Cholera is an acute, diarrheal illness caused by
infection of the intestine with the bacteria Vibrio
cholerae. The infection is often mild or without
symptoms, but can be severe.
Who gets cholera?
Although cholera is extremely rare in the United
States, anyone can get cholera if they drink water or
eat food contaminated with the cholera bacterium.
an outbreak situation, the source of contamination is
usually the feces (stool) of an infected person. The
disease can spread rapidly in areas with inadequate
treatment of sewage and drinking water.
Cholera has been very rare in industrialized nations
for the last 100 years; however, the disease is still
common today in other parts of the world, including
the Indian subcontinent and sub-Saharan Africa.
Since 1991, epidemic cholera has been a problem in
South America. A few people in the United States
have contracted cholera after eating raw or
undercooked shellfish from the Gulf of Mexico.
How is cholera spread?
Cholera is spread in contaminated water and food. Cases of cholera that occur in the United States are usually among people who have traveled to places where cholera is common, or among people who have eaten contaminated food brought back to the United States by other travelers. The disease is not likely to spread directly from one person to another.
How soon after exposure do symptoms
Symptoms can occur within hours up to five days
after consumption of contaminated food or water,
usually in two or three days.
How is cholera diagnosed?
Cholera is diagnosed by isolating the cholera
bacterium, Vibrio cholerae, from stool or vomit, or
by finding evidence in the blood of the recent
production of antibodies against cholera.
What is the treatment for cholera?
Cholera can be treated by immediate replacement of
the fluid and salts lost through diarrhea. Patients can
often be treated with oral rehydration solution, but
severe cases also require intravenous fluid
With prompt rehydration, fewer than
one percent of cholera patients will die. Antibiotics
shorten the course and diminish the severity of the
illness, but they are not as important as rehydration.
How can cholera be prevented?
The risk of cholera in the United States is virtually
nonexistent, and the risk for cholera is very low for
travelers visiting even those areas with epidemic
cholera when simple precautions are observed.
If traveling to an area where cholera has occurred,
the following precautions are recommended:
If you drink water, buy it bottled or bring it to a
rolling boil for one minute before you drink it.
Bottled carbonated water is safer than
uncarbonated water. Other safe beverages
include tea and coffee made with boiled water
and carbonated, bottled beverages with no ice.
Ask for drinks without ice unless the ice is made
from bottled or boiled water. Avoid popsicles
and flavored ices that may have been made with
Eat only foods that have been thoroughly cooked
and are still hot, or fruit that you have peeled
Avoid undercooked or raw fish or shellfish,
Make sure all vegetables are cooked; avoid
Avoid foods and beverages from street vendors.
Do not bring perishable seafood back to the
A simple rule of thumb is: "Boil it, cook it, peel it
or forget it!"
A vaccine is available; however, it confers only
brief and incomplete immunity and is not
recommended for travelers.
Where can I get more information?
Contact your doctor or the Southern Nevada Health District, Office of Epidemiology at (702) 759-1300.
The Division of Quarantine, National Center for
Infectious Diseases, Centers for Disease Control and
Prevention has information on cholera and other diseases of concern to travelers at www.cdc.gov/travel/index.htm.
This fact sheet was based on the Centers for Disease Control
and Prevention’s Cholera Prevention Guide (last updated