Cholera is a disease caused by infection of the intestine by the bacteria - Vibrio cholerae which causes diarrhoea. Children as well as adults can get infected.

A person with cholera infection can have some or all of the following symptoms:

1. Large amounts of watery painless diarrhoea
   
2. Vomiting
   
3. Abdominal pain (uncommon)
   
4. Fever (uncommon)

In most cases, infection causes only mild diarrhoea or no symptoms at all. In 5 to10 percent of the cases, patients develop very severe watery diarrhoea and vomiting which can last from 6 hours to 5 days after exposure to the bacteria. In these cases, the loss of large amounts of water can rapidly lead to severe dehydration. This is why it is important for patients to seek early treatment when they develop symptoms of diarrhoea or vomiting.

Cholera infection is transmitted via the consumption of water or food contaminated by the bacteria. Potential sources of infection include raw or poorly cooked seafood, peeled fruits, salads, and other foods contaminated during preparation or storage. Bacteria present in the faeces of an infected person are the main source of contamination. The bacteria can also live in coastal waters and in rivers where the water is slightly salty. Thus, the disease can spread rapidly in areas where sewage and drinking water supplies are inadequately treated. However, the disease is not likely to spread directly from one person to another; therefore, casual contact with an infected person does not put one at risk of becoming ill.

Yes. Cholera can be prevented by following a few simple rules of good hygiene and safe food preparation. These include:

1. Thorough washing of hands, especially before food preparation and eating.
2. Thorough cooking of food.
3. Boiling or treatment of drinking water.
4. Use of sanitary facilities and hygienic disposal of human waste.

The most important treatment is rehydration, i.e. the prompt replacement of the water and salts lost through severe diarrhoea and vomiting. Early rehydration can save the lives of nearly all cholera patients. Most patients can be rehydrated quickly and easily by drinking large quantities of a solution containing oral rehydration salts. Packets of these salts are available from most pharmacies and health care facilities.

In cases of severe cholera, an effective antibiotic can help shorten illness, though rehydration remains the main method of treatment. However, for whole communities, preventive mass treatment with an antibiotic does not limit the spread of cholera and is thus not recommended.

The previously used cholera vaccine which was injected, conveyed incomplete, unreliable protection of short duration and is no longer recommended. There are 2 new oral cholera vaccines, one of which is registered in Singapore, which provides a higher level of protection and fewer side effects. However, as neither of these vaccines provides 100 percent protection, basic hygienic precautions should always be followed.

Cholera remains a risk in many countries. New outbreaks can occur sporadically in any part of the world where water supplies, sanitation, food safety, and hygiene are inadequate. The greatest risk occurs in overpopulated communities such as refugee camps characterized by poor sanitation and unsafe drinking water. Cholera occurs sporadically in Singapore. This is due to the occasional importation of contaminated seafood such as shellfish.