Bacterial infection caused by Vibrio cholerae. The patient suffers profuse watery DIARRHOEA, with resultant dehydration and electrolyte imbalance. Cholera remains a major health problem in many countries of Asia, Africa and South America. It is one of three quarantinable infections.

Incubation period varies from a few hours to five days. Watery diarrhoea may be torrential and the resultant dehydration and electrolyte imbalance, complicated by cardiac failure which may be fatal. Diagnosis is by detection of V. cholerae in a faecal sample. Treatment consists of rapid rehydration. Whereas the intravenous route may be required, the majority of patients can be treated with oral rehydration (using an appropriate solution containing sodium chloride, glucose, sodium bicarbonate, and potassium). ANTIBIOTICS, for example, tetracycline and doxycycline, reduce the period during which V. cholerae is excreted); in an epidemic, rapid resistance to these, and other antibiotics, is commonplace. Prevention consists of improving public health infrastructure – in particular, the quality of drinking water. When supplies of the latter are satisfactory, the infection fails to thrive. The risk of tourists and travellers in endemic areas contracting the disease is low if they take simple precautions. These include eating safe food (avoid raw or undercooked seafood, and wash vegetables in clean water) and drinking clean water. There is no cholera vaccine at present available in the UK as it provides little protection and cannot control spread of the disease.