Communicable disease factsheets

Cholera

Cholera is an acute bacterial enteric disease which is transmitted through the ingestion of food or water which has been contaminated with human excreta. This fact sheet covers: background; occurrence; vaccination requirements for travel; treatment; avoidance; quarantine measures.

Background

Cholera is an acute bacterial diarrhoeal disease that is transmitted through the ingestion of food or water contaminated with human faeces. The primary symptom of infection is the sudden onset of watery diarrhoea, with or without vomiting. If untreated, the fatality rate in severe cases can be as high as 50 per cent due to dehydration and kidney failure. Infection without symptoms, or with only mild diarrhoea, is common particularly in children.

Occurrence

Cholera has been reported from all continents. It is endemic in Asia, South America, central Europe, Africa, and is reported sporadically in Northern America and the Pacific. Australia is free of the disease except for the occasional case in an international traveller and very rarely, cases acquired from some eastern rivers.

World-wide cholera appears to be increasing in both the number of cases and their distribution. In 1998, there were over 290,000 cases in 74 countries with 10,500 deaths reported to the World Health Organization (WHO).

Vaccination requirements for travel

No country officially requires proof of cholera vaccination as a condition of entry.

Cholera vaccine is available in Australia. You should consult a medical practitioner for advice on the use of cholera vaccine before travel to a cholera endemic country.

Treatment

Cholera infection may result in a life threatening dehydration which must be treated urgently. The initial treatment for cholera infection is oral rehydration therapy with oral rehydration solution (ORS). This therapy may be all that is required to treat mild to moderate illness but severe dehydration usually requires the replacement of fluid by intravenous infusion and antibiotic therapy. Oral rehydration powder (available from pharmacies) should be carried by travellers intending to visit areas where cholera occurs. The water used to reconstitute the powder should be made safe to drink by boiling or by a chemical sterilisation process.

Avoidance

Travellers should avoid consuming food and liquids which may potentially be contaminated with cholera bacteria. Also avoid contact with the vomitus and faeces of an infected person especially during the illness and for several days after symptoms of illness cease.

Detailed advice for travellers on the prevention of food borne illness can be found in the WHO publication titled International Travel and Health. This booklet is available for sale from the WHO or can be viewed on the WHO web site at: http://www.who.int/ith.
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