Clinical Presentation and Diagnosis of Cholera

• Incubation period of 18 hours to 5 days

• Abrupt onset of watery diarrhea and vomiting

• Large volumes of rice-water stools

• Dehydration, may be severe. Patients suffering from severe dehydration owing to rapid fluid loss are at risk for death within several hours of disease onset.

• Severe muscle cramps in extremities owing to the electrolyte imbalance are caused by the fluid loss. These cramps should resolve with treatment.

• Metabolic acidosis

The main prevention strategies include ensuring a safe water supply and safe food preparation, improving sanitation, and patient education. Several oral vaccines are in development, and two are available in countries outside the United States.19-24

However, these vaccines do not provide protection against all cases of cholera be-

cause the immunity may be overcome by high inocula.

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