Travelers Returning to the U.S. with Cholera: CDC Information and Guidance for HCP

The Centers for Disease Control and Prevention (CDC) has identified an unprecedented global increase of cholera infections, with large outbreaks currently occurring in Haiti, Malawi, and Syria. Currently, CDC considers 25 countries to have active cholera transmission.

Thus far in 2022, 8 travelers with cholera have returned to the United States from Pakistan, Iraq, and Bangladesh. Although cholera in travelers is rare and sustained community transmission in the United States is unlikely, widespread cholera outbreaks in other countries highlight the need for clinicians in the United States to be prepared to treat travelers with cholera (JAMA 1994;272:1203), as they could arrive in the United States at any time.

Clinicians evaluating patients with acute onset of watery diarrhea should obtain a travel history, consider cholera in patients returning from affected regions, obtain a stool specimen for testing, and begin prompt treatment. Without treatment, death can occur within hours.

See CDC’s cholera website for more information on diagnosing, preventing, and treating cholera.