Cholera

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What is it

Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae1. It is most often spread by drinking water or eating food that has been contaminated1. Cholera occurs most commonly in regions where there is inadequate sanitation, poor hygiene, overcrowding and a lack of safe food and water. prevalence is highest in developing countries including parts of Africa, Asia, and Central and South America1.

What are the symptoms

  • Most infected people do not show any symptoms1,2.
  • For those that do develop symptoms, it takes between 12 hours to 5 days for symptoms to appear after ingesting contaminated food or water2.
  • Among people who develop symptoms, the majority have mild to moderate cases2.

In mild to moderate cases, symptoms include1:

  • Diarrhea, with or without vomiting

In more severe cases, symptoms include1:

  • Leg cramps, nausea, vomiting and frequent watery diarrhea
  • Can lead to severe dehydration and even death within hours if not treated promptly.

Who is at risk

Most travellers are at very low risk if they practice good personal hygiene and safe food and water precautions, even in countries where cholera outbreaks are being reported2. Travellers at higher risk include those visiting, working or living in areas with limited access to safe food, water and proper sanitation, or to areas where outbreaks are occurring1.

How is it spread

The bacteria can be found in the feces of an infected person which can be transmitted to others who consume food and water contaminated with the bacteria1. Cholera is prevalent in areas with poorly treated sewage and drinking water1.

Undercooked or raw seafood can be contaminated by water containing the bacteria, or if it’s handled by an infected person1.

How is it prevented

Consult a healthcare provider or visit a travel health clinic preferably six weeks before you travel to an area where cholera occurs.

  1. Practice safe food and water precautions1.
  2. Wash hands frequently with soap under warm water for at least 20 seconds before eating, preparing food, and after using the bathroom or changing diapers1.
    • Use alcohol-based hand sanitizer if water is not available
  3. Travellers at higher risk (those in areas with limited access to clean water and food and/or with poor sanitation) may benefit from vaccination1,3.
  4. Monitor your health and carry oral rehydration salts1.
    • If you develop severe diarrhea and/or vomiting, seek medical attention immediately.
      • Drink fluids and use oral rehydration salts to prevent dehydration.
      • Infants, young children, the elderly and those with underlying health conditions are at greatest risk of dehydration.

How is it treated

Cholera is an easily treatable disease; the majority of people can be treated successfully through prompt administration of oral rehydration solution (ORS)2. Adults may require up to 6 liters of ors to treat moderate dehydration on the first day2.

The most important treatment is to stay hydrated1.

If a person with symptoms is treated promptly, the illness is rarely fatal1. In severe cholera cases, antibiotics can help shorten the length of the illness1. Severely dehydrated patients require rapid administration of intravenous fluids in addition to ORS2. Medical advice is recommended for the onset of symptoms. for further information regarding cholera and immunization, please speak with your healthcare provider.

REFERENCES

  1. Public Health Agency of Canada. Cholera (2016). https://travel.gc.ca/travelling/health-safety/diseases/cholera
  2. World Health Organization. Cholera (2016). http://www.who.int/mediacentre/factsheets/fs107/en/
  3. Valneva Dukoral PM (2015). http://healthsensetravelclinic.ca/wp-content/uploads/dukoral.pdf