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Definition of Disease...


Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae. Most infected persons have no symptoms or only mild diarrhea. However, persons with severe disease can die within a few hours after onset due to loss of fluid and salts through profuse diarrhea and, to a lesser extent, through vomiting if not properly treated. How does a person get cholera?

Cholera is transmitted by ingestion of contaminated food or water through municipal water supplies, ice made from that water, foods and beverages bought from street vendors, and vegetables irrigated with fresh sewage. Travelers should not assume municipal water in affected areas is safe to drink, even if the local information is reassuring. Previous experience in other cholera epidemics and other epidemiological investigations also suggest that raw and undercooked seafood are important in the transmission. It is particularly important to avoid raw or undercooked seafood.


Food borne outbreaks have been caused by contaminated seafood brought into this country by travelers. Cases of cholera have occurred in the United States after people brought back crabs in their luggage from South America. Travelers should not bring back perishable crabs or seafood when they return to the United States.


Since cholera is associated with areas of poor sanitation, the risk of cholera in travelers who follow the normal tourist itineraries has been exceedingly low in other cholera epidemics. When simple precautions are observed, contracting the disease is unlikely.

All travelers to areas where cholera has occurred should observe the following recommendations:

  • Drink only water that you have boiled or treated with chlorine or iodine. Other safe beverages include tea and coffee made with boiled water and carbonated, bottled beverages with no ice.

  • Eat only foods that have been thoroughly cooked and are still hot or fruit that you have peeled yourself. - Avoid undercooked or raw fish or shellfish, including ceviche.

  • Make sure all vegetables are cooked-avoid salads.

  • Avoid foods and beverages from street vendors.

  • Do not bring perishable seafood back to the United States.

  • A simple rule of thumb is: "Boil it, cook it, peel it, or forget it."

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C. Michael Lewis, D.O.
G-8195 S. South Saginaw Street
Suite B
Grand Blanc, MI 48439

Phone: (810) 694-5393
Toll Free: 800-966-5393
Fax: (810) 694-5394

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