Diagnosis

Although signs and symptoms of severe cholera can be unmistakable in areas where it's common, the only way to confirm a diagnosis is to identify the bacteria in a stool sample.

Rapid cholera dipstick tests enable doctors in remote areas to quickly confirm a cholera diagnosis. Quick confirmation helps to decrease death rates at the start of cholera outbreaks and leads to earlier public health interventions for outbreak control.

Treatment

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 made with boiled or bottled water.

    Without rehydration, approximately half the people with cholera die. With treatment, fatalities drop to less than 1%.

  • Intravenous fluids. Most people with cholera can be helped by oral rehydration alone, but severely dehydrated people might also need intravenous fluids.
  • Antibiotics. While not a necessary part of cholera treatment, some antibiotics can reduce cholera-related diarrhea and shorten how long it lasts in severely ill people.
  • Zinc supplements. Research has shown that zinc might decrease diarrhea and shorten how long it lasts 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've been exposed to cholera, but your symptoms are not severe, call your family doctor. Be sure to say that you suspect your illness may be cholera.

Here's some information to help you get ready for your appointment.

When you make your appointment, ask if there are restrictions you need to follow before your visit.

Make a list of:

  • Your symptoms, when they began and how severe they are
  • Recent exposure to possible sources of infection, particularly if you've traveled abroad recently
  • Key medical information, including other conditions for which you're being treated
  • All medications, vitamins or other supplements you take, including doses
  • Questions to ask your doctor

Some questions to ask your doctor about cholera include:

  • Are there other possible causes for my symptoms?
  • What tests do I need?
  • What treatment approach do you recommend?
  • 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?

What to expect from your doctor

Your doctor is likely to ask questions, such as:

  • Have you had watery diarrhea? How severe?
  • Is there 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?
  • Have you recently eaten raw shellfish, such as oysters?
  • Are you pregnant?
  • What is your blood type, if you know?

What you can do in the meantime

Stay well hydrated. For diarrhea and vomiting that may be cholera-related, use an oral rehydration solution.

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. Stir the powder into clean drinking or boiled water according to the package directions.

If no oral rehydration solutions are available, 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.

Feb. 01, 2020
  1. Kliegman RM, et al. Cholera. In: Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Dec. 12, 2019.
  2. Ferri FF. Cholera. In: Ferri's Clinical Advisor 2020. Elsevier; 2020. https://www.clinicalkey.com. Accessed Dec. 12, 2019.
  3. Cholera. Centers for Disease Control and Prevention. http://www.cdc.gov/cholera/index.html. Accessed Dec. 12, 2019.
  4. Cholera. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/cholera. Accessed Dec. 12, 2019.
  5. LaRocque R, et al. Cholera: Clinical features, diagnosis, treatment, and prevention. https://www.uptodate.com/contents/search. Accessed Dec. 12, 2019.
  6. WHO position paper on oral rehydration salts to reduce mortality from cholera. World Health Organization. https://www.who.int/cholera/technical/en/. Accessed Dec. 12, 2019.

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