Cholera

霍乱

Evidence-backed information EN 5/7 applicable sections · ZH 5/7 applicable sections Updated Oct 23, 2026

Cholera is an acute diarrheal infection caused by ingesting food or water contaminated with Vibrio cholerae and remains a global public health threat reflecting social and economic inequity ^[1]^[2]. Annual worldwide estimates indicate millions of cases and tens of thousands to over one hundred thousand deaths ^[2]^[3]. Outbreaks have afflicted populations for centuries and continue to occur, with recent deadly events reported in Haiti, Ethiopia, and Yemen ^[1]^[4].

Read the full clinical and epidemiological profile 6

Definition

Cholera is an acute diarrheal infection acquired by consuming food or water contaminated with the bacterium Vibrio cholerae ^[1]^[2]. It is a severe diarrheal disease that can be rapidly fatal if untreated and is typically transmitted via contaminated water and person-to-person contact ^[5].

Clinical features

Most infected persons have mild or moderate diarrhea, while a minority develop severe acute watery diarrhea with life-threatening dehydration that can progress to hypovolemic shock from rapid fluid and electrolyte loss ^[1]^[3]. Symptom onset occurs 12 hours to 5 days after infection, and the illness can kill within hours if untreated ^[1]^[2]. Many infected individuals remain asymptomatic but shed bacteria in feces for 1–10 days ^[1]^[2].

Epidemiology

Cholera has caused recurrent pandemics since the 19th century, with the current seventh pandemic beginning in South Asia in 1961 and continuing globally ^[1]. Yearly burden is estimated at 1.3 to 4.0 million cases and 21,000 to 143,000 deaths worldwide, with persistence concentrated in developing countries lacking safe water and sanitation ^[2]^[3]. Only V. cholerae serogroups O1 and O139 cause outbreaks, and O1 has driven all recent events ^[1]. Recent outbreaks in Haiti, Ethiopia, and Yemen illustrate ongoing deadly impact ^[4].

Transmission

The disease is transmitted fecal-orally through consumption of contaminated food or water and can also spread person-to-person ^[1]^[5]^[3]. Asymptomatic carriers shed V. cholerae in feces for up to 10 days, returning bacteria to the environment and potentially infecting others ^[1]^[2].

Prevention

Provision of safe drinking water, basic sanitation, and hygiene is fundamental to preventing cholera and related waterborne diseases ^[1]^[2]. Oral cholera vaccines are a major component of integrated control during outbreaks or in endemic zones, supplemented by health education and food hygiene promotion ^[2]^[3]. Outbreak WASH activities—such as water quality monitoring, kits distribution, and hygiene promotion—reduce transmission, while mass antibiotic chemoprophylaxis is not recommended ^[1]^[2]^[3].

References

1 World Health Organization. Cholera [Internet]. cited 3 Sept 2026. Available from: https://www.who.int/news-room/fact-sheets/detail/cholera
2 World Health Organization. Cholera [Internet]. cited 3 Sept 2026. Available from: https://www.who.int/health-topics/cholera
3 Chowdhury F et al. Diagnosis, Management, and Future Control of Cholera. Clin Microbiol Rev. 2022 Sep 21. PMID: 35726607. doi: 10.1128/cmr.00211-21. PubMed: https://pubmed.ncbi.nlm.nih.gov/35726607/
4 Hsueh BY et al. Combating Cholera. F1000Res. 2019. PMID: 31069064. doi: 10.12688/f1000research.18093.1. PubMed: https://pubmed.ncbi.nlm.nih.gov/31069064/
5 Baker-Austin C et al. Vibrio spp. infections. Nat Rev Dis Primers. 2018 Jul 12. PMID: 30002421. doi: 10.1038/s41572-018-0005-8. PubMed: https://pubmed.ncbi.nlm.nih.gov/30002421/