What should you know about what causes cholera?

The bacteria leave an infected person's body in stool. If sanitation is poor, waste can contaminate water, food, hands, or surfaces. Another person becomes infected after swallowing the bacteria. The organism then acts in the intestine and may trigger sudden watery diarrhoea and vomiting. Cholera is not caused by cold weather, stress, or simply having an unsettled stomach.

Not everyone exposed becomes severely ill, and diarrhoea can have many other causes. If you have watery stools, use the [Diarrhoea](/symptoms/diarrhoea/) guide while arranging clinical advice.

Choose boiled, treated, or safely supplied water for drinking and cooking. Wash hands with soap after using the toilet and before touching food. Keep raw food away from cooked food, and clean items that may have been contaminated. For illness, begin [Oral Rehydration Therapy](/treatments/acute-and-urgent-care/oral-rehydration-therapy/) promptly and tell the clinician about unsafe water, travel, or other affected household members.

Urgent assessment is needed when watery diarrhoea is heavy or persistent, vomiting limits drinking, or there is faintness, confusion, marked weakness, dry mouth, or reduced urine. Children and older adults may deteriorate before they describe thirst. If oral replacement is inadequate, [IV Fluid Therapy](/treatments/acute-and-urgent-care/iv-fluid-therapy/) can be provided by a healthcare team.

Ask whether the illness could be cholera or another infection, how to disinfect shared items, which fluids are suitable, and when close contacts should seek advice.