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Microscopic image of Cholera

What is cholera?

Cholera is an intestinal infection caused by bacteria. The bacteria can be found in water or food that has been contaminated with stool (poop) from a person who is infected with cholera. In Ontario, an average of one case per year is reported and all cases have been exposed to cholera in another country while travelling. Places in the world with poor sanitation, poor water treatment and inadequate hygiene are more likely to have cholera.

How does cholera spread?

  • Cholera spreads by drinking water or eating food that has been contaminated with the bacteria (water and food contaminated with feces)
  • Eating undercooked or raw shellfish can also be a source of cholera infection

What are the signs and symptoms?

Symptoms can appear up to 5 days after exposure. Some people do not show any symptoms with cholera.  Mild symptoms include diarrhea and vomiting. In severe cases, a person might experience leg cramps, nausea, vomiting and frequent watery diarrhea.  When a person loses a lot of body fluid, they become dehydrated and can go into shock.

How is it treated?

Cholera is often managed with plenty of fluids, good hygiene and sometimes antibiotics.

It is important to see a health care provider if you are ill after travelling. 

How can it be prevented?

If you plan to travel:

  1. Consult with a travel clinic regarding vaccination recommendations before you travel. There are safe and effective vaccines to prevent cholera.
  2. Take precautions when eating and drinking water while travelling to areas where Cholera is present.
  3. Don’t eat raw oysters and undercooked shellfish and fish.
  4. Practice good hand hygiene and food safety.
  5. Consider the risk when travelling.  The risks of cholera are higher after a disaster such as after an earthquake or a hurricane if the water and sanitation systems may have been damaged. A map of areas reporting cholera may help you understand your risk.

Health Care Providers

All clinically diagnosed, suspected and confirmed laboratory cases are reportable to the Health Unit immediately by telephone or fax.  Our secure fax line is 226-783-2132. If you have any questions or reports during our office hours, please call 519-258-2146 ext. 1420 or after hours to 519-973-4510.  

Stools specimens must specifically request “cholera”.

For more information:

Ontario’s Public Health Cholera Infectious Disease Protocol / Management

Provincial Case Definition, Cholera  

Health Care Providers, Information on laboratory diagnosis  1-877-604-4567

Exclusions from school and work

Food handlers, healthcare providers and day care staff should not return to work until they are symptom-free for 24 hours, or 48 hours after completion of antibiotic or anti-diarrheal medications. If the healthcare setting is a hospital, use the “Enteric Diseases Surveillance Protocol for Ontario Hospitals” for exclusion criteria.

Management of Contacts

  1. Household contacts should see their health care provider to discuss reducing the likelihood to secondary transmission.
  2. Meal companions in the 5 days before the onset should be assessed for symptoms and seek medical care if indicated.  Managing a symptomatic contact is the same as for cases.