Cholera : symptoms, causes and management

Cholera : symptoms, causes and management

Cholera is an intestinal infection which is caused when a person consumes contaminated food or water. It is generally caused by the bacterium Vibrio cholerae. It has a short incubation period, from one day to five days. After contamination, bacteria produces an enterotoxin that causes a copious, painless, watery diarrhea that can quickly lead to severe dehydration and death if treatment is not promptly given. Vomiting also occurs in most patients.

The cholera bacteria are generally seen in water or food sources, that have been contaminated by faeces from a person infected with cholera. Cholera is usually seen in places with inadequate water treatment, poor sanitation and inadequate hygiene.

The cholera bacterium may also live in the environment in salty rivers and coastal waters.


Cholera infection is often mild or without symptoms, but can sometimes be severe.
Infected persons with severe disease  will have:
  • Profuse watery diarrhea
  • Vomiting
  • Leg cramps.
In people, rapid loss of body fluids leads to dehydration and shock. If not treated it can lead to death within hours.


Cholera is a diarrheal illness caused by the bacteria Vibrio cholerae. This species is not common to humans, and its presence in the human digestive system is not part of the natural life cycle of the bacteria.

A person can get infected by drinking water or eating food contaminated with the cholera bacterium. In an epidemic, the source of the contamination is usually the faeces of an infected person that contaminates water and/or food. The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water. The disease is not likely to spread directly from one person to another therefore, casual contact with an infected person is not a risk for becoming ill.


Laboratory tests include stool gram stain (gram negative rods) culture, dark field microscopy or stool PCR. One must begin treatment even before diagnostic work-up.

Stool sample or a rectal swab is taken and is then send to a laboratory for the cholera bacterium.

Cholera cots: These are cots with openings to allow fecal output into a bucket, are used to measure volumes of stool loss and fluid replacement needs.


Have plenty of fluids:

It is important to drink plenty of fluids to avoid dehydration. Oral Rehydration Salt (ORS) is used to prevent dehydration. Standard home solutions such as salted rice water, salted yogurt drinks, vegetable and chicken soups with salt can be given. Home solutions such as water in which cereal has been cooked, unsalted soup, green coconut water, weak tea (unsweetened), and unsweetened fresh fruit juices.


Antibiotics can shorten the course and diminish the severity of the illness, but they are not as important as receiving rehydration.


WHO recommends a child with diarrhea should be fed continuously. Continued feeding speeds the recovery of normal intestinal function. In contrast, children whose food are restricted, have diarrhea of longer duration and recover intestinal function more slowly.


To prevent cholera:
  1. Drink safe and clean water
  2. Wash your hands frequently with soap and clean water
  3. Proper hygiene and sanitation
  4. Cook food welland cover it properly

Now a days, there are two oral cholera vaccines available, Dukoral (manufactured by SBL Vaccines) which is World Health Organization (WHO) prequalified and licensed in over 60 countries, and ShanChol (manufactured by Shantha Biotec in India), which is licensed in India and is pending WHO prequalification. Because the vaccine is a two dose vaccine, multiple weeks can elapse before persons receiving the vaccine are protected.

Therefore, vaccination should not replace standard prevention and control measures.