Cholera is a severe diarrheal illness that can spread rapidly. Historically, cholera outbreaks have caused widespread fatalities, earning it the Thai nickname “Rok Ha”—a term associated with deadly epidemics. While the severity and incidence of cholera have decreased in recent years, the disease still poses a risk, especially during the hot season and in areas with poor sanitation.
Transmission
Cholera is primarily transmitted through the consumption of contaminated food or water. It can also spread via contact with objects handled by infected individuals, particularly when flies act as vectors that carry the bacteria from contaminated surfaces to others.
Symptoms
Some individuals may carry the bacteria without showing any symptoms, acting as silent reservoirs that spread the disease unknowingly. In mild cases, patients experience abdominal cramps and frequent watery stools, which usually resolve within 1–2 days. However, severe cases involve profuse, watery diarrhea resembling “rice-water,” often accompanied by a strong, fishy odor. Vomiting may also occur. Without prompt medical intervention, the body rapidly loses fluids and electrolytes, leading to fatigue, dry mouth, intense thirst, restlessness, sunken eyes, weak pulse, and—in extreme cases—death.
Treatment
When cholera is suspected, especially in cases of acute diarrhea, physicians may collect stool samples for culture. Intravenous fluids are administered to replenish lost fluids and electrolytes, and antibiotics are prescribed strictly under medical supervision. With timely and appropriate treatment, patients usually recover fully within a few days without complications. Delayed treatment significantly increases the risk of life-threatening dehydration.
Prevention
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Consume only freshly cooked, hygienic food free from fly contamination.
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Drink clean, safe water.
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Dispose of vomitus and feces from cholera patients in toilets or by deep burial. Do not discard waste on the ground or into rivers and canals. Contaminated clothing should be burned or buried, never washed in natural water sources.
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Close contacts of infected individuals may require stool screening to detect asymptomatic infections and ensure timely treatment.
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Always wash hands thoroughly before food preparation and meals. Store food in covered containers or enclosed cabinets. Use hygienic toilet facilities for defecation.
Acknowledgements
With thanks to Bangkok Hospital Chanthaburi and Phyathai Hospital for the information provided.
