What is Cholera?
Cholera is a diarrhea illness caused by infection of the intestine with the bacterium Vibrio cholerae. It is rare in Canada. This illness is common in underdeveloped parts of the world like India and Africa where water and sanitation treatment facilities are inadequate or nonexistent. Travellers should be aware of how the disease is spread and how to prevent it.
What are the signs and symptoms?
Most people infected with cholera do not become ill, but the bacterium is present in their feces for 7 to 14 days. When illness does occur, 90% of the cases have only mild to moderate diarrhea. Another 5-10% get severe watery diarrhea, losing large amounts of liquid very quickly. Stools are typically colorless with flecks of mucus, called rice water diarrhea. The rapid loss of fluids can lead to dehydration and death if not treated. The symptoms may appear from a few hours to 5 days after exposure, but usually within 2 to 3 days.
How is it spread?
People get cholera by drinking water or eating food contaminated with the bacteria. Raw seafood, and raw fruits and vegetables are high-risk foods. Thoroughly cooking the foods kills the bacteria.
How can travelers protect themselves?
- Drink only water that you know is uncontaminated. If you are unsure, boil water for at least five minutes, or treat with chlorine or iodine. Other safe beverages would be carbonated or bottled drinks with no ice added.
- Chlorinate or boil water that will be used for drinking, cooking, washing dishes, washing hands and brushing teeth.
- Eat only foods that have been thoroughly cooked and are served hot.
- Eat only fruits that you have peeled yourself.
- Avoid undercooked or raw fish or shellfish.
- Avoid salads.
- Avoid foods and beverages form street vendors.
- Do not swim, wade, or wash in waters contaminated with human sewage.
- Consider Dukoral®, the oral, inactivated traveller’s diarrhea and cholera vaccine.
Can Cholera be treated?
Cholera is simply and easily treated by immediate replacement of the fluid and salts lost through diarrhea. Patients are treated with a pre-packaged oral rehydration mixture or intravenous fluid replacement. By seeking prompt medical attention, less than 1% of cholera patients die.
References
- Centers for Disease Control & Prevention, Cholera, April 2008.
- Kingston, Frontenac and Lennox & Addington Public Health, Cholera, May 2007.
- Heymann D. L. (2008). Control of Communicable Diseases Manual. (19th Ed.). Washington, DC: American Public Health Association.
