Cholera – Symptoms and Causes
Overview
Cholera is a bacterial infection that affects the intestines. It spreads through contaminated water or food and is more common in areas with poor sanitation and limited access to clean water.
While some people show no symptoms, others can become seriously ill. Cholera can progress rapidly and is considered a public health concern in both endemic areas and emergency situations.
Signs and Problems
Cholera symptoms typically appear 2โ3 days after infection, but they can start as soon as a few hours or up to five days after exposure. While many cases are mild or asymptomatic, others progress quickly and require urgent treatment.
Common symptoms include:
- Watery diarrhea (often described as โrice-water stoolโ)
- Nausea and vomiting
- Rapid dehydration
- Muscle cramps
As fluid loss increases, signs of dehydration may develop:
- Rapid heart rate
- Loss of skin elasticity
- Dry mouth and mucous membranes
- Low blood pressure
- Thirst
- Restlessness or irritability
Cholera can also cause severe electrolyte imbalances, which may present as:
- Muscle cramps (especially in the legs)
- Fatigue or weakness
- Irregular heartbeat
- Mental confusion
- Decreased skin elasticity
These symptoms can develop rapidly and worsen in a matter of hours without treatment.
When to Call a Doctor
Contact your healthcare provider right away if you have severe watery diarrhea and vomiting, especially after traveling to areas where cholera outbreaks happen. Quick treatment can save lives when dealing with cholera.
Seek immediate medical care if you show signs of dehydration, including:
- Extreme thirst
- Dry mouth or tongue
- Little or no urination
- Severe weakness
- Confusion or irritability
- Rapid heart rate
- Low blood pressure
Children need urgent attention if they appear very tired, have sunken eyes, or cry without tears. These symptoms can happen quickly, sometimes within hours after cholera symptoms begin.
Don’t wait to seek treatment if you’ve been in a cholera-affected area and develop diarrhea. Tell your doctor about your recent travels to help them make the right diagnosis faster.
What Causes Cholera
Cholera is caused by bacteria called Vibrio cholerae that infect the intestines. People most often get cholera by drinking water or eating food contaminated with these bacteria.
When someone with cholera has diarrhea, the bacteria spread in their feces. In places with poor sanitation, these bacteria can contaminate water supplies.
Common sources of infection include:
- Drinking contaminated water
- Eating raw or undercooked seafood, especially from coastal waters
- Consuming food handled by someone with the infection
- Eating raw fruits and vegetables washed with contaminated water
Once inside the body, the bacteria produce a toxin that disrupts normal fluid balance in the intestines.
This toxin causes the intestinal walls to release large amounts of water and salts into the digestive tract, much more than the body can absorb.
The result is sudden, watery diarrhea that can lead to rapid dehydration and electrolyte loss.
Cholera spreads quickly in communities without clean water, especially during natural disasters or in overcrowded living conditions.
Risk Factors
Several factors may increase a person’s risk of getting cholera. The disease is more likely in environments where clean water and proper sanitation are lacking.
Environmental and situational risk factors include:
- Living in or traveling to areas with active cholera outbreaks
- Poor sanitation and contaminated water sources
- Overcrowded conditions (such as refugee camps)
Personal and medical risk factors include:
- Low stomach acid, which reduces the body’s ability to kill ingested bacteria
- Blood type O, which may be more susceptible to severe infection
- Poor nutritional status or weakened immunity
- Close contact with an infected person
- Children, who have underdeveloped immune systems
Household and dietary practices also increase risk, such as eating raw or undercooked seafood from contaminated waters, or using unsafe water to wash food or make ice.
Complications
Cholera can lead to serious health problems if not treated quickly. The rapid loss of fluids and electrolytes can cause severe dehydration, which happens within hours.
One of the most dangerous complications is hypovolemic shock. This occurs when low blood volume causes a drop in blood pressure and a reduction in the amount of oxygen reaching your tissues.
Without treatment, hypovolemic shock can be fatal within minutes.
Kidney failure may develop as the kidneys lose their ability to filter due to decreased blood flow. This can happen quickly as dehydration worsens, leading to a buildup of waste products in the blood.
In children, severe dehydration can also cause hypoglycemia (low blood sugar).
Death from cholera can occur within 18 hours to several days without proper treatment. The mortality rate can be as high as 50โ60% in untreated cases, but drops to less than 1% with proper fluid replacement therapy.
Ways to Prevent Cholera
Preventing cholera involves several practical approaches. Clean water, proper sanitation, and good hygiene are the most important defenses. These simple steps can greatly reduce the risk of getting sick.
Handwashing with soap and clean water is essential, especially before eating or preparing food. Drinking only bottled, boiled, or treated water helps keep you safe.
When traveling in areas where cholera exists, remember to avoid raw foods, unpeeled fruits, and undercooked seafood.
Cholera Vaccines
Vaccines offer important protection against cholera. Two oral cholera vaccines are currently available worldwide:
- Dukoral: Provides protection for about 2 years.
- Shanchol and Euvichol: Offer protection for up to 3 years.
These vaccines help the body build immunity against the cholera bacteria. They don’t provide complete protection, but they reduce the risk of getting sick.
The World Health Organization recommends vaccines in cholera outbreak areas and for travelers going to high-risk regions. For best protection, the vaccine needs all recommended doses.
