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Cholera is an infectious disease that causes severe watery diarrhea, which can lead to dehydration and even death if untreated. It is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae. Cholera was prevalent in the U.S. in the 1800s before modern water and sewage treatment systems eliminated its spread by contaminated water. Only about 10 cases of cholera are reported each year in the U.S. and half of these are acquired abroad. Rarely, contaminated seafood has caused cholera outbreaks in the U.S.
However, cholera outbreaks are still a serious problem in other parts of the world, where cholera affects an estimated 3 to 5 million people and causes more than 100,000 deaths each year. The disease is most common in places with poor sanitation, crowding, war, and famine. Common locations include parts of Africa, south Asia, and Latin America. If you are traveling to one of those areas, knowing the following cholera facts can help protect you and your family.
Cholera Causes

Vibrio cholerae, the bacterium that causes cholera, is usually found in food or water contaminated by feces from a person with the infection. Common sources include:
Municipal water supplies
Ice made from municipal water
Foods and drinks sold by street vendors
Vegetables grown with water containing human wastes
Raw or undercooked fish and seafood caught in waters polluted with sewage When a person consumes the contaminated food or water, the bacteria release a toxin in the intestines that produces severe diarrhea. It is not likely you will catch cholera just from casual contact with an infected person.
Cholera Symptoms
Symptoms of cholera can begin as soon as a few hours or as long as five days after infection. Often symptoms are mild. But sometimes they are very serious. About one in 20 people infected have severe watery diarrhea accompanied by vomiting, which can quickly lead to dehydration. Although many infected people may have minimal or no symptoms, they can still contribute to spread of the infection. Signs and symptoms of dehydration include:
Rapid heart rate
Loss of skin elasticity (the ability to return to original position quickly if pinched) Dry mucous membranes, including the inside of the mouth, throat, nose, and eyelids
Low blood pressure
Thirst
Muscle cramps
If not treated, dehydration can lead to shock and death in a matter of hours.
Yellow fever is caused by a virus. The yellow fever virus is a single-stranded RNA virus that belongs to the Flavivirus genus. After transmission of the virus occurs, it replicates in regional lymph nodes and subsequently spreads via the bloodstream. This widespread dissemination can affect the bone marrow, spleen, lymph nodes, kidneys, and liver, in addition to other organs. Tissue damage to the liver, for example, can lead to jaundice and disrupt the body’s blood-clotting mechanism, leading to the hemorrhagic complications sometimes seen with yellow fever. Yellow fever is transmitted to humans by the bite of infected mosquitoes.
Various species of Aedes and Haemagogus mosquitoes serve as vectors and are responsible for the transmission to human and nonhuman primates, which serve as reservoirs for the disease. Three transmission cycles for yellow fever have been identified. Sylvatic (jungle) cycle: In tropical rain forests, infected monkeys pass the virus to mosquitoes that feed on them. These infected mosquitoes then bite humans who enter the rain forest for occupational (for example, loggers) or recreational activities. Intermediate (savannah) cycle: In humid or semi-humid regions of Africa, mosquitoes that breed around households and in the wild (semi-domestic mosquitoes) infect both humans and monkeys.
The virus can be transmitted from monkeys to humans, or from human to human by the mosquitoes. This is the most common type of outbreak in Africa. Urban cycle: When infected humans introduce the virus into urban areas with large numbers of unvaccinated individuals, infected mosquitoes (Aedes aegypti) transmit the disease from human to human. This form of transmission can lead to large epidemics.