Although signs and symptoms of severe cholera may be unmistakable in endemic areas, the only way to confirm a diagnosis is to identify the bacteria in a stool sample.
Rapid cholera dipstick tests are now available, enabling health care providers in remote areas to confirm diagnosis of cholera earlier. Quicker confirmation helps to decrease death rates at the start of cholera outbreaks and leads to earlier public health interventions for outbreak control.
Cholera requires immediate treatment because the disease can cause death within hours.
- Rehydration. The goal is to replace lost fluids and electrolytes using a simple rehydration solution, oral rehydration salts (ORS). The ORS solution is available as a powder that can be reconstituted in boiled or bottled water. Without rehydration, approximately half the people with cholera die. With treatment, the number of fatalities drops to less than 1 percent.
- Intravenous fluids. During a cholera epidemic, most people can be helped by oral rehydration alone, but severely dehydrated people may also need intravenous fluids.
- Antibiotics. While antibiotics are not a necessary part of cholera treatment, some of these drugs may reduce both the amount and duration of cholera-related diarrhea for people who are severely ill.
- Zinc supplements. Research has shown that zinc may decrease and shorten the duration of diarrhea in children with cholera.
Preparing for your appointment
Seek immediate medical care if you develop severe diarrhea or vomiting and are in or have very recently returned from a country where cholera occurs.
If you believe you may have been exposed to cholera, but your symptoms are not severe, call your family doctor. Be sure to tell him or her that you suspect your illness may be cholera.
Here's some information to help you get ready and what to expect from your doctor.
Information to gather in advance
- Pre-appointment restrictions. When you make your appointment, ask if there are any restrictions you need to follow in the time leading up to your visit.
- Symptom history. Write down any symptoms you've been experiencing and for how long.
- Recent exposure to possible sources of infection. Your doctor will be especially interested to know if you have recently traveled abroad and where.
- Medical history. Make a list of your key medical information, including other conditions for which you're being treated and any medications, vitamins or supplements you're currently taking.
- Questions to ask your doctor. Write down your questions in advance so that you can make the most of your time with your doctor.
The list below suggests questions to raise with your doctor about cholera.
- Do I have cholera?
- Are there any other possible causes for my symptoms?
- What kinds of tests do I need?
- What treatment approach do you recommend?
- Are there any possible side effects from the medications I'll be taking?
- How soon after I begin treatment will I begin to feel better?
- How long do you expect a full recovery to take?
- When can I return to work or school?
- Am I at risk of any long-term complications from cholera?
- Am I contagious? How can I reduce my risk of passing my illness to others?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may leave you time to go over any points you want to talk about in-depth. Your doctor may ask:
- What are your symptoms?
- Where and when have you traveled?
- When did you first begin experiencing symptoms?
- Have you had watery diarrhea? How severe?
- Have you noticed anything else unusual about the appearance of your stools?
- Have you been vomiting?
- Have you experienced symptoms of dehydration, such as intense thirst, muscle cramps or fatigue?
- Have you been able to keep down any food or liquid?
- What other signs or symptoms concern you?
- Have you recently eaten raw shellfish, such as oysters?
- Are you pregnant?
- What is your blood type, if you know it?
- Are you being treated for any other medical conditions?
- Are you currently taking any medications?
What you can do in the meantime
Be sure to stay well-hydrated in the time leading up to your appointment. For diarrhea and vomiting that may be cholera-related, drinks such as water, juice and soda won't adequately replenish both fluids and electrolytes. Instead, use an oral rehydration solution such as Pedialyte.
In most developing countries, you can buy powdered packets of oral rehydration salts (ORS) originally developed by the World Health Organization to treat diarrhea and dehydration in infants with cholera. Reconstitute the powder in clean drinking or boiled water according to the directions on the package.
If no oral rehydration solutions are available, you can make your own by combining 1 quart (about 1 liter) of bottled or boiled water with 6 level teaspoons (about 30 milliliters) of table sugar and 1/2 level teaspoon (about 2.5 milliliters) of table salt.