Cholera is an acute diarrhoeal infection. Cholera is an acute gastrointestinal infection. The causative agent is a bacterium that enters the body through contaminated food or water. The period from infection to becoming ill is very short (1-5 days). Most people don’t get sick after being infected, but 20% of those infected get typical diarrhea. Diarrhea can cause severe dehydration and lead to death in a few hours. Cholera poses a major health threat in countries and areas with poor hygiene conditions. Every year there are 4,000,000 cases worldwide and 120,000 people die of cholera. The chance of contracting cholera as a traveler in a tropical country is extremely low (1 in 500,000 travelers).
Symptoms of cholera?
After a short incubation period of 1 to 5 days, the disease starts with vomiting, diarrhea, and abdominal pain. The stools come in large quantities and are watery, sometimes up to 40 times a day. The moisture loss is huge. A life-threatening situation may arise because circulation is insufficient. There are also many lighter cases during epidemics. Depending on the nutritional status, at the time of the onset of the disease, mortality can rise to 75%.
How does cholera develop?
Cholera is caused by eating or drinking water or food that is contaminated with cholera bacterium (Vibrio cholera). This bacteria can survive and spread well under poor hygienic conditions. This can especially occur after disasters and under war conditions, with large numbers of people living together in camps with inadequate hygiene provisions. The bacterium produces a toxic substance (enterotoxin). This substance stimulates the intestinal wall to produce large amounts of moisture. People with poor nutritional status are much more prone to getting the disease.
Is it serious what can you expect?
Cholera can have a very serious course and lead to death in a few hours. The severity of the disease is highly dependent on the health and nutritional status. However, the disease usually has a mild course.
When to the doctor?
Cholera does not occur in the Netherlands. Contamination can occur in countries with poor hygienic facilities. The incubation period is very short. You are usually still present in the country in question when the symptoms occur. It is advisable to consult a doctor in the case of complaints that indicate cholera. The doctor can give you a course of antibiotics. With indications of dehydration, it may be necessary to administer fluid through an infusion.
What can you do about it yourself?
When cholera is suspected, the most important thing is to ensure that you get plenty of fluids and salts. This is best with ORS (Oral Rehydration Solution). This is available almost everywhere and possibly also to make yourself. Do this by dissolving 8 level teaspoons of sugar and 1 level teaspoon of 1 salt in 1 liter of clean water. Drink a lot of this in severe diarrhea (liters!).
General advice and precautions?
You mainly encounter Cholera in high-risk areas, such as refugee camps. Try to avoid this. Pay close attention to hygiene, use bottled water or boiled water, wash your hands regularly with soap and water, do not eat raw food (fish, lettuce), peel fruit and do not buy food or drink on the street. A cholera vaccine is available. The vaccine prevents around 85% of cholera infections. Given the small chance of getting cholera, there is in principle no indication for travelers to administer this vaccine for the journey. With the exception of people who go to work in a refugee camp and probably cannot have boiled or bottled water.
Some countries do require the requirement for a cholera vaccination certificate for incoming travelers. This is against the guidelines of the World Health Organization. Travelers who travel to such countries receive the so-called “cholera medically not indicated” stamp in their vaccination booklet. This is sufficient to prevent problems at the border.
Cholera is an acute diarrhoeal infection