Cholera history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, MBBS [2]


Patient may have a history of consumption of contaminated food or water and/or travel to an endemic area. Cholera symptoms usually develop within 24-48 hour of infection. Patients present with sudden-onset, painless, odorless, rice-watery, large-volume stool; abdominal cramps; vomiting; and fever. If the severe diarrhea and vomiting are not aggressively treated, they can result in life-threatening dehydration and electrolyte imbalances within hours. The typical symptoms of dehydration include dizziness (due to low blood pressure), wrinkled hands (due to poor skin turgor), sunken eyes, muscle cramps (due to hypokalemia), and decreased urine output.[1][2][3]

History and Symptoms


Cholera patients' histories may include consumption of contaminated food/water and/or recent travel to a cholera-endemic area. Symptoms usually develop 24-48 hours after infection.


Symptoms of cholera include the following:[1][2][3]


  • Sudden-onset
  • Painless
  • Odorless
  • Watery consistency (initially it may have some fecal matter but with disease progression stool becomes mostly watery)
  • It is pale white in color and thus is sometimes referred as "rice-water stool" (has a similar color and consistency as water left after washing rice)
  • Voluminous (stool volume during cholera is more than that of any other infectious, diarrhea-causing uncontrolled bowel movements)
    • An untreated person with cholera may produce 10–20 liters of diarrhea a day (with fatal results)
  • Abdominal cramps (due to large volume of intestinal secretion)


  • Caused by decreased intestinal motility and acidemia

Muscle Cramp


Other minor symptoms include excessive thirst, fatigue, oliguria, and weakness. For every symptomatic person, three to 100 people get the infection but remain asymptomatic.[5]


  1. 1.0 1.1 Sack DA, Sack RB, Nair GB, Siddique AK (2004). "Cholera". Lancet. 363 (9404): 223–33. PMID 14738797.
  2. 2.0 2.1 Weil AA, Khan AI, Chowdhury F, Larocque RC, Faruque AS, Ryan ET; et al. (2009). "Clinical outcomes in household contacts of patients with cholera in Bangladesh". Clin Infect Dis. 49 (10): 1473–9. doi:10.1086/644779. PMC 2783773. PMID 19842974.
  3. 3.0 3.1 Morris JG, Wilson R, Davis BR, Wachsmuth IK, Riddle CF, Wathen HG; et al. (1981). "Non-O group 1 Vibrio cholerae gastroenteritis in the United States: clinical, epidemiologic, and laboratory characteristics of sporadic cases". Ann Intern Med. 94 (5): 656–8. PMID 7235397.
  4. McElroy, Ann and Patricia K. Townsend. Medical Anthropology in Ecological Perspective. Boulder, CO: Westview, 2009, 375.
  5. King AA, Ionides EL, J.Luckhurst, Bouma MJ (2008). "Inapparent infections and cholera dynamics". Nature. 454 (7206): 877–80. doi:10.1038/nature07084. PMID 18704085. Unknown parameter |month= ignored (help)

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