bleach or half an iodine tablet per one litre of water.
  • Wash your hands regularly with clean water and soap, or alcohol-based hand sanitisers/cleaners (look for those with at least 60% alcohol in them).
    • Make sure you clean your hands before you eat, prepare food or immediately after using the bathroom.
  • Use boiled, chemically treated or bottled water to:
    • Wash dishes
    • Brush your teeth
    • Wash and prepare food
    • To make ice
  • Do not eat raw and undercooked meats and seafood or fruits and vegetables that haven’t been peeled. Instead, eat foods that are either packaged or have been freshly prepared and are served hot.
  • If there is a lack of sanitation, then dispose of faeces in a sanitary manner to prevent contamination of food and water sources.

For more information on drinking and eating safely while travelling, see our food safety fact sheet

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