Cholera

Cholera is an acute diarrheal disease caused by infection of the intestine with the bacterium Vibrio cholerae. It spreads through contaminated food or water and can cause rapid fluid loss, leading to severe dehydration and death if untreated. While cholera is rare in developed countries, it remains a major health threat in regions with inadequate water treatment, sanitation, and hygiene.

This blog explores everything you need to know about cholera—its symptoms, how it spreads, ways to prevent it, and modern diagnostic and treatment options.

What Is Cholera?

Cholera is a bacterial infection caused by Vibrio cholerae, which produces a toxin in the small intestine. The toxin causes the body to release massive amounts of water into the intestines, leading to watery diarrhea, vomiting, and severe dehydration.

Cholera can kill within hours if left untreated, but it is easily treatable when managed early with hydration and antibiotics.

How Cholera Spreads

Cholera typically spreads through:

• Drinking water contaminated with human feces.

• Eating food washed or prepared with contaminated water.

• Raw or undercooked shellfish from infected waters.

In areas with poor sanitation, cholera outbreaks can spread rapidly, especially during monsoons, floods, or natural disasters when clean water access is compromised.

Symptoms of Cholera

The key symptoms of cholera include:

1. Diarrhea or Extremely Watery Poop

• Sudden onset of painless, profuse watery diarrhea (“rice water stools”).

• Can lead to the loss of up to a liter of fluid per hour.

2. Intense Thirst

• Due to rapid fluid loss, patients feel excessively thirsty and may drink uncontrollably.

3. Lower Amounts of Urine

• Dehydration leads to reduced urine output.

• Urine may become dark and concentrated.

4. Muscle Cramps

• Caused by loss of essential salts (electrolytes) like sodium and potassium.

5. Vomiting

• Often accompanies diarrhea and worsens dehydration.

6. Weakness

• Resulting from fluid loss, low blood pressure, and electrolyte imbalance.

Severe Symptoms and Complications

If untreated, cholera can quickly become life-threatening. Watch out for:

• Sunken eyes

• Dry mouth and skin

• Rapid heart rate

• Low blood pressure

• Shock

• Kidney failure

• Death (in severe cases within hours)

Who Is at Risk?

While anyone can get cholera, the risk is higher for:

• People in areas with poor sanitation and limited access to clean water.

• Refugees and displaced populations.

• Travelers to endemic regions.

• People with weakened immune systems.

• Children under 5 years old and elderly adults.

Diagnosis of Cholera

Clinical Diagnosis:

Doctors often suspect cholera based on:

• Recent travel to or residence in an outbreak area.

• Sudden onset of profuse watery diarrhea and vomiting.

• Dehydration signs like dry skin, sunken eyes, rapid heartbeat.

Laboratory Tests:

• Stool Culture: Confirms presence of Vibrio cholerae.

• Rapid Dipstick Tests: Useful in outbreaks for quick screening.

• Dark-field Microscopy: May help visualize bacteria in stool samples.

Treatment of Cholera

Prompt treatment can save lives and reduce severity.

1. Oral Rehydration Therapy (ORT)

• First-line treatment.

• A mixture of water, sugar, and salt replenishes lost fluids and electrolytes.

• WHO’s Oral Rehydration Salts (ORS) packets are globally recommended.

2. Intravenous (IV) Fluids

• For patients with severe dehydration.

• Ringer’s lactate solution is preferred.

3. Antibiotics

• Shortens duration and severity of illness.

• Common options: doxycycline, azithromycin, ciprofloxacin.

• Reserved for moderate-to-severe cases and outbreak control.

4. Zinc Supplements

• Especially helpful in children.

• Reduces diarrhea duration and severity.

5. Nutritional Support

• Continue breastfeeding in infants.

• Reintroduce normal diet early to improve recovery.

Prevention of Cholera

1. Ensure Safe Drinking Water

• Boil water or use chlorine tablets.

• Avoid tap water in cholera-endemic areas.

2. Practice Good Hygiene

• Wash hands with soap before eating or cooking and after using the toilet.

• Use hand sanitizer when soap isn’t available.

