Patient description: A 34 year old man comes to the clinic complaining of dizziness and severe diarrhea since yesterday. He has returned from an international trip few days ago and was living in a camp in Sudan for a month. He developed abdominal pain followed by bloating and nausea as well as loose bowel movements. Soon he was having profuse watery diarrhea without odor. The stool is watery and white but the patient has no fever. Blood pressure is 95/62 lying down and drops to 75/40 standing. The skin turgor has reduced. HR is 110 and he looks ill with dry mucosa. V. cholerae was seen in dark-field microscopy of a fresh stool specimen. The lab study is as bellow: Sodium 137 meq/L Potassium 2 meq/L Chloride 94meq/L CO2 15 meq/L Fecal leukocytes None seen Fecal occult blood Negative

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Critical Illness Patients are subject to selection by the principal and associate investigators, and will fit any of the following Patient with critical illness, who, in the opinion of the accepting physician, may obtain medical benefit by transfer to the CC. Patient requiring ICU admission according to the SCCM and CCMD guidelines for ICU or intermediate care admissions and with a diagnosis or probable diagnosis on the ICU training protocol diagnosis list or a diagnosis deemed to be appropriate for staff training. Patient not on the diagnosis list may be admitted at the discretion of the attending physician, if there is prospect of direct medical benefit to the patient. Age 18 years or older. Patient may or may not be able to give consent. If the patient is competent, he/she will give written consent prior to transfer to NIH. If the patient is unable to provide informed consent, written witnessed consent will be obtained from the appointed Durable Power of Attorney. Patient may or may not have other chronic illness. Patient may be receiving medications for chronic illness treated by their private primary care physicians. Patient who lacks primary medical care outside the NIH may be enrolled in this protocol, if an appropriate referral can be made to a competent healthcare provider who has agreed to assume care when the patient is discharged. Patient currently on other NIH protocols requiring ICU admission may be included in this study. The benefit of transferring the patient to the NIH out weighs the risk of the transfer for the patient. Available ICU bed in the MICU  Patients with the following problems will be excluded from study: Patient who does not require critical care. Patient for whom further therapy is deemed futile by the attending physician. Patient with known pregnancy, prior to enrollment in the protocol. Any concurrent condition (medical, social, behavioral), which in the opinion of the medical team would preclude or confound acquisition/interpretation of data or delivery of clinical care. Less then 18 years of age. Any patient not requiring ICU admission according to the SCCM and CCMD guidelines for ICU or intermediate care admissions or without a diagnosis or probable diagnosis on the ICU training protocol diagnosis list. Risk of transfer out weighs the benefit of the transfer for the patient. No Durable Power of Attorney