16636 Cholera

Overview

Cholera is an infection in the gut caused by a germ called Vibrio cholerae. It usually spreads through contaminated water or food and causes sudden, severe watery diarrhoea. With quick care, especially replacing lost fluids, most people recover fully.

Cholera is rare in the UK and other countries with clean water and good sanitation. It is more common in places where safe drinking water and proper toilets are not available, or after floods, earthquakes, or conflicts disrupt clean water supplies.

Anyone can get cholera, but people without access to safe water or sanitation are at highest risk. Travellers to affected areas can also catch it. Young children, pregnant women, older adults, and people with weakened immune systems may become dehydrated more quickly.

Symptoms

Common symptoms

• Sudden, very watery diarrhoea that can look like rice water
• Vomiting, sometimes without feeling sick first
• Dry mouth and extreme thirst
• Less urine than usual, or dark urine
• Muscle cramps, especially in the legs
• Feeling weak, dizzy, or faint
• Fast heart rate and low energy

Symptoms in children

• All the common symptoms, but with more risk of fast dehydration
• Drowsiness or being unusually hard to wake
• Sunken eyes or, in babies, a sunken soft spot on the top of the head
• No tears when crying
• Very dry mouth and tongue

Symptoms in older adults

• Dehydration can happen more quickly in older adults
• Confusion or feeling unusually sleepy
• Dizziness on standing up, sometimes leading to falls
• Very little or no urine
• Weakness and cold, clammy skin

Causes

Main causes

• Drinking water that has been contaminated with human waste carrying the cholera germ
• Eating food washed or prepared with contaminated water
• Eating raw or undercooked shellfish, especially from polluted water

Risk factors

• Living in or travelling to areas with unsafe drinking water and poor sanitation
• Being in places affected by humanitarian emergencies, floods, or earthquakes
• Not having access to clean toilets or handwashing facilities
• Eating food from street vendors in high-risk areas
• Having low stomach acid from certain health conditions or medicines

When to see a doctor

See a doctor urgently if:

• See a doctor or go to a clinic the same day if you have severe watery diarrhoea or vomiting, especially after travelling to a place where cholera is found.
• Get urgent help if you are showing signs of dehydration, such as dizziness, dark urine, or feeling unusually thirsty.
• If you or your child cannot keep down fluids, seek medical care straight away.

Book a routine appointment if:

• Before you travel to a country where cholera may be present, ask your doctor or travel clinic for advice about cholera vaccine and food and water safety.
• If you have mild symptoms and are worried, contact your general practice for advice.

Diagnosis

A doctor will ask about your symptoms, how long you have had them, and whether you have recently travelled to an area where cholera is common. To confirm the diagnosis, a sample of your stool is usually sent to a laboratory.

Tests that may be done

• Stool sample to test for cholera bacteria
• Blood tests may be used to check for dehydration and electrolyte imbalances

What to expect at your appointment

Your doctor will also check your pulse, blood pressure, and signs of dehydration. If you are very dehydrated, treatment with fluids will often begin before the test results come back, because acting quickly is important.

Treatment

The main treatment for cholera is replacing the fluids and salts the body has lost. With quick rehydration, cholera is very treatable and most people recover within a few days.

Self-care at home

• Take oral rehydration salts mixed with safe, boiled, or bottled water as instructed by a pharmacist or healthcare provider
• Sip fluids often, even if you vomit — small mouthfuls are easier to keep down
• Wash your hands with soap and safe water before eating and after using the toilet
• Do not take over-the-counter diarrhoea medicines unless a doctor tells you to
• Rest and eat plain, easily digested food as you feel able

Medical treatments

In more serious cases, fluids and salts are given through a drip in a hospital or clinic. Doctors may also prescribe medicines that target the cholera infection; these are chosen by a healthcare professional and should never be taken without advice. The main goal is always replacing fluids and salts safely.

When is surgery considered?

Surgery is not used to treat cholera.

Living with this condition

While you are ill, stay close to a toilet, rest as much as possible, and keep following the rehydration plan given to you. Monitor how much you are drinking and how often you are passing urine. A responsible adult should watch you or your child for signs of dehydration.

Lifestyle tips

• Use safe water for drinking, brushing teeth, and washing food
• Boil water if you are unsure whether it is safe
• Cook food thoroughly and avoid raw seafood in at-risk areas
• Keep good hand hygiene for at least two weeks after recovery to protect other people

Diet and exercise

During the illness, rest and focus on fluids. Once the diarrhoea settles, eat small meals of plain, starchy foods such as rice, bread, banana, or porridge. Avoid heavy exercise until you feel fully back to normal.

Mental health and emotional wellbeing

A serious bout of diarrhoea and dehydration can be frightening, and people who have lived through cholera may feel anxious about their health. It is normal to need support. Talk to your doctor or local health service if stress, worry, or low mood is affecting you.

Prevention

Yes. The most important ways to prevent cholera are clean drinking water, safe food, good handwashing, and proper toilets. If you travel to a cholera-affected area, be extra careful about water and food.

Vaccines

A safe oral cholera vaccine is available for people travelling to affected areas. It does not replace careful food and water choices. Ask your doctor or travel clinic whether the vaccine is recommended for you.

Screening programmes

There is no routine screening for cholera. If you believe you have been exposed or you develop symptoms, see a healthcare provider quickly.

Complications

If left untreated

• Severe dehydration, which can happen within hours
• Kidney failure due to fluid loss
• Shock, when the body does not get enough blood flow
• Coma or death in the most severe untreated cases

Long-term outlook

Cholera is very treatable if people get care quickly. With the right fluids and support, the great majority of people recover within a few days, and serious problems are rare when treatment starts early.

Find support

International organisations

• World Health Organization ↗

Local organisations

• NHS website ↗ · United Kingdom

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