Cholera

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Is cholera contagious?

It takes about 100 million V. cholerae bacteria to infect a healthy adult. Because of this high number, significant contamination of food or water is required to transmit the disease, and direct person-to-person transmission is thought to be uncommon except in outbreaks. In outbreaks, cholera-causing bacteria become highly contagious indirectly and directly by the fecal-oral route because of widespread fecal contamination of food, water, and items like contaminated bedding and clothing.

What is the incubation period for cholera?

The incubation period (time period from exposure to the bacteria to the development of symptoms) may vary from a few hours (about six to 12 hours) to five days, with the average incubation period being about two to three days. About six to 12 hours is considered a very rapid incubation period and may suggest that rapid/immediate intervention is required for recovery.

What is the contagious period for cholera?

The contagious period for cholera begins as soon as organisms are excreted in the feces. This can occur as early as about six to 12 hours after exposure to the bacteria and can last for about seven to 14 days. Some individuals who are asymptomatic (infected but not having symptoms) will also excrete contagious organisms for about seven to 14 days.

What physicians usually treat cholera?

Because most individuals have either mild or no symptoms, these people are either not treated or treated by their primary-care physician. However, in some children and in individuals who have more severe disease, besides the primary-care physician or pediatrician, an infectious-disease specialist, a critical-care specialist, a gastroenterologist, and/or an internist may be needed to help the team manage and treat the patient.

In addition, specialists in travel medicine and/or epidemiology can help individuals avoid cholera and/or can give advice about prevention, treatment, and prognosis to those individuals traveling to or living in endemic areas.

How do health-care professionals diagnose cholera?

Preliminary diagnosis is usually done by a caregiver who takes a history from the patient and observes the characteristic rice-water diarrhea, especially if a local outbreak of cholera has identified. The diarrhea fluid is often teeming with motile, comma-shaped bacteria (presumptively V. cholerae) that can be seen with a microscope. The definitive diagnosis is made by isolation of the bacteria from diarrhea fluid. All state health department laboratories in the U.S. are able to perform tests for Vibrio cholerae. Readers may see terms like serotypes Inaba, Ogawa, and Hikojima to describe V. cholerae; they simply indicate which O antigens (O antigens designated A, B, or C) are found on these strains of V. cholerae. PCR tests have also been developed to detect the genetic material of cholera, but currently they are not as widely used as the immunologic tests based on type-specific antiserum.

Definitive diagnosis helps to distinguish cholera from other diseases caused by other bacterial, protozoal, or viral pathogens that cause dysentery (gastrointestinal inflammation with diarrhea).

Medically Reviewed by a Doctor on 6/16/2016

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