Cholera

Cholera is an acute, secretory diarrheal illness caused by infection with toxigenic Vibrio cholerae, especially O1 or O139 serogroup strains ^[1][2]. The disease has been described historically in the Bay of Bengal region and later spread globally, producing seven pandemics over the past two centuries ^[1][2]. Source-backed detail on alternative clinical definitions or noninfectious mimics is not yet available.

Cholera is characterized by acute watery diarrhea that may be mild or potentially fatal ^[1]. Mild illness may be indistinguishable from other diarrheal syndromes, whereas severe cholera is described as having pronounced diarrheal purging ^[2]. Severe dehydrating cholera can lead to rapid loss of fluids and electrolytes and may progress to hypovolemic shock ^[3]. The available sources also emphasize that outcomes depend strongly on rapid rehydration, with mortality falling markedly when prompt fluid replacement is given ^[3][2].

Cholera has been reported globally and is endemic in more than 50 countries, with large epidemics occurring in multiple settings ^[2]. The disease persists particularly in developing countries where access to safe water, sanitation, and hygiene is inadequate ^[3]. One source estimates approximately 4 million cases and 143,000 deaths each year, and another notes that the seventh pandemic affects 3-5 million people annually ^[3][2]. The global control agenda targets cholera hotspots and aims to reduce deaths and interrupt local transmission through coordinated prevention strategies ^[1][3].

Transmission is fecal-oral, occurring through contaminated food or water ^[3]. The sources associate ongoing circulation with inadequate access to safe water, sanitation, and hygiene ^[3][2]. Source-backed detail on person-to-person spread, duration of shedding, or environmental persistence is not yet available.

Source-backed risk-group detail is limited. The available literature indicates elevated burden in developing countries and in high-risk areas with inadequate safe water, sanitation, and hygiene, which is consistent with the settings targeted by control strategies ^[3][1]. Other specific demographic or occupational risk groups are not stated in the provided sources.

Prevention and control rely on access to safe water and sanitation, together with water, sanitation, and hygiene measures ^[2][3]. Oral cholera vaccines are described as a major component of integrated control packages during outbreaks or in endemic zones ^[3], and health education is also listed as part of prevention and control ^[3]. The global roadmap described in the sources emphasizes stopping transmission in cholera hotspots through vaccination plus improved water, sanitation, and hygiene ^[1].

In surveillance terms, cholera should be interpreted as a water- and sanitation-sensitive diarrheal disease with recognized epidemic potential and substantial mortality when care is delayed ^[3][2]. Reported burden can reflect both endemic background transmission and outbreak activity, so monitoring should distinguish routine circulation from hotspot-driven amplification where possible ^[1][3]. Source-backed detail on formal case definitions, laboratory confirmation thresholds, or notification timing is not yet available.

1. 1 Kanungo S et al. Cholera. Lancet. 2022 Apr 9. PMID: 35397865. doi: 10.1016/S0140-6736(22)00330-0. PubMed: https://pubmed.ncbi.nlm.nih.gov/35397865/
2. 2 Harris JB et al. Cholera. Lancet. 2012 Jun 30. PMID: 22748592. doi: 10.1016/S0140-6736(12)60436-X. PubMed: https://pubmed.ncbi.nlm.nih.gov/22748592/
3. 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. 4 Type III Secretion Is Essential for the Rapidly Fatal Diarrheal Disease Caused by Non-O1, Non-O139 Vibrio cholerae. mBio. 2011. doi: 10.1128/mbio.00106-11. DOI: https://doi.org/10.1128/mbio.00106-11
5. 5 Pathogenesis and Pathophysiology of Diarrheal Diseases Caused by Vibrio cholerae and Enterotoxigenic Escherichia coli. Cholera and Related Diarrheas. None. doi: 10.1159/000403249. DOI: https://doi.org/10.1159/000403249
6. 6 Fowl Cholera (Cholera Gallinarum). Journal of the American Association of Instructors and Investigators of Poultry Husbandry. 1908. doi: 10.3382/ps.0010071. DOI: https://doi.org/10.3382/ps.0010071

ICD-10

A00

ICD-11

1A00

Total cases

990

Total deaths

2

Peak month

2010-08

Coverage

9 reporting countries · 2000-01-01 → 2026-06-20