Health protection – guidance

Cholera

The diagnosis, management and epidemiology of cholera.

Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae serogroups O1 and O139. Cholera is spread by contaminated water and food. It generally occurs in regions of the world where there is no clean water or adequate sewage disposal.

Cholera occurs in Africa, Asia, Central and South America, and more recently, in parts of the Caribbean. Cholera does not occur in the UK but is sometimes reported in returning overseas travellers.

Health professionals should be alert to the possibility of cholera in those who have recently returned from an endemic area presenting with a severe watery diarrhoeal illness.

Cholera is a notifiable disease in England and Wales. Health professionals must inform local health protection teams of suspected cases.

More information about cholera is available from NHS Choices.

Diagnosis

Send the appropriate samples for testing (with a full clinical and travel history) to Public Health England’s Gastrointestinal bacteria reference unit (GBRU).

Management

Preventing person-to-person gastrointestinal infections

Epidemiology

Laboratory confirmed cases of Vibrio cholerae O1 and O139 in England and Wales from 2004 to 2013 (MS Excel Spreadsheet, 11.5KB)

Cholera: epidemiological report

Vaccination

Cholera: the green book, chapter 14