How do I recognise the symptoms of cholera?

In most people, cholera is mild, and it eventually resolves on its own. In these cases, the disease is similar to other diseases with diarrhoea. The most common symptoms of cholera are sudden vomiting and a large amount of watery diarrhoea. This diarrhoea looks like "rice water." It is light-yellow greenish in colour, contains flakes, and has almost no smell.

Cholera patients do not have abdominal cramps, but may have dull or pressing abdominal pain. The greatest risk of cholera is dehydration because patients lose a lot of fluid, sometimes as much as one litre per hour. As people get dehydrated further, they become listless and may become unconscious. Patients then quickly worsen and may die within a day. The mortality rate is about 2%. In areas with low or poor health care, this can reach up to 40%.

How do I get cholera?

People get sick from contaminated food or water. Crustaceans and shellfish pose an additional risk because the bacteria can accumulate in them. The stools of a person with cholera can also infect others. After infection, it takes twelve hours to five days for someone to get sick. The average time is two to three days.

Humans are contagious from the very first symptoms and for a maximum of up to two weeks after recovery. With antibiotics, this period is shorter.

How do I prevent cholera?

If you travel through an area where cholera is present, the main measures to prevent infection are:  

• Wash your hands regularly with soap and water. Be sure to do this after using the toilet and before eating.
• Do not eat or drink anything that could be contaminated:
  • Do not drink water from the tap, but use water from bottles that have not been opened before.
  • Do not use ice cubes or cold milk products such as ice cream or yoghurt drinks.
  • Do not eat raw food, salads or unpeeled fruit. Peel fruit yourself.
  • If you eat meat, fish, crustaceans or shellfish, make sure they are well-cooked or baked.

There are several drinkable vaccines against cholera. Because most travellers have access to clean drinking water, the disease is extremely rare among travellers. They are therefore not vaccinated.

Can cholera be treated?

The treatment of cholera consists of restoring the loss of fluids. This can be done with a sugar-saline solution called ORS (for sale at the pharmacy) or via an infusion in the hospital. In some cases, people are also given antibiotics.

How often does cholera occur?

The cholera bacterium occurs worldwide, especially in South Asia, Africa, South America and the Gulf of Mexico. In the Netherlands, there are between zero and nine reports of cholera patients per year.

In 2024, cholera was reported in 40 countries worldwide. Of the 560,823 patients reported, 6,028 people died. The World Health Organization (WHO) believes that this is only a small part of the actual number of cholera cases. Many countries do not have an adequate system for monitoring the number of patients. Countries are also afraid of fewer tourists and less trade if people know there is cholera.