The salt in turn drags water out of the cells lining the gut, hopelessly overwhelming the gut's reabsorption mechanisms. Medical treatment replaces the water and salts lost in the diarrhoea. This is preferably done orally, with a mixture of water, salts and sugar. If the patient is vomiting or if the stool volume is catastrophic, intravenous salt-containing solutions are used. This is a problem, as intravenous preparations are expensive, often out of the reach of poor countries.
Death can occur within five hours in children.
Antibiotics may be used to decrease the time the patient has diarrhoea, but the fluid replacement is much more important. The disease very rarely invades the bloodstream. Immunity after a bout of cholera appears to be only partial and does not appear to last long. Vaccines are similarly only partially protective, and this protection is steadily lost over a few months. The World Health Organisation, therefore, does not recommend vaccination for travellers to endemic areas, rather advising carefully avoiding contact with contaminated water and food.