Cholera secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Tarek Nafee, M.D. [2], Sara Mehrsefat, M.D. [3], Priyamvada Singh, MBBS [4]


Secondary prevention of cholera includes prompt and appropriate diagnosis and treatment of patients suspected to have cholera.

Secondary Prevention

In case of suspected cholera within a community, secondary prevention methods include prompt and appropriate diagnosis and management of patients with suspected cholera including:[1][2][3][4][5][6]

  • IV fluids (Ringer Lactate is the best, in case of nonavailability of ringer lactate cholera saline or normal saline can be used)
  • Oral Rehydration Salt (ORS)
  • Antibiotics (doxycycline, erythromycin, tetracycline)
  • Rectal swabs and transport medium (Cary Blair or TCBS) for stool samples
  • Zinc supplementation for reduced stool output[6]
  • Safe water is needed to rehydrate patients and to wash clothes and instruments
  • Chlorine or bleaching powder
  • Nasogastric tubes
  • Drips
  • Soap


  1. Lankarani KB, Alavian SM (2013). "Lessons learned from past cholera epidemics, interventions which are needed today". J Res Med Sci. 18 (8): 630–1. PMC 3872598. PMID 24379835.
  2. Hahn S, Kim S, Garner P (2002). "Reduced osmolarity oral rehydration solution for treating dehydration caused by acute diarrhoea in children". Cochrane Database Syst Rev (1): CD002847. doi:10.1002/14651858.CD002847. PMID 11869639.
  3. Kabir I, Khan WA, Haider R, Mitra AK, Alam AN (1996). "Erythromycin and trimethoprim-sulphamethoxazole in the treatment of cholera in children". J Diarrhoeal Dis Res. 14 (4): 243–7. PMID 9203786.
  4. Sack DA, Islam S, Rabbani H, Islam A (1978). "Single-dose doxycycline for cholera". Antimicrob Agents Chemother. 14 (3): 462–4. PMC 352482. PMID 708024.
  5. Roy SK, Hossain MJ, Khatun W, Chakraborty B, Chowdhury S, Begum A; et al. (2008). "Zinc supplementation in children with cholera in Bangladesh: randomised controlled trial". BMJ. 336 (7638): 266–8. doi:10.1136/bmj.39416.646250.AE. PMC 2223005. PMID 18184631.
  6. 6.0 6.1 Nelson EJ, Nelson DS, Salam MA, Sack DA (2011). "Antibiotics for both moderate and severe cholera". N Engl J Med. 364 (1): 5–7. doi:10.1056/NEJMp1013771. PMID 21142691.

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