Cholera – causes and symptoms

Cholera is an infectious disease with diarrhoea caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae.

Cholera was prevalent in the UK in the 19th century before modern water and sewage treatment systems eliminated its spread by contaminated water. However, cholera outbreaks are still a serious problem in other parts of the world, where cholera affects an estimated 3-5 million people and causes more than 100,000 deaths each year.  All reported cases of cholera in England are as a result of people catching the infection while travelling abroad.

The disease is most common in places with poor sanitation, crowding, war and famine. Common locations include parts of Africa, south Asia, and Latin America. If you are travelling to one of those areas knowing the following cholera facts can help protect you and your family.

Cholera causes

Vibrio cholerae, the bacterium that causes cholera, is usually found in food or water contaminated by faeces from a person with the infection. Common sources include:

• municipal water supplies
• ice made from municipal water
• foods and drinks sold by street vendors
• vegetables grown with water containing human wastes
• raw or undercooked fish and seafood caught in waters polluted with sewage

When a person consumes the contaminated food or water, the bacteria release a toxin in the intestines that produces severe diarrhoea.

It is not likely you will catch cholera just from casual contact with an infected person.

Cholera symptoms

Symptoms of cholera can begin as soon as a few hours or as long as five days after infection. Often symptoms are mild but sometimes they are very serious. About one in 20 people infected have severe watery diarrhoea accompanied by vomiting which can quickly lead to dehydration. Although many infected people may have minimal or no symptoms they can still contribute to spread of the infection.

Signs and symptoms of dehydration include:

• thirst
• dry mucous membranes, including the inside of the mouth, throat, nose and eyelids
• loss of skin elasticity (the ability to return to original position quickly if pinched)
• rapid heart rate
• low blood pressure
• muscle cramps

If not treated, dehydration can lead to shock and death.

Cholera treatment and prevention

Although there is a vaccine against cholera, the World Health Organization doesn’t normally recommend it because it may not protect up to half of the people who receive it and it lasts only a few months. However, the NHS says vaccination should be considered for relief or disaster aid workers and people travelling to remote areas where cholera epidemics are occurring and there is limited access to medical care.

Aside from vaccination you can protect yourself and your family by using only water that has been boiled, water that has been chemically disinfected, or bottled water. Make sure you use the bottled, boiled or chemically disinfected water for the following purposes:

• drinking
• preparing food or drinks
• making ice
• brushing your teeth
• washing your face and hands
• washing dishes and utensils that you use to eat or prepare food
• washing fruits and vegetables