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Cholera Symptoms, Causes, Treatment and Prevention


Cholera or watery diarrhoea is an infectious disease. It leads to excessive dehydration and can cause death if left untreated. Cholera was considered a serious disease in the US in the 1800s, but with proper sewage and water treatment systems, cholera has become a rare phenomenon in that country. But cholera is still prevalent in other parts of the world. According to WHO, there are 1.3 million to 4 million cases of cholera every year.

What is Cholera?

Cholera is an acute infection of the small intestine characterized by watery stools, abdominal cramps and vomiting. The bacterium responsible for causing it is Vibrio cholerae, which causes increased release of water in the intestines, producing severe diarrhoea.

Cholera is Caused By

Cholera disease is caused by the vibrio cholerae bacteria. It is found in food and water that has been contaminated by the faeces of an infected person.  Cholera spreads because of the following factors:

  • Ice produced from municipal water.
  • Municipal water supplies.
  • Food products sold by street vendors.
  • Consuming vegetables that are grown in water that is contaminated by human faeces.
  • Consuming fish and seafood contaminated by human faeces or polluted water.

When people do not properly wash their hands after using the toilet, the vibrio cholera bacteria may spread.

Cholera Symptoms

The cholera symptoms can begin in a few hours or it may take a few days. The cholera symptoms are mostly mild but sometimes complications can arise because of severe watery diarrhoea accompanied by vomiting which leads to dehydration. There may be certain infected people who will not have symptoms but will spread the infection.

Danger signs and symptoms:

  • Electrolyte imbalance can cause convulsions or cardiac arrest, especially in children.
  • Muscle cramps
  • A fluid loss of 5-10 litres that has not been replaced.

Danger Signs

In extreme cases, people with cholera can die of dehydration or shock. Apart from dehydration and shock, some other complications of cholera are:

Low blood sugar (hypoglycemia) – cholera can lead to excessive low blood sugar levels which are caused when people are too ill to eat or drink. Hypoglycemia can lead to seizures, unconsciousness or even death, especially in children.

Low potassium levels – People suffering from cholera lose important minerals like potassium through their stool. Low levels of potassium damage the heart and nerve functioning which can be fatal.

Kidney failure – During cholera, the kidneys lose their ability to filter leading to a build-up of excess fluids, electrolytes and waste in the body.

Typical Signs of Dehydration

Classical signs in a dehydrated person can be:

  • Dry mouth and skin
  • “Glassy” eyes with no tears
  • State of confusion, lethargy and sleepiness
  • Rapid pulse
  • Reduced or no urine
  • Thirst

Diagnosing Cholera

The cholera bacteria can be detected through a stool test. Doctors use rapid cholera dipstick tests in remote areas to diagnose cholera. Quick confirmation will allow the government to take steps to control an outbreak of cholera.

Treatment of Cholera

Cholera disease is caused by the cholera bacteria which requires immediate treatment to avoid complication.

  • Your doctor will prescribe Oral Rehydration Salts (ORS) for replacing lost electrolytes and fluids.
  • Intravenous fluids to control fluid loss.
  • Antibiotics like Doxycycline to control the cholera symptoms.

Cholera vaccine

Currently, there are three oral cholera vaccines prequalified by WHO. The vaccines are Dukoral, Shanchol and Euvichol. All the vaccines require two doses. The FDA recently approved an oral vaccine called Vaxchora in the US.

Prevention and control 


  • Drink sterilized or boiled water.
  • Avoid the use of ice cubes in drinks.
  • Boil milk before consumption.
  • Eat well cooked and hot food.
  • Avoid consuming raw fruits, vegetables, fish or meat.


Cholera can be controlled by following certain measures:

  • Provision of clean drinking water.
  • Good sanitation and hygiene at home.
  • Avoiding contaminated food.
  • Vaccination
  • Restricting the movement of people.
  • Giving antibiotics to a large number of people who are not sick or showing symptoms of cholera.
  • Restricting the import of food from affected areas.


Which bacteria are responsible for cholera?

Ans: The vibrio cholerae bacteria is responsible for cholera.

Which food is good for cholera?

Ans: As cholera causes dehydration, liquids that replace the electrolytes and salts can be consumed. A patient should be given lots of water, soda and coconut water throughout the day.

How is cholera transmitted?

Ans: Cholera is transmitted from human to human through faeces and contaminated water.


Verified By Dr Amitav Mohanty
MBBS, MD -Medicine, Senior Consultant - General Medicine, Apollo Hospitals Bhubanswar
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