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Cholerae is an acute bacterial infection of the intestinal tract caused by the bacteria Vibrio Cholerae 01 or 0139. It is characterized by sudden onset of loose watery stools (rice-water stool) with nausea and vomiting. If left untreated one can rapidly develop shock and death. Paradoxically with the simple treatment of aggressive hydration, mortality can be less than 1%.

Where does it occur?

It is primarily seen in the poor areas of developing nations in Asia, Africa, Latin America and Eastern Europe.

How is it transmitted?

It is acquired by eating food or drinking water contaminated with the vibrio cholera bacteria.

Is it contagious from person to person?

It is contagious through hands soiled with fecal material from an infected individual.

What is the risk for travelers?

The risk is generally low unless eating or drinking in unsanitary settings in at risk countries, especially seafood.

How soon after exposure will one develop symptoms?

Symptoms will develop in a few hours to 2-3 days after ingestion of infected material.

What are the signs and symptoms?

Some infected individuals will have no symptoms or mild diarrhea. However classic symptoms are an initial feeling of fullness in the stomach followed by gurgling noises. The initial stool maybe brown and foul smelling, but subsequent ones are watery (“rice water”) and without smell. Most individuals will have associated nausea and vomiting initially.

An individual may rapidly loose significant amount of fluid and develop shock and electrolyte abnormalities progressing to death if untreated.

Are there any lab tests to diagnose the illness?

The bacteria can be cultured from the patients stool.

Is there any treatment?

The most important lifesaving treatment is aggressive hydration. Antibiotics like tetracycline, erythromycin and ciprofloxacin are used in treatment.

What preventive measures can be taken?

Cholera vaccines are not fully effective and not available in the USA. Practicing good water safety and food safety is the key to prevention.

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