Causes of Cholera

Cholera has one cause - Vibrio cholerae - and one doorway: the mouth. Everything about who falls sick comes down to water, food and hygiene.

The bacterium and its toxin

Vibrio cholerae survives in water and is swallowed with contaminated food or drink. In the small intestine it releases cholera toxin, which locks the intestinal cells into pouring out water and electrolytes - liters a day in severe cases. The germ inflames little; it drains. That is why cholera diarrhea is massive but painless.

How it reaches the mouth

• Contaminated drinking water: the classic route - wells, pipelines and storage tanks tainted by sewage
• Food washed or prepared with contaminated water: raw vegetables, cut fruit, street food
• Seafood from polluted waters, eaten raw or undercooked
• Hands: poor hand hygiene after toilet contact spreads it within households
• Floods and pipeline breaks: the classic Indian outbreak setting - monsoon + mixed water lines

Who is more vulnerable

• People with low stomach acid (acidity medicines, stomach surgery): acid kills much of the swallowed dose
• Blood group O: for reasons not fully understood, tends to get more severe disease
• Children under 5 in endemic areas
• Malnourished and crowded populations

What does NOT spread cholera

Casual contact, air, sharing a room: cholera is swallowed, not breathed. Caring for a patient with ordinary hand hygiene is safe - it is the water and food pathway that must be guarded.

One-line summary

Cholera is swallowed with contaminated water or food; floods, mixed pipelines and poor hand hygiene open the door - and stomach acid, clean water and handwashing close it.