3. Safe Food Practices

• Eat thoroughly cooked food.

• Avoid raw seafood and unpeeled fruits.

• Drink only bottled or boiled water.

4. Improve Sanitation

• Use latrines or toilets—never defecate in open water sources.

• Dispose of waste safely.

5. Vaccination

• Oral Cholera Vaccines (OCVs):

  • Dukoral, Shanchol, Euvichol are WHO-approved.

  • Recommended for travelers and people in high-risk areas.

  • Provides protection for up to 3 years.

Cholera in India: A Public Health Concern

India, due to its tropical climate, population density, and periodic floods, remains vulnerable to cholera outbreaks—especially in states like West Bengal, Odisha, Bihar, and parts of Maharashtra.

Outbreaks often occur after monsoons or natural disasters, when sanitation breaks down and safe water becomes scarce.

Cholera Outbreak Management

Health authorities follow these steps during outbreaks:

• Immediate setup of oral rehydration corners and treatment centers.

• Public awareness campaigns via radio, TV, and social media.

• Water purification and chlorination.

• Mass vaccination in outbreak-prone areas.

• Contact tracing and surveillance to prevent further spread.

Cholera and Children

Children are more vulnerable to cholera due to:

• Smaller fluid reserves.

• Weaker immune systems.

• Faster dehydration.

Signs of Dehydration in Children:

• Lethargy or irritability

• Sunken fontanelle (soft spot on the head)

• No tears when crying

• Dry tongue and mouth

• Rapid breathing

Urgent hospitalization is needed for severely dehydrated children.

Cholera and COVID-19

During the COVID-19 pandemic, cholera surveillance and vaccination campaigns were disrupted in many countries. In some regions, this led to a resurgence of cholera outbreaks due to diverted healthcare resources and disrupted water sanitation projects.

Myths About Cholera

❌ Myth: Cholera spreads only in poor countries.

✅ Fact: While more common in developing countries, cholera can spread anywhere sanitation is compromised, including during natural disasters in developed nations.

❌ Myth: Cholera can be treated with home remedies alone.

✅ Fact: Cholera requires immediate medical care, especially in severe cases. ORS is vital, but antibiotics and IV fluids may be lifesaving.

❌ Myth: Once you get cholera, you are immune forever.

✅ Fact: Immunity may be short-lived. Reinfection is possible, especially with different strains.

What to Do If You Suspect Cholera

1. Start ORS immediately.

2. Avoid self-medicating with antibiotics.

3. Visit the nearest diagnostic center or hospital urgently.

4. Inform health authorities if others are also sick—may indicate a local outbreak.

5. Practice strict hygiene to prevent spreading the infection.

Role of Diagnostic Centers in Cholera Control

Diagnostic centers like Sparsh Diagnostic Centre play a critical role in:

• Early detection and confirmation of cholera through stool tests.

• Public awareness through health campaigns (like the infographic above).

• Patient guidance for hydration therapy and follow-up care.

• Outbreak response in collaboration with public health authorities.

Cholera is a preventable and treatable disease. Its rapid progression, however, makes early recognition and prompt action essential. Through clean water, proper sanitation, vaccination, and timely treatment, we can control and even eliminate cholera as a public health threat.

If you or someone around you is experiencing sudden watery diarrhea, vomiting, and signs of dehydration—act immediately. Visit a trusted healthcare facility like Sparsh Diagnostic Centre for accurate diagnosis and lifesaving treatment.

Frequently Asked Questions (FAQs)

Q1. How fast does cholera cause dehydration?
Severe dehydration can occur within hours, especially in children and elderly individuals.

Q2. Is cholera contagious?
Cholera doesn’t spread directly from person to person, but shared contaminated food or water can infect multiple people quickly.

Q3. Can I get cholera more than once?
Yes. Immunity from a previous infection may not protect against other strains.

Q4. What is the mortality rate of untreated cholera?
If untreated, the death rate can be as high as 50%. With proper treatment, it drops to below 1%.

Q5. Can cholera be diagnosed at home?
While symptoms may suggest cholera, a stool test at a diagnostic center confirms the diagnosis.