Overview
Cholera is a bacterial infection that affects the intestines and can cause large amounts of watery diarrhea. Many people have mild symptoms or none at all, but some develop severe illness very quickly. The biggest risk is dehydration from losing too much fluid and salts. Cholera outbreaks are more likely where clean water and sanitation are limited.
Key Symptoms
The most common symptom is sudden, profuse watery diarrhea, sometimes described as looking pale and cloudy. Vomiting and leg cramps can also happen. Signs of dehydration include intense thirst, dry mouth, little or no urination, weakness, dizziness, fast heartbeat, and sunken eyes. In infants and children, unusual sleepiness, irritability, or poor feeding may also be warning signs.
Causes and Risk Factors
Cholera is caused by the bacterium Vibrio cholerae. People usually get infected by drinking unsafe water or eating contaminated food, including raw or undercooked seafood in some areas. Risk is higher during outbreaks, disasters, displacement, or in places with poor sanitation and overcrowding. Household contact with a person who has cholera can also increase exposure risk.
Who Is Affected
Anyone can get cholera if they are exposed to contaminated water or food. It is more common in areas affected by conflict, flooding, weak sanitation systems, or limited access to healthcare. Travelers, aid workers, and people living in or visiting outbreak areas may also be at risk. Young children, older adults, and people who become dehydrated quickly may have more serious illness.
Prevention
Prevention focuses on clean water, good sanitation, and hand hygiene. Drink water from a safe source, use treated or boiled water when needed, wash hands with soap and safe water, and eat food that is cooked thoroughly and served hot. Avoid raw or undercooked seafood and food from unsafe sources during outbreaks. Oral cholera vaccines may be recommended in some high-risk settings or for outbreak control.
Diagnosis and Tests
A healthcare professional may suspect cholera based on symptoms, dehydration, and recent exposure or travel history. Stool testing can help confirm the infection, especially during outbreaks or severe illness. Healthcare teams also check for signs of dehydration and may assess electrolyte problems. Quick evaluation matters because treatment should not wait if severe dehydration is suspected.
Treatment Categories
Treatment aims to replace lost fluids and salts as fast as possible and to monitor for complications. Oral rehydration solutions are commonly used, and some people need intravenous fluids in a clinic or hospital. A healthcare professional may also consider other treatments based on age, severity, and local guidance. Early treatment greatly lowers the risk of severe complications and death.
When to Seek Medical Care
Seek medical care right away for sudden watery diarrhea, repeated vomiting, or any signs of dehydration. Prompt care is especially important for babies, young children, older adults, pregnant people, and anyone with ongoing illness or weakness. Tell the healthcare professional about recent travel, outbreak exposure, or unsafe water or food exposure. Do not wait for symptoms to become severe before getting help.
When It May Be an Emergency
Get urgent medical help if a person has severe watery diarrhea and seems very weak, confused, faint, or hard to wake. Emergency signs also include very little or no urination, severe thirst, inability to keep fluids down, fast breathing, cold or clammy skin, or signs of shock. In children, seek urgent help for unusual drowsiness, limpness, or poor feeding along with diarrhea or vomiting.