Cholera is an infectious disease that is caused by the bacterium Vibrio cholerae. People who are infected usually experience severe, watery diarrhoea that can quickly lead to severe dehydration. The term Cholera was already used in ancient Greece and derives from the word ‘chole’ meaning bile. The cholera bacterium is a moving, curved strain, which nestles in the intestines. After infection, the incubation period may vary from 12 hours to five days, but is typically two to three days.
Cholera in the Netherlands
In India, cholera was a known disease even before the 19th century. Around 1830 the disease reached Europe via Russia. In the 1830’s a major cholera outbreak in the Netherlands led to the death of 5,000 people. Cholera occurred in the Netherlands up until the early 20th century. Today, infected travellers only occasionally import the disease.
Cholera can spread through contaminated water. You can for example become ill by drinking contaminated tap water, but also by eating the wrong foods. Think of vegetables that have been washed in contaminated water or meat that originates from animals having swum in contaminated water. Raw shellfish and seafood pose an increased risk. Also, in risk areas it is wise to avoid food from street vendors.
Other means of infection with cholera are swimming in contaminated water and contact with the faeces of a patient. In South Asia, Africa and South America, the cholera bacterium is sometimes found in surface water.
Cholera risk areas
Cholera is prevalent on almost all continents. However, most cases occur in South Asia, South America and particularly in Africa where large outbreaks occur regularly.
Initial cholera symptoms are often vomiting and watery diarrhoea, which can range from mild diarrhoea – that is difficult to distinguish from diarrhoea caused by other factors – to very severe, watery diarrhoea. Diarrhoea that is caused by a cholera infection often has a yellowish green colour, contains flakes and doesn’t smell. This type of diarrhoea is sometimes described as “rice water”. Characteristic for this type of diarrhoea is the absence of abdominal cramps. The watery diarrhoea can lead to severe dehydration. In rare cases, fever is one of the symptoms of cholera.
Preventing cholera: vaccinations and other measures
If you plan to travel to a cholera risk area, you can vaccinate against cholera with Dukoral. If you wish to get more information about this vaccine, please feel free to contact us.
Whilst travelling, we advise you to pay attention to general hygiene and cleanliness. It is best to only drink water that’s been recently boiled or disinfected, or to drink from a properly sealed bottle. Furthermore, it is wise to only eat well-heated food that is served hot. Also, avoid ice cream, uncooked shellfish and seafood and other raw foods such as salads and fruit. In other words: cook it, peel it, boil it – or leave it
A cholera stamp is a statement in your vaccination book stating ‘cholera not indicated’. This stamp prevents you from border crossings issues. Madagascar, Angola and Zanzibar are the only countries that require a cholera stamp, however you may be prompted to show the stamp at some remote border posts in other African countries. If you fail to show your stamp, you may be forced to get vaccinated against certain costs and risks. These practices are intended primarily to make money off you. Since 2015, a cholera stamp is valid for life.