Home
Bupa members

Support and offers for individual members and customers

Cholera

Published by Bupa's health information team, June 2008.

This factsheet is for people who have cholera, or who are travelling to a country where there is a risk of cholera infection.

Cholera is caused by infection with a bacterium called Vibrio cholerae. Cholera affects your bowel and causes watery diarrhoea. It's mainly found in areas that aren't very clean, and where hygiene and sanitation aren't very good.

About cholera

The main areas of the world in which cholera is present are Africa, Asia and parts of the Middle East.

There are more than 100 types of cholera. However, there are only two types of cholera that affect humans:

  • Vibrio cholerae O1 of which there are two subtypes (Classical and El Tor)
  • Vibrio cholerae O139

Vibrio cholerae O1, subtype El Tor accounts for most of the cholera found in the world today.

If you drink a liquid or eat food containing these types of Vibrio cholerae, then the bacteria get into your small bowel (intestine), where they produce a poison (toxin) which causes diarrhoea.

Only a large number of the bacteria can cause an infection. Cholera doesn't occur in the UK, and it's rarely reported in people who travel in and out of the UK. Between 1996 and 2005 an average of 12 people per year in England and Wales were infected with cholera, and all of these were people who had recently travelled abroad.

Symptoms of cholera

The time between catching cholera and getting the symptoms of diarrhoea - known as the incubation period - can be anything between a few hours and five days. Most people get symptoms after two to five days.

If you have cholera, you may have symptoms including:

  • watery faeces with bits of mucus - this is sometimes called 'rice water' faeces since it looks like water in which rice has been washed
  • faeces with a mild fishy smell
  • vomiting
  • tummy cramps
  • dehydration
  • fever, but this is rare and usually only in children

About three-quarters of people who are infected with cholera don't realise they have it, as they don't become ill. Eight in 10 people who do become ill have mild symptoms of diarrhoea and vomiting, just like a tummy bug.

Less commonly, cholera can cause severe diarrhoea. This can lead to extreme dehydration, which can be fatal. If you think you may have severe cholera, seek medical advice urgently.

Causes of cholera

You can get cholera by:

  • drinking contaminated water
  • eating contaminated food (such as poorly cooked seafood)

You are unlikely to catch cholera from another person.

Diagnosis of cholera

Your GP will ask about your symptoms and examine you. He or she will also ask you a number of questions such as which countries or regions you have recently visited (including any stopovers).

Your GP may ask you for a faeces sample (also known as a stool sample). This will be sent to a laboratory for examination to find out if you are infected with cholera bacteria.

Treatment of cholera

The main treatment for cholera is to drink plenty of fluids to replace those you have lost. You should drink water and replace the salt and minerals you have lost with an oral rehydration solution. You can buy these from your pharmacist. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice. You can also make homemade solutions using sugar and salt, but you should contact your GP or pharmacist for advice first.

If you are very dehydrated, you may need hospital treatment. A needle is used to place a small plastic tube in your arm and an intravenous drip attached. Fluids will be given to you through the drip.

Medicines

You may be given antibiotics to treat cholera. Antibiotics (such as tetracycline and erythromycin) kill the bacteria which are causing your symptoms. They will also help to control diarrhoea and stop you losing any more fluids.

Prevention of cholera

There are a number of precautions you can take to help protect yourself from getting cholera if you are travelling to an area where there is a risk of developing it.

  • Only drink bottled water (make sure the seal is intact) or tap water that has been boiled.
  • Eat food that is freshly prepared, cooked thoroughly and hot - in particular, don't eat raw or undercooked seafood.
  • Don't eat raw vegetables such as green salads as they may have been washed in contaminated water - only eat raw vegetables and fruit that you can peel.
  • Wash your hands after going to the toilet and particularly before handling food or drinking water.

Vaccine

A cholera vaccine (Dukoral) has been available in the UK since 2004.

Most people who travel abroad don't need to have the cholera vaccine as taking preventive measures (see Prevention) will usually provide enough protection against cholera.

You will usually only be offered the vaccine if:

  • you work in an area of known cholera outbreaks, such as relief or disaster aid areas
  • you plan to stay long-term in a place where the risk of cholera is high - especially if there is limited access to good medical care

If you feel you are at high risk and may need the cholera vaccine, contact your GP for advice.

Dukoral is an oral vaccine (you take it by mouth) that comes in sachets that you dissolve in a drink. It can be used by adults and children over two.

The vaccine course is:

  • two doses for adults and children aged over six years
  • three doses for children aged two to six years

You shouldn't eat or drink anything one hour before or after taking the vaccine. The doses must be separated by a period of one week. You must have completed the course at least a week before you plan to travel to an area with cholera.

You will need to have a booster vaccine to keep you protected against cholera. This is needed after:

  • two years for adults and children over six
  • six months for children aged two to six

A few people will have side-effects after having the cholera vaccine, but usually these are very mild. You may have mild symptoms such as tummy pain or cramps, diarrhoea and feeling sick.

Fewer than one in 10,000 people will get more serious side-effects like a rash, flu-like symptoms or joint pain.

The vaccine doesn't provide complete protection as it doesn't protect against all strains of cholera. It's therefore still important to take preventive measures with hygiene, food and drink.

Further information

 

Sources

  • Cholera. National Travel Health Network and Centre. Department of Health. www.nathnac.org, accessed 12 February 2008
  • Cholera. Green Book, Chapter 14. Department of Health. 2006. www.doh.gov.uk
  • Cholera. Health Protection Agency. www.hpa.org.uk, accessed 12 February 2008
  • Cholera. eMedicine. www.emedicine.com, accessed 12 February 2008
  • Cholera. World Health Organization. www.who.int, accessed 12 February 2008
  • Warrell DA, Cox TM, Firth JD. Oxford Textbook of Medicine. 4th ed. Oxford, 2005:515-521
  • British National Formulary (BNF). BMJ Publishing Group, 2007. 54: 638
  • Prevention of food- and water-borne diseases. Travel Health Network and Centre. Department of Health. www.nathnac.org, accessed 12 February 2008

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr W H Simpson, MBBS, General Practitioner, and by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: June 2008.

 

Rate this page

Up to £100 off a Bupa Health assessment

Bupa health insurance

Free online health check

Bupa Care Homes

Bupa travel cover