Cholera

Signs & Symptoms

When someone is infected with the cholera bacterium, symptoms can appear in a few hours or as late as 5 days later. Many kids with cholera have no signs or symptoms, but some cases can be severe and life threatening.

Common symptoms of cholera and the dehydration it causes include:

• watery, pale-colored diarrhea, often in large amounts
• nausea and vomiting
• cramps, particularly in the abdomen and legs
• irritability, lack of energy, or unusual sleepiness
• glassy or sunken eyes
• dry mouth and extreme thirst
• dry, shriveled skin
• low urine output and a lack of tears
• arrhythmia (irregular heartbeat) and low blood pressure

If your child develops symptoms like these, especially after visiting an area where cholera is likely or common, call your doctor or get medical help right away. Severe dehydration can happen very quickly, so it's essential to start replacing lost fluids right away to avoid damage to internal organs.

Diagnosis

To confirm a diagnosis of cholera, doctors may take a stool or vomit sample or a rectal swab to examine for signs of the bacteria. Rapid, dipstick-style tests are now available, which help health care providers in remote areas identify the disease more quickly and control outbreaks more effectively. All confirmed cases of cholera must be reported to local health officials.

Treatment

Since severe dehydration and death can occur within hours, cholera needs to be treated immediately. Most kids recover with no long-term problems as long as they receive prompt treatment.

The goal of treatment is to replace all the fluids and salts lost through diarrhea and vomiting. For mild dehydration, a doctor may recommend giving your child an over-the-counter rehydration solution. Kids with more severe cases of cholera may need to stay in the hospital and get intravenous (IV) fluids.

Sometimes doctors prescribe antibiotics to treat cholera. The antibiotics are not as important as rehydration, but can help shorten the length of time someone is sick. They also might make cholera-related diarrhea less severe. Sometimes doctors also prescribe zinc supplements.

Anti-diarrheal medicines can actually make the symptoms of cholera worse, so if your child has cholera (or you think your child has it), do not offer them.

Prevention

Some countries have cholera vaccines that can help protect people against cholera for a short while. Because cholera isn't a problem in the United States, the vaccine is not offered here.

If you're going to an area that has cholera, you can greatly reduce your family's chances of getting sick by following a few simple precautions while you're there:

• Boil or disinfect any water that you'll use for drinking, washing or preparing food, making ice, making coffee or tea, or brushing your teeth. Choose bottled water or other drinks that come in sealed cans or bottles. Be sure to wipe the outside of the can or bottle before you drink from it, though. Avoid tap water, fountain drinks, and drinks with ice cubes.
• Fully cook all food, especially seafood. Avoid food from street vendors. Instead, eat packaged foods and meals that are freshly cooked and served hot. Avoid sushi and any other raw or partly cooked seafood.
• Avoid raw vegetables, including salads, and fruits that have already been peeled or cannot be peeled (like grapes and berries). Bananas, avocados, and oranges are better choices.
• Dairy foods are often contaminated, so be careful with things like ice cream, milk, and cheese. Eat only pasteurized dairy and be sure dairy foods are refrigerated and kept cold.
• Wash your hands frequently with soap and clean water, especially after you use the bathroom or before you prepare food. If no soap and water are available, use a hand cleaner that's at least 60% alcohol.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: October 2012