Vomiting and cholera: what to know

Cholera mainly affects the intestine, where it can cause profuse watery diarrhoea. Vomiting may happen at the same time, increasing the water and salt loss. It can also make it difficult to keep rehydration fluid down. Vomiting by itself does not establish cholera: [Vomiting] may have causes such as gastroenteritis, food poisoning, migraine, gallstones or pancreatitis. The combination of sudden watery diarrhoea, vomiting and dehydration requires prompt clinical attention rather than self-diagnosis.

A clinician may ask about food and water exposure, travel, other affected people and the appearance of the stool. They may also assess alertness, pulse, blood pressure and urine output.

After vomiting, pause briefly, then try very small, frequent sips of an oral rehydration solution. [Oral Rehydration Therapy] is more suitable for replacing salts than plain water alone during significant diarrhoea. If each attempt triggers vomiting, contact urgent medical services. Keep food preparation separate, wash hands with soap and use safe drinking water. Do not take anti-vomiting or anti-diarrhoeal medicines without professional advice, particularly if you are severely unwell or caring for a child.

Seek urgent care if you cannot keep fluids down, pass very little urine, feel faint, become confused, develop severe weakness, have a very dry mouth or become difficult to wake. A child may show fewer wet nappies, no tears or marked sleepiness. Severe dehydration can worsen quickly. [IV Fluid Therapy] may be needed when oral replacement fails. Emergency help is appropriate for collapse, altered consciousness, severe abdominal pain or blood in vomit or stool.

Ask what fluid to use, how to give it after vomiting, whether you need testing or observation, and which warning signs should prompt a return to care. Tell the clinician about pregnancy, age, long-term illness and every medicine or supplement taken.