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Cholera
Cholera is an infection of the small intestine that causes a large amount of watery diarrhea.
Causes
Cholera is caused by the bacterium Vibrio cholerae . These bacteria release a toxin that causes an increased amount of water to be released from cells that line the intestines. This increase in water produces severe diarrhea.
People get the infection from eating or drinking food or water that contains the cholera germ. Living in or traveling to areas where cholera is present raises the risk of getting it.
Cholera occurs in places with a lack of water treatment or sewage treatment, or crowding, war, and famine. Common locations for cholera include:
- Africa
- Some parts of Asia
- India
- Bangladesh
- Mexico
- South and Central America
Symptoms
Symptoms of cholera can be mild to severe. They include:
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Abdominal cramps
Abdominal cramps
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
ImageRead Article Now Book Mark Article - Dry mucous membranes or dry mouth
- Dry skin
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Excessive thirst
Excessive thirst
Excessive thirst is an abnormal feeling of always needing to drink fluids.
ImageRead Article Now Book Mark Article - Glassy or sunken eyes
- Lack of tears
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Lethargy
Lethargy
Fatigue is a feeling of weariness, tiredness, or lack of energy.
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Low urine output
Low urine output
Decreased urine output means that you produce less urine than normal. Most adults make at least 500 ml of urine in 24 hours (a little over 2 cups)....
ImageRead Article Now Book Mark Article - Nausea
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Rapid
dehydration
Dehydration
Dehydration occurs when your body does not have as much water and fluids as it should. Dehydration can be mild, moderate, or severe, based on how muc...
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Rapid pulse
(heart rate)
Rapid pulse
A bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.
ImageRead Article Now Book Mark Article - Sunken "soft spots" (fontanelles) in infants
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Unusual
sleepiness
or tiredness
Sleepiness
Drowsiness refers to feeling abnormally sleepy during the day. People who are drowsy may fall asleep in inappropriate situations or at inappropriate...
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- Watery diarrhea that starts suddenly and has a "fishy" odor
Exams and Tests
Tests that may be done include:
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Blood culture
Blood culture
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
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Stool culture
and Gram stain
Stool culture
A fecal culture is a lab test to find organisms in the stool (feces) that can cause gastrointestinal symptoms and disease.
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Treatment
The goal of treatment is to replace fluid and salts that are lost through diarrhea. Diarrhea and fluid loss can be fast and extreme. It can be hard to replace lost fluids.
Depending on your condition, you may be given fluids by mouth or through a vein ( intravenous , or IV). Antibiotics may shorten the time you feel ill.
Intravenous
Intravenous means "within a vein. " Most often it refers to giving medicines or fluids through a needle or tube inserted into a vein. This allows th...
The World Health Organization (WHO) has developed packets of salts that are mixed with clean water to help restore fluids. These are cheaper and easier to use than the typical IV fluid. These packets are now being used around the world.
Outlook (Prognosis)
Severe dehydration can cause death. Most people will make a full recovery when they are given enough fluids.
Possible Complications
Complications may include:
- Severe dehydration
- Death
When to Contact a Medical Professional
Call your health care provider if you develop severe watery diarrhea. Also call if you have signs of dehydration, including:
- Dry mouth
- Dry skin
- "Glassy" eyes
- 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. (This vaccine is not available in the United States.)
Travelers should always be careful when eating food and drinking water, even if they are vaccinated.
When outbreaks of cholera occur, efforts should be made to establish clean water, food, and sanitation. Vaccination is not very effective in managing outbreaks.
References
DuPont HL. Approach to the patient with suspected enteric infection. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 283.
Haines CF, Sears CL. Infectious enteritis and proctocolitis and bacterial food poisoning. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 110.
Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 140.
United Nations World Health Organization. WHO position paper on oral rehydration salts to reduce mortality from cholera. WHO 2016. www.who.int/cholera/technical/en/ . Accessed March 18, 2016.
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Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
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Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
-
Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
-
Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
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Travel to developing countries
(In-Depth)
Review Date: 3/13/2016
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
