Cholera is an acute intestinal infection that occurs in many of the developing countries of Africa and Asia, where sanitary conditions are less than optimal. Most recently, cholera outbreaks have occurred in parts of Latin America.
Most infected persons have no symptoms or only mild diarrhea.
However, persons with severe disease can die within a few hours after onset due to loss of fluid and salts through profuse diarrhea and, to a lesser extent, through vomiting. Only a few cases of cholera have occurred among non-travelers in the United States since 1973. Even with foreign travel, the risk of infection to the U.S. traveler is very low, especially for those who follow the usual tourist itineraries and stay in standard accommodations. Worldwide cholera activity is characterized by occasional epidemics in developing countries. During epidemics, it is spread by ingestion of food or water contaminated directly or indirectly by feces or vomit from infected persons.