Cholera

Cholera is a reportable disease in Oklahoma.  Cholera is a severe diarrheal illness caused by two strains of the bacteria Vibrio cholerae; serogroup O1 and O139.  Cholera became rare in the United States following the introduction of modern sewage and water treatment systems, although a few imported or domestically acquired cases continue to be reported each year.  Two related diseases also caused by Vibrio species are Vibrio vulnificus and Vibrio parahaemolyticus.  Other strains of V. cholerae can cause disease, but produce a much milder diarrheal illness or wound infection.  These bacteria, which exist worldwide, are called non-O1/O139 Vibrio cholerae.  They live in fresh or salt water and can cause disease when water comes into contact with an open wound, or following ingestion of raw or undercooked seafood.

Symptoms of cholera include mild to severe diarrhea, vomiting, and dehydration.  Fever is usually absent.  Approximately one in 20 infected individuals experience severe symptoms characterized by profuse, watery diarrhea, vomiting, and leg cramps.  In these individuals, rapid dehydration, shock or kidney failure can occur without treatment.

A person can acquire cholera bacteria by ingesting contaminated water or food.  In epidemics, the most common source of exposure is fecal material in the water supply from previously infected individuals.  Modern sewage and water treatment systems have made cholera extremely rare in developed countries.  However, the disease still occurs in other parts of the world with inadequate water treatment facilities.  Most cases in the US today are associated with international travel.  In addition, some cases are the result of eating raw or undercooked shellfish from a contaminated water supply

Treatment for severe cases of cholera consists of immediate replacement of fluid and salts lost through diarrhea.  A standard oral rehydration solution, a prepackaged mixture of sugar and salts mixed with water, is commonly used.  In some severe cases, intravenous fluid replacement is necessary.  Antibiotics shorten the course and diminish the severity of the illness, but rehydration is still necessary.  Persons with severe diarrhea and vomiting symptoms should seek medical attention promptly.

How to prevent cholera during international travel:

• Avoid water from sources that do not use appropriate water treatment and may be exposed to sewage.
• Avoid raw or undercooked food.
• Drink only water that you have boiled or treated with chlorine or iodine.  Other safe beverages include tea and coffee made with boiled water and carbonated, bottled beverages with no ice.
• Eat only foods that have been thoroughly cooked and are still hot, or fruit that you have peeled yourself.
• Avoid undercooked or raw fish or shellfish.
• Make sure all vegetables are cooked.
• Avoid foods and beverages from street vendors.

Cholera Fact Sheets and Information:

Cholera Fact Sheet (42k.pdf)
Travel Safety Fact Sheet (48k.pdf)

External Cholera Resources:
 
Traveler’s Health (CDC)
Cholera (CDC)