What is cholera?
Cholera is a disease with diarrhea caused by the bacteria (germ) Vibrio cholerae. It is rare in the United States.
How do people get cholera?
It is spread by eating food or drinking water that is contaminated with the bacteria. It can also be spread by eating contaminated shellfish such as oysters and clams. Shellfish become infected by coming into contact with contaminated sewage.
What are the symptoms of cholera?
A person may have mild to severe diarrhea, vomiting and dehydration (loss of water from the body). Fever is usually absent. Some people develop a lot of watery diarrhea, nausea, vomiting and leg cramps, and if they do not receive treatment quickly enough they can die from dehydration, shock or kidney failure.
How soon do symptoms of cholera appear?
Symptoms appear from a few hours to five days after exposure to the germ.
How is cholera diagnosed?
It is diagnosed by finding the bacteria in a stool sample that is sent to a laboratory.
How is cholera treated?
The best treatment is to replace the water lost through diarrhea as quickly as possible. If this does not take place a person may go into shock and can die from the loss of fluids. Antibiotics can be used to shorten the length of the disease.
Is there a vaccine (shot) for cholera?
There is no vaccine for cholera that is currently available in the United States.
Where does cholera occur?
It is commonly found in countries with poor hygiene and insufficient water treatment.
How can cholera be prevented?
There are several steps that you can take to reduce your chance of being exposed to cholera (also read recommendations on the next page if you will be traveling outside the United States):
- Always wash your hands thoroughly with soap and water after going to the bathroom, after changing diapers, before preparing meals, and before eating
- Dispose of bodily wastes properly and make sure to wash or dispose of soiled diapers properly
- Avoid drinking untreated water
- Avoid eating raw or undercooked fish and shellfish
If I am traveling outside of the United States, should I be concerned about cholera?
In general, your risk of getting sick when traveling depends on the area you visit. Travelers in less economically developed countries are at greater risk than those traveling in developed areas. In most developed countries, such as Canada, Japan, Australia, New Zealand and most of the European nations, the risk to your health is about the same as that in the United States. In Africa, South and Central America and the Middle and Far East, sanitation and hygiene vary considerably, and the risk for cholera may be higher. Avoid traveling to areas with known outbreaks of cholera. In addition to the steps listed above, travelers should practice the following:
- “Boil it, cook it, peel it, wash it, or forget it.” Eat foods that have been thoroughly cooked and are still hot and steaming. Don’t eat raw vegetables and fruits that can't be peeled or washed. Vegetables like lettuce are easily contaminated and are very hard to thoroughly wash.
- Avoid foods and beverages from street vendors.
- Drink only bottled water and carbonated beverages, keeping in mind that bottled carbonated water is safer than uncarbonated water.
- Ask for drinks without ice unless the ice is made from bottled or boiled water.
- Avoid popsicles and flavored ices that may have been made with contaminated water.
- For more information regarding international travel and cholera, contact the Centers for Disease Control and Prevention (CDC) at (800) 232- 4636, or visit the CDC Traveler's Health website.
Are there any health regulations for people with cholera?
Yes. Because cholera is a disease that can easily be spread to other people, health care providers are required by law to report cases of cholera to the local board of health. In order to protect the public, workers at food-related businesses who have cholera must stay out of work until diarrhea is gone and laboratory tests on two different stool samples show that there are no cholera germs. Workers in food-related businesses who have diarrhea and live with someone who has cholera must also show that they have no cholera germs in their stool. Food-related businesses include restaurants, sandwich shops, hospital kitchens, supermarkets, dairy or food-processing plants. This law also includes workers in schools, residential programs, day-care and health care facilities who feed, give mouth care or give medicine to clients.
Can cholera be used for bioterrorism?
Yes. Bioterrorism is the use of any biological organism to intentionally hurt people or create fear. The Centers for Disease Control and Prevention lists cholera as a possible bioterrorism agent; however, it has never been successfully used in this manner.
Where can I get more information?
- Your doctor, nurse or health care clinic or your local board of health (listed in the telephone directory under “government”)
- The Massachusetts Department of Public Health (MDPH), Division of Epidemiology and Immunization at (617) 983-6800/(888) 658-2850 or the DPH website
- The Centers for Disease Control and Prevention (CDC) website
Spanish and Portuguese translations of this fact sheet are available under additional resources.