Travel Health Service Cholera
Travel related diseases

Cholera

What is cholera?

Cholera is an acute disease of the gastrointestinal tract caused by the bacterium called Vibrio cholerae. The incubation period ranges from a few hours to 5 days. While most patients have no symptoms or only mild diarrhea, some develop severe watery diarrhea with ‘rice water’ like stool and vomiting. Without prompt treatment, these patients may die from severe dehydration.

How does it spread?

Cholera is usually contracted through consumption 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. Human-to-human transmission rarely happens.

How can you prevent it?

It is most important to maintain good personal and food hygiene. Avoid eating raw food and cold dishes such as salads. Travellers should eat food that has been thoroughly cooked. Wash and peel fruit yourself. Avoid food and beverage from unlicensed street vendors. Drink boiled water and avoid ice in beverage. If water cannot be boiled, water should be treated with chlorine or iodine before consumption (follow the instructions on the package carefully). Travellers should always wash hands before eating and after going to toilet.

Oral cholera vaccine is rarely recommended except for those at high risk e.g. aid workers. It is not officially required as a condition of entry of any country.

How is it treated?

The mainstay of treatment is timely and adequate fluid and electrolytes replacement. Oral or intravenous fluid may be given. Pre-packed oral rehydration solution is widely available. Antibiotic may be used to shorten the duration of diarrhoea and diminish the severity of illness.