Cholera is an acute diarrhoeal illness caused by the bacterium Vibrio cholerae. The disease infects the small bowel and causes painless, watery diarrhoea. It is known to only infect humans.
Cholera is usually transmitted via infected water that has been contaminated by faeces and less commonly via food.
The disease is found throughout the world particularly in countries where sanitation is poor particularly parts of Africa, India and South East Asia.
The disease causes rapid onset of watery diarrhoea and vomiting. Extreme dehydration can occur due to the affected individual's inability to retain fluids orally. Medical attention should be urgently sought as individuals can die quickly if they are not treated promptly.
Antibiotic therapy is required in conjunction with rapid and adequate fluid replacement.
Recommendations for Travellers
Prevention is focused on ensuring safe food and water, particularly in countries where cholera is more common. Food and drink to be wary of include untreated water, ice, shellfish, salads, unwashed fruit and vegetables.
Good personal hygiene is also very important. Individuals should ensure that they wash their hands prior to eating and after visiting the bathroom.
A vaccine called Dukoral is available to protect against cholera. Adults and children over 6 years require 2 doses. The vaccine is administered at intervals of at least one week and immunisation should be completed at least 1 week prior to potential exposure. For those at ongoing risk a booster dose is required at 2 years. The requirements for children under 6 years should be discussed with the GP. Individuals should consider being vaccinated if they are travelling to a country where cholera is present and they will be unable to take reasonable precautions with food and water, for example, during wars and when working in refugee camps or slum areas.