While cholera is rare in the United States, travelers to foreign countries where outbreaks are occurring may be at risk for infection. People who consume raw or undercooked seafood from warm coastal waters subject to sewage contamination may also be at risk. Cholera is spread by eating or drinking food or water contaminated by the fecal waste of an infected person. This occurs more often in developing countries with inadequate water supplies and improper sewage disposal. People with cholera may experience mild to severe watery diarrhea, vomiting, and dehydration.
Fever is usually absent.
The symptoms may appear from six hours to five days after exposure. Because of the rapid dehydration that may result from severe diarrhea, replacement of fluids by mouth or by the intravenous route is critical. A vaccine is available and is occasionally recommended for travelers to certain foreign countries where cholera is occurring. Many physicians feel that foreign travelers almost never contract cholera and the use of the current vaccine cannot be justified. The single most important preventive measure is to avoid consuming uncooked foods in foreign countries where cholera occurs, unless they are known to be safe or have been properly treated.