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Cholera (also called Asiatic cholera) is a severe, infectious disease of the small intestine. It is marked by heavy diarrhea, vomiting, and muscle cramps and can result in coma and death. For centuries, it was confined to India, but in the early 19th century it began to spread to other parts of Asia, Europe, and the Americas. In the 1970s and 1980s, cholera epidemics occurred in the Middle East and Africa, and there was a localized outbreak of the disease in Naples, Italy. In the early 1990s, an epidemic that began in Peru spread to several other countries in Latin America.

The disease is contracted by ingesting food or drink—usually water—that is contaminated with a bacterium found in feces. After cholera bacteria are swallowed, they multiply in the small intestine, where they set off an infection that interferes with normal intestinal functions. Frequent diarrhea results. This can cause a great deal of fluid loss—water and essential salts—in a short period of time. In some cases, three to four gallons of fluid loss has been reported in a 24-hour period. In addition, vomiting and other symptoms often develop. Sometimes, however, an infected cholera victim will develop only mild diarrhea and can get rid of the disease through excretion. With prompt treatment, recovery is almost certain. Treatment consists of replenishing the body’s fluids until the diarrhea stops. Sometimes antibiotics, such as tetracycline, are administered. Unfortunately, about 50 percent of all those who contract cholera are not treated and die of the disease.

Cholera remains common in impoverished tropical and semitropical developing nations where poor sanitation and contaminated water are common. Clean food and drinking water can prevent cholera outbreaks. A vaccine can provide partial protection for a limited time, but the vaccine cannot prevent the spread of infection on a large scale.