Cholera is a rare, but serious infection caused by the bacteria vibrio cholerae. Cholera symptoms include watery diarrhoea that appears suddenly, therefore sufferers can lose a lot of fluids rapidly. There are many things you can do to prevent cholera transmission, including taking the cholera vaccine and being aware of what you eat and drink while travelling.

Risk areas
Africa, South East Asia, South America, Caribbean
Deaths a year
Infections a year
4 million
People at highest risk
Volunteers, aid workers and medical staff in disaster relief situations, expats living in epidemic countries
Fatality rate with treatment
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01. Cholera: virus or bacteria?

Many people do not know if cholera is a virus or a bacteria.

The answer is that cholera is caused by a bacteria known as vibrio cholerae. There are more than 100 types of vibrio cholerae, but only two types cause the disease.

One of the main differences between a virus and a bacteria is that bacteria respond to antibiotics, but viruses do not. Because of this, antibiotics can be used in cholera treatment.

02. Transmission of cholera

Cholera transmission mainly occurs through having foods and drinks that have been contaminated with the bacteria, vibrio cholerae.

The bacteria can occur naturally in water or be found in infected faeces, therefore cholera transmission is most common in poorer communities with limited access to clean water and adequate toilet facilities.

If you are travelling to a poorer area, you should therefore make sure you are aware of the ways cholera can spread, and how to protect yourself against the disease.

Although it is uncommon, cholera is contagious, so it can also be passed from person to person.

Remember, many people who have been infected with cholera do not show symptoms, so be cautious when making contact with others while travelling in risk areas, even if they appear well.

Take extra care if you are travelling with young children. Dispose of nappies and other products, such as wipes, carefully, as faeces can carry the disease.

03. Risk areas

Cholera does not usually occur in high-income countries where there is access to safe drinking water and adequate sewage disposal. Because of this, there is a low risk of cholera for travellers who visit such areas, for example Europe and North America.

Those at the highest risk of cholera are people travelling in more remote areas and poorer communities in parts of Africa, where 60 % of all cases occurred, and South-East Asia, where 26 % of all cases occurred annually between 2008 and 2012.

If you are travelling to one of these areas, it is recommended that you check if you need to get vaccinated to reduce the risk of contracting the disease.  

Even though cholera is more common in poorer communities, outbreaks can occur anywhere in the world, and the cholera risk changes.

It has been estimated that up to four million cases and 95,000 deaths occurred annually across the world between 2008 and 2012 due to cholera.

Check if the country you are travelling to has a risk of cholera through the search bar below.

04. Symptoms of cholera

Cholera symptoms can begin within a few hours, or up to five days after becoming infected.  

Cholera symptoms can include:

  • sudden watery diarrhoea

  • nausea and vomiting

  • mild to severe dehydration

  • shock

  • loss of fluids, up to 20 litres a day

Mild cholera symptoms can be similar to having a sickness bug or food poisoning, and 75% of those infected do not show any symptoms at all. In these cases, the infection leaves the body within one to two weeks with no need for treatment.

05. Diagnosis of cholera

Diagnosis of cholera is usually done through several tests of your faeces.

Doctors will look for the bacteria, vibrio cholerae, in your stool so they can confirm whether or not you have cholera.

If you have cholera, it is crucial that you get diagnosed as soon as possible, as cholera can progress rapidly resulting in death, and immediate treatment is therefore required.

06. Treatment of cholera

Cholera is an easily treatable disease, and with the right cholera treatment, nearly everyone makes a full recovery. However, this requires rapid access to treatment.  

For over 50% of those who have severe symptoms and do not receive cholera treatment, the disease can be fatal.

Cholera treatment can include replacing the fluids you have lost with drinks called rehydration salts or solutions.

If you are seriously dehydrated, you may need to go to a hospital where doctors can give you fluids intravenously, through a small tube that goes into your vein, called an IV.

You may also need antibiotics to help your body fight the infection.

07. Prevention of cholera

There are many things you can do to prevent cholera, such as getting vaccinated.

If you need to get vaccinated for cholera, you can book a vaccination appointment online today.

If you are unsure if the cholera vaccine is right for you, book a free telephone consultation to speak to one of our prescribing nurses who can advise you.

For effective cholera prevention, it is recommended that you:

  • check if you need the cholera vaccine before travelling

  • wash your hands with soap and water regularly

  • only drink bottled water or tap water that has been boiled

  • brush your teeth using bottled or boiled water

  • use bottled or boiled water to wash fruit and vegetables

  • avoid shellfish and seafood

  • avoid ice cream and ice in your drinks

  • avoid contact with others infected with cholera, if possible

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Content reviewed by

Anne Marie Major, Independent Nurse Prescriber
24 June 2019