Cholera: symptoms, causes, treatment and prevention when travelling

The NHS lists the symptoms of cholera as lots of watery diarrhoea, feeling sick or being sick, tummy pain and dehydration. UK Health Security Agency (UKHSA) describes acute, profuse watery diarrhoea, sometimes called rice water stools, and vomiting, leading to dehydration.

The signs of dehydration the NHS names are feeling thirsty and dark yellow, strong-smelling pee. UKHSA notes that cases may be asymptomatic or have mild symptoms, while some infections progress to severe disease and, in extreme cases, may result in death if untreated.

Cholera is an infection that can cause severe diarrhoea, according to the NHS. UKHSA says it is caused by infection with one of two serogroups of Vibrio cholerae bacteria, serogroups O1 and O139, and that it is an acute diarrhoeal disease caused by eating and drinking contaminated food or water.

The danger lies in the loss of fluid. The NHS treatment advice focuses on replacing the salts, sugars and minerals your body has lost through diarrhoea, so that you do not become dangerously dehydrated.

The NHS says the main treatment for cholera is drinking plenty of fluids, including rehydration solution. Rehydration solution is a powder you mix with water to replace salts, sugars and minerals your body has lost through diarrhoea, and it is usually available from pharmacies.

If you are very unwell, you may need treatment in hospital, where you may be given fluids through a vein and antibiotics.

The NHS says to see a doctor if you have been in an area where there is cholera and you have severe watery diarrhoea and vomiting, or symptoms of dehydration such as feeling thirsty or dark yellow, strong-smelling pee. Tell the doctor if you have been in an area where cholera is found in the last few weeks, because you may need treatment to stop you becoming dangerously dehydrated.

UKHSA tells health professionals to be alert to cholera in anyone who has recently returned from an endemic area with a severe watery diarrhoeal illness. Cholera is a notifiable disease in England and Wales, so suspected cases are reported to local health protection teams, and samples are sent for testing with a full clinical and travel history.

The NHS says you can get cholera from drinking unclean water, eating food (particularly shellfish) that has been in unclean water, or eating food handled by an infected person. UKHSA adds that activities that may increase risk include drinking untreated water or eating poorly cooked food, particularly seafood, in areas where outbreaks are occurring.

UKHSA says cholera occurs mainly in Asia, Africa and the Americas, and that large outbreaks have been reported in recent years in Africa and Asia. It does not occur in the UK but is sometimes reported in returning overseas travellers.

The NHS gives practical advice for areas where cholera is found. You can check health advice for a country on the TravelHealthPro website.

The NHS says there is a vaccine for cholera, but most people do not need it. It is usually only recommended if you are travelling to an area where cholera is common and will be visiting remote places without access to medical care, or you are an aid or disaster relief worker going to an area where an outbreak is likely.

The vaccine is given as a drink. For adults, the NHS says 2 doses given 1 to 6 weeks apart can provide protection for up to 2 years, and you need to have had both doses at least a week before travelling. If you need it, you may be able to get it free on the NHS by asking at your GP surgery.

On the NHS, severe diarrhoea after travel is assessed by your GP, NHS 111 or hospital services, and the cholera vaccine may be free in the circumstances the NHS lists.

Private travel clinics can review your itinerary and advise whether a vaccine is justified. The decision rests on the same criteria: areas where cholera is common, remote travel without access to medical care, and aid work. It is worth asking why a vaccine is being recommended before paying for it, and always tell clinicians where you have travelled.