Care Advice
Cholera Questions
What You Should Know About Cholera:
- It is a severe diarrhea disease caused by a bacteria.
- World Impact: There are over 4 million new cases per year. It causes over 100,000 deaths per year.
Symptoms:
- Mild to severe diarrhea. About 5% develop severe watery diarrhea.
- Without treatment, it can progress to severe dehydration and shock within 12 hours.
- Other symptoms are vomiting, leg cramps and fever.
Cause:
- Cholera is caused by the Vibrio cholera bacteria found in stool.
- You get sick by swallowing food or drink made dirty with germs from stools.
Time Period to Get Sick:
- The time from contact to symptoms is 1-5 days.
Contagious Period:
- The disease can be spread to others for 1-2 weeks if not treated with antibiotics.
Tests and Treatment:
- Stool tests are needed to diagnose it.
- It is treated with special electrolyte fluids by mouth or IV fluids. These fluids are life-saving.
- Antibiotics may also be helpful.
What to Expect:
- Good outcome if diarrhea losses are replaced promptly with fluid.
How to Prevent:
- Vaccine: new cholera vaccines taken by mouth are very protective.
- Good hand washing.
- Avoid unsafe food and drink.
- Drink only bottled or boiled water.
- Eat only well-cooked food.
Countries with Cholera:
- It is seen in Africa and other tropical countries.
- Rarely is seen in US in Florida and other Gulf states. Cause in US: shellfish that isn't cooked fully.
- For more info and current high-risk countries, see the CDC website.
Call Your Doctor If:
- You have other questions or concerns
Typhoid Fever Questions
What You Should Know About Typhoid Fever:
- It is a severe diarrhea disease caused by a bacteria.
- World Impact: There are 20 million new cases each year. It causes over 200,000 deaths each year.
Symptoms:
- Starts with fever, stomach pain and diarrhea.
- The fever lasts for weeks.
- The diarrhea worsens and can become bloody.
- Feeling tired, weakness and loss of appetite are common.
- A rash of small rose-colored spots may occur on the chest and stomach.
Cause:
- Typhoid is caused by the Salmonella typhi bacteria found in stool.
- You get sick by swallowing food or drink made dirty with germs from stools.
Time Period to Get Sick:
- The time from contact to symptoms is 6 to 30 days.
Contagious Period:
- Can be prolonged if not treated with antibiotics.
- Even those who are treated can become carriers.
Tests and Treatment:
- Stool tests and blood tests are needed to diagnose it.
- It is treated with special electrolyte fluids by mouth or IV fluids.
- Antibiotics are given to kill the bacteria.
What to Expect:
- With treatment, symptoms improve in 2 to 4 weeks.
- Without treatment, the symptoms may last for months.
- The disease may come back after treatment.
How to Prevent:
- Vaccine: there is a typhoid vaccine.
- Use good hand washing.
- Avoid unsafe food and drink.
- Drink only bottled or boiled water.
- Eat only well-cooked food.
Countries with Typhoid:
- It is common in Africa, Asia and Latin America.
- It does occur in the US in low numbers. Mainly in travelers coming back to the US.
- For more info and current high risk countries, see the CDC website.
Call Your Doctor If:
- You have other questions or concerns
Traveler's Diarrhea (TD) Questions
What You Should Know About Traveler's Diarrhea (TD):
- It is a disease seen in travelers to developing countries in the tropics.
- World Impact: in high-risk countries, TD affects up to 40% of travelers. There are about 20 million new cases each year. Mainly, it disrupts vacations. About 30% of people can't pursue planned activities. Deaths are very rare.
Symptoms:
- Sudden onset of loose stools, twice or more the normal number.
- Nausea is often present, but only 20% have vomiting.
- May also include stomach cramps and an urgent need to pass a stool.
- Fever occurs in 10%.
- Blood in the stools occurs in 5% of cases. This means the infection has become more severe.
Cause:
- Caused by germs from stools present in the water, food or drinks.
- Over 80% is caused by E. coli bacteria. These bacteria are not harmful ones. But, they are new to the traveler's body and gut.
- Sometimes, more serious bacteria such as Shigella are the cause.
- Parasites cause 5-10%. Diarrhea from parasites has a more gradual onset.
Time Period to Get Sick:
- The time from contact to symptoms is 1-3 days for bacteria.
- Diarrhea from parasites takes 2-4 weeks to start.
Contagious Period:
- TD can be passed to others until the stools are formed.
Tests and Treatment:
- Most often, the diagnosis is based upon symptoms and recent travel history. Lab tests are not needed.
- If the stools become bloody, stool tests may be done. If it lasts more than 2 weeks, parasite tests may be done.
- It is treated with special electrolyte fluids by mouth. Less than 1% of people need IV fluids.
- Probiotics (such as yogurt) may also be helpful.
- Antibiotics are sometimes given to kill the bacteria. They are mainly used if fever, bloody stools, severe diarrhea or stomach cramps occur.
What to Expect:
- TD is a self-limited illness.
- Most people that aren't treated have diarrhea that lasts 3 to 5 days.
- About 5% develop blood in the stools.
- It is more severe and lasts longer in young children.
How to Prevent:
- Wash Hands: use good hand washing.
- Diet: avoid unsafe food and drink. Drink only bottled or boiled water. Eat only well-cooked food.
- Medicines: in some cases, Pepto-Bismol 4 times a day is advised. Antibiotics to prevent TD are not advised for healthy people. Check with your doctor before you travel out of the country.
- Vaccine: there is no vaccine for TD.
Countries at Risk:
- High-risk countries are in Latin America, Africa and Southern Asia. About 40% of travelers there get diarrhea.
- Moderate-risk countries are in Southern Europe, Middle East, China and Russia. About 15% of travelers will get it.
- Low-risk countries are the US, Western Europe, Canada and Japan.
- For more info and for current high risk countries, see the CDC website.
Call Your Doctor If:
- You have other questions or concerns
Diarrhea Disease: How to Prevent
Safety Tips in All Countries:
- Hand washing is the key to prevent the spread of infections.
- Always wash the hands before eating, feeding or handling young children or cooking.
- Always wash the hands after any contact with vomit or stools.
- Wash the hands after using the toilet or changing diapers. Help young children wash their hands after using the toilet.
- Cook all poultry fully. Never serve chicken that is still pink inside. Reason: Poultry that isn't cooked all the way is a common cause of diarrhea.
Extra Safety Tips in Developing Countries:
- Drink bottled water or boiled water. Avoid tap water, ice cubes and flavored ices.
- Eat foods that have been fully cooked and that are still hot.
- Dry foods such as bread are usually safe.
- Avoid salads and raw veggies. Avoid fruits that cannot be peeled. Bananas, oranges and apples are safe. Wash your hands before peeling fruit.
- Avoid all meat and fish that isn't cooked all the way.
- Avoid buying foods and drinks from street vendors. Reason: this is a common cause of traveler's diarrhea.
- Formula for babies: breastfeed if possible. If not, use premixed formula. If you prepare your own, mix the formula with bottled or boiled water.
- Feeding babies: wash bottles, nipples, spoons and dishes with soap and water. Then sterilize them in boiling water for 5 minutes if possible.
- Brush your teeth with bottled or boiled water.
Call Your Doctor If:
- You have other questions or concerns
Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.