Cholera outbreak: What’s the best way to fight the disease?

Kerala recorded the first cholera death of 2025, when a 63-year-old man who died in a private hospital in Thiruvananthapuram tested positive for cholera. The acute diarrheal disease is still reported as an epidemic in many parts of the world. Cholera still claims hundreds of lives as a silent killer in many countries, including India. It is challenging to eliminate the disease, as millions of people act as carriers of the virus without exhibiting any prominent symptoms. Dr. P Vinod, general medicine consultant at the General Hospital, Kottayam, speaks to Manorama Online about the various prevention measures and the treatment protocols of cholera.

What is cholera? Is it contagious?
Cholera is an acute diarrheal disease caused by the bacterium Vibrio cholerae. This global epidemic has been reported countless times in various parts of the world. Meanwhile, the bacteria have also undergone many mutations. Initially, the virus was identified as the classic type; however, the El Tor strain is now causing the current infection.

Cholera spreads primarily through contaminated water. The cholera bacteria that are expelled through stool could contaminate the water bodies. People contract cholera by drinking contaminated water. Cholera is highly contagious and can quickly spread from an infected person to another. The virus would spread to those who come in close contact with the patient. Individuals diagnosed with cholera should wash their hands with soap and water every time after using the toilet. The virus can spread through food cooked or served by an infected person. Washing vegetables and other food items with contaminated water can also cause cholera.

The symptoms would begin to appear within 1 – 5 days after the bacteria enter the body. However, the disease could spread to other people even before the symptoms begins to show. If contracted, the disease would be cured entirely within one or two weeks even without any medications or treatment. But, these patients could remain vectors or carriers of bacteria for almost two weeks after their symptoms disappear. Cholera would spread quickly if the water is contaminated and unsafe.

Drinking clean water is key in curing any type of contagious disease. Water should either be chlorinated or disinfected. Bleaching powder should be used to disinfect the water bodies. Ensure you only drink boiled water. Hands should be washed thoroughly using soap and water before and after eating and also after using toilet.

Symptoms
Some of the primary symptoms of cholera are diarrhoea, nausea and vomiting, weak legs, severe dehydration, high heart beats, shrinkage of small intestine, muscle cramps, sunken eyes, lower amounts of urine, lack of tears, wrinkles on skin and indigestion.

Sudden and extreme diarrhoea is the most common symptom of cholera. In most cases, the patient will pass loose stool unintentionally. However, the patient might not have fever or stomach pain. In extreme cases, the patient might pass stool up to 30 – 40 times a day. Diarrhoea is often followed by vomiting. As the patient loses too much water content and minerals from the body due to diarrhoea and vomiting, he/she would soon get dehydrated. The patient would then lose sodium and potassium, causing muscle cramps.

In extreme cases of diarrhoea and vomiting, the patient is often admitted to the hospital. The patient is then rehydrated by administering IV fluid drips. Antibiotics are prescribed as the second step. Many antibiotics could effectively treat cholera.

Treatment
Giving ORS solutions is the most effective treatment as dehydration due to diarrhoea and vomiting could lead to a lower amount of urine, causing damage to the kidneys. It is essential to rehydrate the body with ORS after each episode of diarrhoea.

If the patient gets weaker due to the symptoms, then he/she will be admitted in the hospital. IV fluid drips may be administered to rehydrate and replenish the body with minerals. Treating the patients using antibiotics results in faster recovery and lowers the risk of disease getting spread.

Around five to ten per cent more people suffer cholera without any prominent symptoms than those who exhibit severe and dangerous symptoms. The disease could be contained only by identifying individuals who do not show symptoms and administering antibiotics to them. One of the most prominent features of cholera is that it is a highly contagious disease that can spread among huge number of people.

Cholera could be controlled only by adopting stricter and efficient preventive measures. One of the main disadvantages is the absence of an effective vaccine against cholera. The existing ones can only provide immunity for a short period. Meanwhile, personal hygiene is the most effective and easiest way to fight cholera. Drinking boiled water, eating freshly cooked hot meals and keeping the food covered are some of the steps that could reduce the risk of cholera.