Cholera What is cholera? Cholera is an acute disease of the gastrointestinal tract caused by the contamination of food or drink by a bacterium called Vibrio cholerae. A typical case, after an incubation period of a few hours to 5 days, begins suddenly with severe diarrhea without pain or colic. Fluid gushes from the bowel and stomach. After the fecal contents of the guts have been evacuated the typical 'rice-water' material is passed. The patient has severe loss of water from the body and this can cause death. Symptoms, however, can range from very mild to severe. How does it spread? Cholera is spread through ingestion of food or water contaminated directly or indirectly with faeces or vomitus of infected persons. The disease can occur in large-scale epidemics where proper sanitary measures have broken down. Raw or undercooked seafood from polluted water can cause outbreaks. How can you prevent it? Avoid contaminated food by eating only foods that have been thoroughly cooked and are still hot, especially meat, fish and shellfish like clams, oysters, etc., or eating fruit that you have peeled yourself. Make sure all vegetables are cooked and avoid salads. Avoid foods and beverages from unlicensed street vendors. Avoid contaminated water. Drinks only water that you have boiled or has been treated with chlorine or iodine, or bottled beverages with no ice. Be careful about personal hygiene. Always wash your hands before eating and after going to toilet. No country requires proof of cholera vaccination as a condition for entry. The traditional cholera vaccine by injection only provides incomplete protection of short duration and can convey a false sense of security. Its use for prevention is not recommended. How is it treated? Treatment of cholera consists mainly of fluid and mineral replacement. Oral or intravenous fluid may be given. Pre-packed oral rehydration salts are widely available; from these, solutions can easily prepared for oral use. Appropriate antibiotic can shorten the duration of diarrhoea and diminish the severity of illness.