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Disease

Cholera

Page last updated on 05 February 2019

Cholera is not regularly found in Australia. There have been a small number of cases reported in Australia over the past few years, however they were either contracted overseas or from eating raw imported fish (whitebait).

Cholera is a vaccine-preventable disease, which typically spreads through contaminated water or food. Modern sewage and water treatment have helped to eliminate cholera in most countries. However, it’s still a problem in countries affected by war, poverty, and natural disasters and where conditions may force people to live in crowded areas without proper sanitation.

In most cases (up to 75% of reported cases), people infected with cholera show no signs of symptoms of the disease, but the person does remain potentially infectious to others. Common symptoms include watery diarrhoea and vomiting. Although cholera is easily treated, if symptoms are ignored and left untreated then it can be fatal in a matter of hours, even in people who were otherwise healthy.

Reported cases of cholera are usually linked to a recent history of travel to a cholera-endemic area. Vaccination is recommended for some people, in particular travellers at increased risk of acquiring diarrhoeal disease.

For further information on cholera and its prevention, speak with your healthcare professional.

Key disease information

What is cholera?

Cholera is an acute (sudden onset) disease with symptoms of severely, watery diarrhoea (“rice-water stools”) and vomiting. This causes rapid fluid loss, leading to dehydration – which can be fatal. However, some people experience only mild symptoms and some none at all. 

Cholera is caused by the bacterium Vibrio cholerae, which is found in water and soil contaminated with faeces (poo). Therefore, cholera is acquired by eating food or drinking fluid that is contaminated with faeces. 

The best way to prevent getting cholera is to practice good personal hygiene, and ensure food and water is not contaminated with faeces. While cholera is generally not found in Australia (only a small number of cases have been reported, and almost always in relation to overseas travel), if you are planning on travelling to a country that is at risk of a cholera outbreak, precautions are important to consider.
 

How is cholera spread?

Spreading cholera between person-to-person is unlikely, however, cholera is a disease often found in areas with poor sanitation, poor water treatment, and low levels of personal hygiene (mostly in developing countries).

Cholera is spread by:

  • drinking contaminated water
  • eating food contaminated by dirty water, soiled hands or flies
  • eating fish or shellfish from contaminated waters.
What are the symptoms of cholera?

In most cases), people infected with cholera show no signs or symptoms of the disease, but the infected person can still remain infectious to others. Symptoms may appear quickly, in as little as 12 hours after initial exposure to the bacterium, or it appear up to five days later.

Symptoms of severe cholera include:

  • sudden onset of painless, but severe, watery diarrhoea
  • nausea and vomiting (early in the illness)
  • severe dehydration (as a result of rapid fluid loss)

In severe untreated cases, death may occur within hours, but with simple treatment, full recovery can be expected.
 

How do you treat cholera?

In severe cases, where a large amount of fluid is lost through vomiting and diarrhoea, rapid fluid replacement is immediately required.

Patients can drink an oral rehydration solution (ORS), which is pre-packaged sugar and salts mixed with water, or if required, intravenous fluids (i.e. drips) and electrolytes (salts) may be administered though a needle in a vein. 

Antibiotics may also be used to shorten the duration of symptoms. 

Before administering treatment see your healthcare professional who will assess your situation. 

Which countries are affected by cholera?

Cholera is not usually found in Australia, but the bacteria have been found in some rivers along the eastern coast as well as, on rare occasions, in river mouths. 

Cholera is commonly found in developing countries with poor sanitation, poor water treatment and lower levels of personal hygiene. Regions where cholera is most commonly found include parts of Africa, Asia, and Latin America. Intermittently is has also been reported in the Middle East and the Pacific Islands. 

How can cholera be prevented?

Although vaccines for cholera are available, routine vaccination is generally not recommended for cholera and is not an official entry requirement for any country. Vaccination may be considered for special cases, such as people with some existing medical conditions, or those working in humanitarian relief or natural disaster areas. 

Before and during travel to high-risk countries:

  • seek advice from a travel medical clinic or an experienced general practitioner on how to protect yourself from cholera and other diarrhoeal illnesses
  • regularly wash hands with soap and water
  • drink only water that has been boiled or disinfected with iodine or chlorine tablets. Carbonated bottled drinks are usually safe (if no ice is added)
  • eat freshly prepared and/or hot food, and avoid eating raw foods or vegetables (unless they can be peeled) 
  • always practice good food handling procedures.
     

VaccineHub offers general information only. Please see a healthcare professional for medical advice

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Sources & Citations

  1. The Australian Immunisation Handbook 10th Edition, 4.1 Cholera. Available at http://immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part4~handbook10-4-1 (accessed 7 April 2018).
  2. Australian Government, Department of Health, Australia’s notifiable disease status, 2014: Annual report of the National Notifiable Diseases Surveillance System (main page). Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi4001e.html (accessed 7 April 2018).
  3. NSW Government, Department of Health, Cholera Fact Sheet. Available at http://www.health.nsw.gov.au/Infectious/factsheets/Pages/cholera.aspx (accessed 7 April 2018)
  4. Victorian Government, Health, Cholera. Available at https://www2.health.vic.gov.au/public-health/infectious-diseases/disease-information-advice/cholera (accessed 7 April 2018).
  5. Centers for Disease Control, Traveller’s Health - Cholera. Available at https://wwwnc.cdc.gov/travel/diseases/cholera (accessed 7 April 2018).
  6. Centers for Disease Control, Cholera – Illness and Symptoms. Available at https://www.cdc.gov/cholera/illness.html (accessed 7 April 2018).
  7. Centers for Disease Control, Cholera – General Information FAQs. Available at https://www.cdc.gov/cholera/general/index.html (accessed 7 April 2018).
  8. Centers for Disease Control, Cholera Home. Available at https://www.cdc.gov/cholera/index.html (accessed 7 April 2018).
  9. World Health Organisation, Media Centre – Cholera Factsheet. Available at http://www.who.int/mediacentre/factsheets/fs107/en/ (accessed 7 April 2018).
  10. Mayo Clinic. Cholera. Available at: https://www.mayoclinic.org/diseases-conditions/cholera/symptoms-causes/syc-20355287 (accessed 12 April 2018).
  11. Government of South Australia. Cholera – including symptoms, treatment and prevention. Available at: http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+topics/health+conditions+prevention+and+treatment/infectious+diseases/cholera (accessed 12 April 2018).
  12. Australian Government, Department of Health, Number of notifications of all diseases received from State and Territory health authorities, 2017. Available at: http://www9.health.gov.au/cda/source/rpt_2.cfm (accessed 27 April 2018)
  13. Queensland Health. Cholera- Queensland Health Guidelines for Public Health Units. Available: https://www.health.qld.gov.au/cdcg/index/cholera (accessed 5 June 2018)

SPANZ.SAPAS.18.04.0130 - Date of preparation May 2018

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