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Cholera often breaks out when there is overcrowding and inadequate access to clean water, rubbish collection and proper toilets. It causes profuse diarrhea and vomiting, which can lead to death by intense dehydration, sometimes within a matter of hours.

According to the World Health Organization, cholera affects three to five million people worldwide and causes between 100,000 and 130,000 deaths per year.

What causes cholera?

Cholera is caused by an infection of the small intestine with the bacterium Vibrio cholerae. The bacterium causes the cells lining the intestine to produce large amounts of fluid, leading to profuse diarrhea and vomiting.

The infection spreads when someone ingests food or water contaminated with the feces or vomit of someone carrying the disease.

Contaminated food or water supplies can cause massive outbreaks in a short period of time, particularly in overcrowded areas such as slums or refugee camps.

Symptoms of cholera

Typically, symptoms of cholera appear within two to three days of infection. However, it can take anywhere from a few hours to five days or longer for symptoms to appear.

A cholera infection is often mild or without symptoms but can sometimes be severe, resulting in profuse watery diarrhea and vomiting.

Sufferers rapidly lose body fluids, leading to dehydration and shock. Without treatment, they may die within hours.

Diagnosing cholera

Cholera can be diagnosed by examining stool samples or rectal swabs, although due to the fast-acting nature of the disease there is often little time to do so.

In epidemic situations, a diagnosis is often made by taking a patient history and conducting a brief examination, with treatment given before there is time for a laboratory to confirm the diagnosis.

Treating cholera

Cholera can be treated simply and successfully by immediately replacing the fluids and salts lost through vomiting and diarrhea — with prompt rehydration, less than one per cent of cholera patients die.

Cholera victims are treated with oral rehydration solutions — prepackaged mixtures of sugars and salts that are mixed with water and drunk in large amounts. Severe cases will need to receive fluids intravenously, and antibiotics are sometimes administered.

MSF has treated cholera outbreaks in Algeria, Angola, Cameroon, the Democratic Republic of Congo, Haiti, India, Kenya, Pakistan, Papua New Guinea, Somalia, South Sudan, Uganda and Zimbabwe.

In 2012, MSF treated 57,400 people for cholera.