EUGENE J. GANGAROSA, M.D.; GERALD A. FAICH, M.D.
Cholera has spread widely in the past decade. Although the disease is clinically characterized by severe diarrhea that can lead to cardiovascular collapse and death within a few hours, infection may be mild or subclinical. Appropriate use of intravenous fluids and electrolyte replacement can reduce case-fatality rates to less than 1%. Only four documented cases of cholera in millions of American travelers have occurred in the past decade. Because the risk of cholera is so small, it should not be necessary for anyone to cancel travel plans anywhere in the world. Several factors including personal hygiene and vaccination account for this low risk. Travelers to infected areas should be vaccinated, ideally within 2 months of their planned departure. The risk of cholera spread within the United States is remote because of existing water standards in most areas. Stool cultures should be obtained from travelers returning from infected areas with diarrhea.
GANGAROSA EJ, FAICH GA. Cholera: The Risk to American Travelers. Ann Intern Med. ;74:412–415. doi: 10.7326/0003-4819-74-3-412
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Published: Ann Intern Med. 1971;74(3):412-415.
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