Development of cholera: what to know

Cholera bacteria release a toxin in the small intestine. The toxin disrupts normal movement of salts across the intestinal lining, so water follows into the bowel. The result can be sudden, large-volume watery diarrhoea, sometimes described as rice-water stool, with vomiting and muscle cramps. Fluid loss can quickly reduce blood circulation and disturb salts needed by the heart, muscles, and nerves. Infection can spread where drinking water, sanitation, or hand hygiene is unsafe. Many other causes of diarrhoea exist, so suspected cholera needs clinical assessment and may require testing and public-health advice.

Treat suspected cholera as urgent, especially after travel or exposure to unsafe water. Begin oral rehydration therapy while arranging medical care, using a properly prepared solution and frequent small sips if vomiting occurs. Continue breastfeeding when relevant and use safe fluids; very sugary drinks alone are not a substitute for a balanced rehydration solution. Clinicians may give antibiotics in selected cases and will monitor hydration and salts. Severe dehydration may need IV fluid therapy. Wash hands carefully, use treated water, and avoid preparing food for others while unwell.

Get urgent help for repeated watery diarrhoea, inability to drink, persistent vomiting, very little urine, intense thirst, dizziness, fainting, confusion, cold or clammy skin, or unusual sleepiness. Children, older adults, pregnant people, and anyone with significant medical conditions can deteriorate quickly. Emergency care is needed when a person cannot stay awake, has signs of shock, or cannot replace fluid by mouth.

Could this be cholera or another infection? How should I prepare and use oral rehydration solution? Do I need IV fluids or antibiotics? How can I protect people at home? Should close contacts or local health services be notified?