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Cholera: Symptoms, causes, prevention, and treatment as cases rise in Cross River

Cholera is an acute diarrhoeal infection caused by ingesting food or water contaminated with the bacterium Vibrio cholera. It can lead to severe dehydration and death if left untreated.

While about 1.3 billion people, mostly from the Global South, are at risk of Cholera, 2.86 million cases happen every year, with an estimated 95,000 deaths. Nigeria has witnessed three major cholera outbreaks in the past two decades alone. In 2021 the country fought the worst cholera outbreak in a decade. The Nigerian Centre for Disease Control (NCDC) said that it had recorded 19,228 suspected cases of cholera, with 466 deaths across 31 states as of the end of October 2022. 

On Thursday, December 15, 2022, the Cross River State Government confirmed deaths from a cholera outbreak in the Ekureku community in the Abo Council of the state. The case was said to have escalated following the ingestion of contaminated water from the village water source.

Cholera: Symptoms, causes, prevention, and treatment as cases rise in Cross River
A community water source in Abi, Cross River State.

Causes of Cholera 

A person is infected with Cholera when he consumes food or drinks water infected by the bacterium vibrio cholera.

The disease’s fatal outcomes are caused by a toxin produced by the bacteria in the small intestine. This toxin triggers the body to release excessive amounts of water, resulting in diarrhoea and quick depletion of fluids and electrolytes.

Cholera is easily spread in communities that lack access to clean water, refuse disposal, and that practice open defecation.  There have also been reported cases of people getting cholera after eating fresh seafood, uncooked fruits and vegetables.

Areas with a high population density and lack proper access to healthcare are also susceptible to Cholera.

Symptoms of Cholera

The signs of cholera usually manifest within two or five days after a person has been exposed to the disease. The most common symptoms of cholera include watery diarrhoea, vomiting, and muscle cramps. There may be no symptoms in some cases, especially in milder cases of cholera. Other symptoms include: 

Dehydration: This is the most dangerous complication of cholera, as it can lead to shock and death if not treated promptly. Signs of dehydration include dry mouth and throat, sunken eyes, decreased urine output, and dry skin.

Abdominal cramps: These are caused by the contraction of the muscles in the intestines as they try to expel the bacteria.

Nausea and vomiting: These symptoms may occur as the body tries to rid itself of the bacteria.

Low blood pressure: This can result from dehydration and shock. Sometimes, the infected person may develop a mild fever, headache, and muscle weakness.

Note that it is possible for an individual with cholera to be asymptomatic and, therefore, unaware that they have been infected. However, for up to 14 days after being infected, these individuals can still spread the bacteria through their faeces and potentially contaminate water sources.

Risk Factors

Since cholera can be spread through contaminated water, people living in areas without clean water are at a higher risk of contracting the disease. People travelling to areas with poor sanitation and lack access to clean water are also at risk of cholera.

In addition, People who do not have access to health care are at a higher risk of dying from cholera, as the disease can progress rapidly if not treated promptly.

Children under five years old and older adults are more vulnerable to cholera. Also, living in crowded conditions increases the risk of cholera spreading quickly.

Dr Chikwe Ihekweazu, the Director General of NCDC, explained that Cholera is preventable when people follow the necessary hygiene protocols, such as keeping their environment clean.

“We urge Nigerians to keep their environments clean, only drink or use water that is boiled and stored safely, ensure food is cooked and stored in a clean and safe environment, avoid open defecation and wash their hands regularly with soap and running water.” 

He adds that Cholera is preventable and even treatable but can be hazardous if people do not access adequate health care on time. 

“Cholera is preventable and treatable; however, it can be deadly when infected people do not access care immediately. Nigerians are advised to visit a health facility immediately if they have sudden onset of profuse watery diarrhoea, nausea, vomiting, and weakness,” Dr Ihekweazu said. 


Cholera can be prevented by improving access to clean water and sanitation and practising good hygiene. Some specific ways to prevent cholera include:

Access to clean water: One of the most effective ways to prevent cholera is by providing clean water. This can be done by providing pipe-borne water and water treatment systems and educating people on how to properly purify their water, for example, by boiling it before using it. 

Proper sanitation: Providing access to proper sanitation is also important in preventing cholera. This can be done by building toilets, promoting good hygiene practices, and educating people on properly disposing of human waste.

Cholera: Symptoms, causes, prevention, and treatment as cases rise in Cross River
A community-built toilet to stop open defecation in Abi, Cross River.

Oral cholera vaccines: Oral cholera vaccines can be given to people at a high risk of contracting cholera, such as those living in areas where cholera is common.

Practice good hygiene: You can prevent cholera by practising good hygiene, such as washing your hands frequently with soap and clean water, especially before eating or preparing food and after using the toilet.

Food safety: Cholera can also be spread through contaminated food, so it’s important to be careful about what you eat and drink, especially in areas where cholera is common.

Education: Educating people on how to prevent cholera, such as the importance of clean water, sanitation, and good hygiene, is also crucial in preventing the spread of the disease.

Rapid response: Rapid response to outbreaks of cholera, including case detection, treatment, and contact tracing, can help to prevent the spread of the disease.

Treatment of Cholera

Cholera is treated by addressing the dehydration caused by the disease and by treating the underlying infection. The treatment typically involves the following steps:

Rehydration: The most important aspect of cholera treatment is rehydration. This is typically done by giving the patient an oral rehydration solution (ORS), a mixture of water, salt, and sugar. This solution replaces the fluids and electrolytes that the body has lost due to diarrhoea and vomiting. In severe cases, intravenous fluids may be required.

Antibiotics: Antibiotics are also used to treat cholera. These drugs help kill the bacteria that cause the infection and shorten the illness’s duration. Common antibiotics used to treat cholera include doxycycline, azithromycin, and ciprofloxacin.

Zinc supplement: Zinc supplements can also be given to children with cholera as they can reduce the duration of diarrhoea and the risk of complications.

Nutritional support: Nutritional support is also important for children and adults with cholera. This may involve providing the patient with a high-calorie diet to help them regain strength.

Follow-up care: Patients with cholera should be closely monitored for several days to ensure that they are recovering properly and that their condition does not worsen.


A World Health Organization (WHO) report has outlined that the world is currently in the middle of the latest cholera pandemic, which began in 1961 and originated in southern Asia. A decade later, it spread to Africa. It reached North and South America in 1991. Although efforts have been remarkably significant since then, a lot is tied to what individuals do daily. 

The researcher produced this fact-check per the DUBAWA 2023 Kwame KariKari Fellowship partnership with CrossRiverWatch to facilitate the ethos of “truth” in journalism and enhance media literacy in the country.

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