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Definition:

Cholera is an infection of the small intestine that causes a large amount of watery diarrhea.



Alternative Names:

V. cholerae; Vibrio



Causes, incidence, and risk factors:

Cholera is caused by the bacterium Vibrio cholerae. The bacteria releases a toxin that causes increased release of water in the intestines, which produces severe diarrhea.

Cholera occurs in places with poor sanitation, crowding, war, and famine. Common locations for cholera include:

  • Africa
  • Asia
  • India
  • Mexico
  • South and Central America
  • The Mediterranean

People get the infection by ingesting contaminated food or water.

A type of vibrio bacteria also has been associated with shellfish , especially raw oysters.

Risk factors include:

  • Exposure to contaminated or untreated drinking water
  • Living in or traveling to areas where there is cholera


Symptoms:

Note: Symptoms can vary from mild to severe.



Signs and tests:

Tests that may be done include:



Treatment:

The objective of treatment is to replace fluid and electrolytes lost through diarrhea. Depending on your condition, you may be given fluids by mouth or through a vein (intravenous ). Antibiotics may shorten the time you feel ill.

The World Health Organization (WHO) has developed an oral rehydration solution that is cheaper and easier to use than the typical intravenous fluid. This solution of sugar and electrolytes is now being used internationally.



Support Groups:



Expectations (prognosis):

Severe dehydration can cause death. Given adequate fluids, most people will make a full recovery.



Complications:
  • Severe dehydration
  • Death


Calling your health care provider:

Call your health care provider if :

  • You develop severe watery diarrhea
  • You have signs of dehydration, including:
    • Dry mouth
    • Dry skin
    • "Glassy" eyes
    • Lethargy
    • No tears
    • Rapid pulse
    • Reduced or no urine
    • Sunken eyes
    • Thirst
    • Unusual sleepiness or tiredness


Prevention:

The U.S. Centers for Disease Control and Prevention does not recommend cholera vaccines for most travelers. (Such a vaccine is not available in the United States.)

Travelers should always take precautions with food and drinking water, even if vaccinated.

When outbreaks of cholera occur, efforts should be directed toward establishing clean water, food, and sanitation, because vaccination is not very effective in managing outbreaks.



References:

Gotuzzo E, Seas C. Cholera and other vibrio infections. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 325.




Review Date: 2/21/2009
Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100