Cholera is an infectious disease commonly associated with severe watery diarrhoea. If not treated promptly and adequately, victims die from the disease within hours.

Cause and Transmission

Cholera is caused by a bacterium called Vibrio cholerae. It is usually found in food or water contaminated by faeces from a person with the infection. It is therefore commonly transmitted through;

  • ŸContaminated water supply
  • ŸIce made from contaminated water
  • ŸFoods and drinks contaminated by the bacteria for instance from food vendors
  • ŸVegetables grown with water containing human wastes
  • ŸRaw or undercooked fish and seafood caught in waters polluted with sewage

Disease process

Upon entry into the body, the bacteria releases its poison (toxin) into the intestines. This results in irritation of the intestines with numerous and rapid episodes of severe diarrhoea. It’s this heavy loss of fluid that causes death in victims with cholera.

Vulnerable groups

1. Travellers

2. Communal eating e.g. hotels, weddings and other gatherings.

3. Health workers

4. Street food consumers.

5. Slum dwellers

6. Fishing communities.

7. Children

Cholera symptoms

Symptoms of cholera may set in within a few hours, but may take as long as five days following infection. Commonly, symptoms are mild, but sometimes they are very serious.

Although some infected people may have minimal or no symptoms, they can still contribute to spreading of the infection.

Diarrhoea and sometimes vomiting are the most significant symptoms.

Others include;

  • Rapid heart rate
  • Loss of skin elasticity ( ability to return to original position quickly
  • if pinched)
  • ŸDry mouth, throat, nose, and eyelids
  • ŸLow blood pressure
  • ŸThirst
  • ŸMuscle cramps

Risk factors and disease

  • Cholera transmission is common in both urban and rural settlements with limited or inadequate source of clean water. The following are some of the risk factors;
  • ŸLack of proper toilets or inadequate human waste disposal contributes to transmission on cholera.
  • ŸOvercrowded camps can increase the risk of cholera transmission should the bacteria be present or
  • introduced.
  • ŸLimited access to water or limitations in maintaining water quality coupled by inadequate hygiene practices for instance omission of or poor hand washing, insufficient safety in food preparation practices.
  • ŸCrowded settings like in dense urban slums, refugee or displaced sites, institutions, gatherings (weddings, funerals)
  • ŸSeasonal upsurges especially in dry seasons with water shortages and in rainy season with flooding and contamination of water sources.
  • ŸLow immunity levels in children, malnourished individuals, elderly, expectant mothers, HIV/AIDS among others.
  • ŸLack of access to early detection and proper treatment including individual knowledge and beliefs.
  • ŸRecent studies indicated that persons with blood group O have increased risk for reasons not well established.


Tests that are performed to confirm cholera infection include;

  • ŸBlood culture
  • ŸStool culture and gram stain


The goal of treatment is to replace fluid and salts that are lost through diarrhoea. Diarrheal and subsequent fluid loss can be fast and extreme. It can be hard to replace lost fluids.Depending on your condition, you may be given fluids by mouth or through a vein (intravenous, or IV). Antibiotics may shorten the time you feel ill.

The World Health Organization (WHO) has developed a cheaper and easier solution that helps restore fluids.

Recovery and treatment outcome

Most people will make a full recovery when they are given sufficient fluids during treatment.


Prevention of cholera is achieved through proper and adequate hygiene.

Wash hands with soap and water frequently, especially after using the toilet and before handling food. Rub soapy, wet hands together for at least 15 seconds before rinsing. If soap and water aren’t available, use an alcohol-based hand sanitizer.

Use of toilets at all times: Toilets should be used for disposal of human waste. This is if contamination of the environment especially was by the cholera bacteria.

Use of clean safe water: Use boiled, chemically disinfected, or bottled water for the following purposes:

  • ŸDrinking
  • Preparing food or drinks
  • ŸMaking ice
  • ŸBrushing your teeth
  • ŸWashing your face and hands
  • Washing dishes and utensils that you use to eat or prepare food
  • ŸWashing fruits and vegetables
  • To disinfect your own water, boil it for one minute (or 3 minutes at higher elevations) or filter it and use a commercial chemical disinfectant.

Cooked food: Eat food that’s completely cooked and hot and avoid street vendor food, if possible. If you do buy a meal from a street vendor, make sure it’s cooked in your presence and served hot.

Take clean food only

You should also avoid raw foods, including the following:

  • Unpeeled fruits and vegetables
  • Unpasteurized milk and milk products
  • Raw or undercooked meat or shellfish
  • Fish caught in tropical reefs, which may be contaminated