Cholera

Cause: Bacterial toxin from Vibrio cholerae serogroup O1 or O139. Other V. cholerae do not produce toxin and cause milder illness notifiable as Vibriosis.

Illness and treatment: Illness ranges from mild symptoms to severe sudden profuse watery diarrhea leading to life-threatening dehydration. Treatment is fluid replacement and antibiotics.

Sources: The bacteria are carried in the human intestine and spread mainly through fecally contaminated food or water. The only environmental reservoir in the United States is the Gulf of Mexico where raw seafood may be contaminated.

Additional risks: Unsafe drinking water, poor hygiene, poor sanitation and crowded living conditions can cause epidemics, particularly in urban areas of developing countries and in refugee situations in Asia, Africa and Latin America with poor sanitation. Persons with reduced stomach acid are at increased risk.

Prevention: If traveling to risk areas, consult with a travel clinic or the CDC Travelers' Health website for recommendations about vaccination and other measures.

Recent Washington trends: A case was reported in 2002 following travel to the Philippines.

Purpose of Reporting and Surveillance

To identify persons infected with Vibrio cholerae and to prevent transmission from such individuals.
To identify sources of transmission (e.g., contaminated water or a contaminated lot of shellfish) and to prevent further transmission from such sources.

Legal Reporting Requirements

Health care providers and Health care facilities: immediately notifiable to local health jurisdiction
Laboratories: Toxigenic Vibrio cholerae O1 or O139 immediately notifiable to local health jurisdiction, submission required – isolate or if no isolate available, specimen associated with positive result, 2 business days.
Local health jurisdictions: immediately notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE): 1-877-539-4344.