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Cholera

What is cholera?

Cholera is a disease spread by drinking water or eating food contaminated with cholera bacteria. Severe cholera is characterized by large amounts of watery diarrhea, often described as “rice-water stool” because it can have a pale, milky appearance. It can also be accompanied by nausea and vomiting. If untreated, the loss of fluid can be deadly. But simple treatment, including replacing lost body fluids, can lower the risk of death to less than 1%.

Who is at risk?

A person is at risk for cholera if he or she eats food or drinks water contaminated with cholera bacteria. Cholera is extremely rare in the United States and other industrialized nations, but cases continue to occur in Haiti and the Dominican Republic, along with parts of Africa and Asia. Travelers to countries where cholera is a risk very rarely get cholera because they do not typically visit areas with cholera outbreaks and have better access to safe food and water. Travelers may be at higher risk if they are visiting friends and family in an outbreak area or working in high-risk settings (such as refugee camps or cholera treatment centers). These travelers may also be at higher risk because they stay longer or have less access to safe food and water.

What can travelers do to prevent cholera?

Because it is spread through contaminated food and water, cholera is easily prevented by sticking to safe eating and drinking habits and regularly washing hands.

A newly licensed cholera vaccine (Vaxchora, PaxVax Corporation) is available in the United States, and is recommended by CDC for adults traveling to areas with active cholera transmission; most people do not travel to areas of active cholera transmission. Vaxchora prevents severe diarrhea caused by the most common type of cholera bacteria. Avoiding unsafe food and water can also prevent many cholera infections. Travelers should consider the following questions:

  • How common is cholera where I am going?
  • How common is cholera in travelers to this area?
  • What would put me at risk for cholera?
  • Will I be able to receive rapid treatment (if needed) at my destination?

How is cholera treated?

The key to treating cholera is to replace lost body fluids (rehydration). Antibiotics can shorten the length of illness and help prevent loss of fluids (dehydration) in people with cholera. If you are seriously ill and think you may have cholera, visit a health care provider immediately and tell him or her about where you have recently traveled.

Areas with cholera

The following countries have areas with cholera. However, it’s important to remember that most cholera is spread in limited outbreaks, and travelers are rarely at risk.

  • Africa: Benin, Burundi, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Malawi, Mozambique, Nigeria, Somalia, South Sudan, Tanzania, Uganda, Zambia
  • Asia: Afghanistan, Bangladesh, India, Iraq, Malaysia, Myanmar, Thailand, Yemen
  • Americas: Dominican Republic, Haiti

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