What is cholera?

Cholera is a disease spread by drinking water or eating food contaminated with cholera bacteria. Severe cholera is characterized by large amounts of watery diarrhea, often described as “rice-water stool” because it can have a pale, milky appearance. It can also be accompanied by nausea and vomiting. If untreated, the loss of fluid can be deadly. But simple treatment, including replacing lost body fluids, can lower the risk of death to less than 1%.

Who is at risk?

A person is at risk for cholera if he or she eats food or drinks water contaminated with cholera bacteria. Cholera is extremely rare in the United States and other industrialized nations, but cases continue to occur in Haiti and the Dominican Republic, along with parts of Africa and Asia. Travelers to countries where cholera is a risk very rarely get cholera because they do not typically visit areas with cholera outbreaks and have better access to safe food and water. Travelers may be at higher risk if they are visiting friends and family in an outbreak area or working in high-risk settings (such as refugee camps or cholera treatment centers). These travelers may also be at higher risk because they stay longer or have less access to safe food and water.

What can travelers do to prevent disease?

Because it is spread through contaminated food and water, cholera is easily prevented by sticking to safe eating and drinking habits and regularly washing hands.

Though a newly licensed cholera vaccine (Vaxchora, PaxVax Corporation) is available in the United States, it is not routinely recommended because most adults who travel to countries where cholera is a risk do not travel to areas with cholera, and those who do are usually able to prevent infection by avoiding unsafe food and water. When considering a cholera vaccine, which may be expensive and potentially effective for a short time, travelers should discuss their travel plans with their travel medicine specialist.

Page reviewed on: Mar 09, 2017

Page reviewed by: Jessie L. Leyse, MD