Most people who are exposed don’t become ill and never know they are infected. However, because they shed the cholera bacteria in their stool for seven to 14 days, they can still infect others.
Most people who become sick with cholera experience only mild or moderate diarrhoea that’s hard to distinguish from diarrhoea caused by other problems.
The onset of cholera is usually sudden, with incubation periods ranging from six hours to five days.
Cholera symptoms can range from mild to severe and include:
- Severe, watery diarrhoea. Diarrhoea (look out for the characteristic ‘rice water’ stools or diarrhoea that has a fishy odour). What makes it so deadly is the loss of huge amounts of fluids in a short period.
- Nausea and vomiting. It occurs in the early and later stages, it may persist for hours.
- Muscle cramps. This is a result from the loss of salts: chloride, sodium and potassium.
- Dehydration. This can develop within hours. Depending on how much body fluid has been lost, dehydration can range from mild to severe.
- Signs of cholera dehydration. Irritability, lethargy, sunken eyes, dry mouth, extreme thirst, dry, shriveled skin, little or no urine output, low blood pressure, irregular heartbeat, rapid pulse, dry mucous membranes, extreme thirst, lethargy, unusual sleepiness, infrequent urination or sunken fontanelles in infants.
- Shock. Hypovolemic shock is one of the most serious complications. This occurs when low blood volume causes a drop in blood pressure this results in reduction of the amount of oxygen reaching the tissues. If this is not treated it could lead to death.
Signs and symptoms in children
Children generally have the same symptoms as adults, but could also experience:
- Extreme drowsiness or even coma
Testing for cholera is done by taking a stool culture (cholera does not get into the blood).