Cholera

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KEY POINTS

• Cholera is an infection caused by a type of bacteria that can enter your child’s body when he drinks dirty water or eats food contaminated or polluted with the bacteria.
• Diarrhea often gets better in a few days with oral hydration treatment. For serious cases, your child may need to stay in the hospital to get IV fluids and medicines.
• To keep your child from getting cholera when traveling, use only bottled water or purified water, and he should use good hand washing.

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What is cholera?

Cholera is an infection caused by a type of bacteria called Vibrio cholerae. The bacteria can enter your child’s body when he drinks dirty water or eats food contaminated or polluted with the bacteria. It can make adults and children get sick quickly and can be fatal.

Your child may get it when traveling. It is not common in the US.

What is the cause?

The bacteria can live in salty (brackish) rivers and water near a coastline. The bacteria can also live in the animal or human intestine in someone who is infected. Bowel movements can spread the bacteria to soil or water.

Your child may get infected if:

• Your child swallows polluted water that has the bacteria in it
• Your child eats raw or undercooked shellfish that has the bacteria in it from polluted water
• Your child eats food that is not cooked or served hot, or he eats fruit that does not have an outer peel
• Your child lives in or visits an area that has poor water and sewer treatment

What are the symptoms?

Symptoms can start within a few hours or up to five days after your child gets infected. Your child may not have symptoms if he has a mild infection. In some cases, your child may have serious symptoms within hours of infection such as:

• Very watery diarrhea
• Belly cramps
• Feeling very thirsty
• Dry skin and mouth
• Decreased urine or lack of tears
• Leg cramps
• Nausea and vomiting
• Irritability
• Acting very tired
• Glassy or sunken eyes

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine your child. Your provider needs to know your child’s recent travel history. Tests may include:

• Test of a sample of your child’s bowel movements
• Blood tests

How is it treated?

Have your child drink enough liquids to keep his urine clear to light yellow in color.

If your child has severe diarrhea, your child’s body can lose too much fluid and can get dehydrated. Dehydration can be very dangerous, especially for children and older adults. Your child may also be losing minerals that his body needs to keep working normally. Your child’s healthcare provider may recommend an oral rehydration solution (ORS), which is a drink that replaces fluids and minerals. You can buy an ORS at drug and grocery stores. Follow package directions for mixing powders or taking frozen products. Have your child drink small amounts over several hours if he has vomiting along with diarrhea.

If you don’t have an ORS, you can have your child drink clear broth or water mixed with fruit juice. These are easy for your child’s body to absorb. Avoid concentrated fruit juices, dark sodas, milk, and milk products. They are not as easily absorbed and usually have too much sugar.

For serious cases, your healthcare provider will prescribe an antibiotic and IV fluids. Your child may need to stay in the hospital to get enough fluids.

How can I take care of my child?

Follow the full course of treatment prescribed by your child’s healthcare provider. In addition:

• Rest your child’s stomach and bowel but make sure that he drinks enough liquids to keep his urine clear to light yellow in color. Your child can do this by not eating anything and by drinking clear liquids only. Clear liquids include water, weak tea, fruit juice mixed half-and-half with water, or Jell-O.
• Have your child avoid liquids that are acidic, like orange juice, or caffeinated, like coffee, and milk.
• Your child may eat soft, plain foods. Good choices are soda crackers, toast, plain noodles, or rice, cooked cereal, applesauce, and bananas. Your child should eat small amounts slowly and avoid foods that are hard to digest or may irritate his stomach, such as foods with acid (like tomatoes or oranges), spicy or fatty food, meats, and raw vegetables. Your child may be able to go back to his normal diet in a few days.

Ask your child’s healthcare provider:

• How and when you will get your child’s test results
• How long it will take your child to recover
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent cholera?

To keep from getting cholera when you are visiting an affected area:

• Use only bottled water for drinking, washing, brushing teeth, preparing food, or making ice.
• If you are camping or won’t be where you can get bottled water, bring a way to purify water, such as a filter or purifier, chlorine or iodine tablets, or a pot and stove for boiling water. If you need to buy a water filter or purifier, buy one that can filter out organisms as small as the ones that cause giardiasis, cholera, and amoebic diarrhea.
• Have your child eat only cooked food that is served hot, or eat fruit that can be peeled.
• Wash your hands and your child’s hands with soap and water for at least 20 seconds after you help him use the bathroom. Teach children to wash their hands carefully with soap and water after using the toilet and before having a snack or meal.
• Cholera vaccines are not available in the US.