Cholera
Cholera is a disease that can cause severe runny poos (diarrhoea) and dehydration. It usually occurs in people who were infected overseas, and is spread through drinking contaminated water. It can be easily treated by giving people enough fluids to replace those they have lost. Left untreated, cholera can quickly be fatal, even in previously healthy people.
How cholera spreads
In countries that have poor access to clean drinking water and sanitation, the cholera bacteria can be found in drinking water, uncooked seafood and other foods. Cholera is then spread by:
- eating shellfish collected from areas contaminated by raw sewage
- eating contaminated food such as rice, seafood, fresh vegetables and fruit
- drinking unsafe water from rivers, ponds, lakes, tanks or bores.
It is very rare for cholera to be passed from person to person. However, people with the infection should wash their hands properly to help prevent this.
Cholera in Aotearoa New Zealand
Cholera is very rare in Aotearoa New Zealand, but occasional cases usually associated with travel overseas occur, mainly in travellers from Asia.
Most travellers to countries with cholera are at very low risk if they follow guidelines for eating and drinking safely.
Symptoms of cholera
Most people exposed to cholera do not get sick and never know they have been infected. Around 1 in 10 infected people develop more serious signs and symptoms of cholera, usually within a few days of infection.
Symptoms of cholera infection may include:
- runny poos (diarrhoea)
- throwing up and feeling sick (vomiting and nausea)
- muscle cramps
- collapsing
- dehydration (when your body does not have enough fluids and salts to function properly).
Dehydration can lead to:
- tiredness
- sunken eyes
- a dry mouth
- extreme thirst
- dry and shrivelled skin
- little or no wee (urine).
People infected with cholera can infect others if their poo (faeces) contaminates water or food that other people then eat or drink. This can occur between 7 to 14 days after cholera infection, even if you do not have any symptoms.
Diagnosing cholera
If you think you have cholera visit your healthcare provider. You may be asked to send a sample of your poo to a laboratory for testing. Testing is the only way to confirm cholera. If you require testing it will be free and your healthcare provider will let you know what you need to do.
If you have cholera, people you live with or have travelled with may also need to be tested and stay at home if they have symptoms.
The role of public health
Cholera is a notifiable disease. This means that healthcare providers or laboratories will inform public health when someone has it. This way, we can monitor how many people are sick and give advice on how to reduce its spread.
We will contact people who work in jobs where cholera can be easily spread. This includes those working with food, in childcare or health care to provide advice on how to stop others from getting sick.
Reducing the risk to others
If you have cholera you should stay away from work, school or early childhood centres until 2 days after the symptoms have stopped. If you work at or attend a high-risk place, you will also need to have 2 follow up negative poo samples before you return.
Do not go swimming in a pool if you have runny poos. You need to wait until at least 2 weeks after symptoms have gone.
Wash your hands with soapy water for 20 seconds, then dry well with a clean cloth or paper towel every time:
- after going to the toilet
- before preparing food, eating or drinking
- after changing nappies.
If you have symptoms, avoid preparing food for other people. If you must do so, wash and dry your hands well first.
High-risk places
There are some high-risk places where cholera can spread very easily, such as:
- workplaces that handle food or drinks
- health and aged care facilities
- early childhood centres.
People should only return to high-risk places if they have had:
- no symptoms for at least 48 hours
- 2 follow-up tests after being symptom free, at least 48 hours apart.
These will check you are no longer infectious and reduces the risk of you passing cholera to others.
Treating cholera
Cholera is an easily treatable disease. Most people can self-manage their symptoms at home by drinking lots of fluids to avoid dehydration. But left untreated, cholera can quickly be fatal, even in previously healthy people.
If you become severely dehydrated you may need to be given fluids directly into your vein (intravenously).
Seek health advice if your symptoms are severe or last for a long time. You can contact your doctor or usual healthcare provider, or call Healthline for free anytime on 0800 611 116
Preventing cholera
If you are travelling to a country with cholera you can get immunised. You can pay to get the vaccine from your healthcare provider or a travel clinic.
If you are travelling to countries where cholera is more common you can reduce your risk of infection.
- Avoid unsafe drinking water, including ice and drinks mixed with water.
- Only drink bottled water and boiled water.
- Avoid food from street stalls.
- Make sure hot food is well cooked and eat it while it is hot.
- Avoid uncooked and raw food, including fruit and vegetables, unless you are able to wash, prepare and peel them yourself.
- Avoid raw (unpasteurised) milk or dairy products.
- Wash your hands often and thoroughly.
Preventing the spread of food and water borne diseases (internal link)