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Overview of cholera

Regina LaRocque, MD, MPH
Jason B Harris, MD, MPH
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Allyson Bloom, MD


Cholera is an acute secretory diarrheal illness caused by toxin-producing strains of the gram-negative bacterium Vibrio cholerae. Severe cholera is characterized by profound fluid and electrolyte losses in the stool and the rapid development of hypovolemic shock, often within 24 hours from the initial onset of vomiting and diarrhea. Administration of appropriate rehydration therapy reduces the mortality of severe cholera from over 10 percent to less than 0.5 percent [1].

This topic discusses the epidemiology, clinical manifestations, diagnosis, treatment, and prevention of cholera. The microbiology and pathogenesis of V. cholerae and infections caused by non-O1/O139 V. cholerae strains are discussed elsewhere. (See "Microbiology and pathogenesis of Vibrio cholerae infection" and "Infections due to non-O1/O139 Vibrio cholerae".)

The general approaches to acute diarrhea among adults and children in resource-limited settings are also discussed elsewhere. (See "Approach to the adult with acute diarrhea in resource-limited countries" and "Approach to the child with acute diarrhea in resource-limited countries".)


V. cholerae is a diverse species and includes pathogenic and non-pathogenic variants. Only cholera toxin-producing (toxigenic) strains of V. cholerae are associated with cholera. V. cholerae is classified serologically; of over 200 serological groups identified, only 2 (V. cholerae O1 and O139) have caused cholera epidemics. This is discussed in detail elsewhere. (See "Microbiology and pathogenesis of Vibrio cholerae infection", section on 'Microbiology'.)


Cholera is vastly underreported, and precise measurements of the morbidity and mortality attributable to V. cholerae infection are lacking. However, there are an estimated 3 million cases of diarrheal illness and approximately 100,000 deaths worldwide caused by V. cholerae annually [2].


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Literature review current through: Sep 2016. | This topic last updated: Oct 6, 2016.
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