Cholera and Pregnancy

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Way back in the summer of 1854, in the Soho district of London, a lot of people starting getting sick. Many died. At the time, the source of the illness was unknown. Epidemiologist Dr. John Snow was determined to get the bottom of it, find the source of the disease, and prevent more people from getting sick.

Having surveyed where the illnesses were clustered, he sat down with a map and plotted it all out. He saw that most of the houses where the illness had been reported were clustered around a certain water pump. Furthermore, he saw there were fewer disease reports near the town brewery. It seemed to him that the illness came from the drinking water. And where people were drinking beer, there were fewer cases.

His conclusion was clear. The disease was coming from the water pump. In a triumph of public health advocacy, Snow convinced the town leaders to remove the handle from the pump, thereby preventing anyone else from using that water. Sure enough, the outbreak subsided. But he was still left with the question of what had actually caused the water pump to become contaminated.

What is Cholera?

It turns out, the water pump had been contaminated with bacteria called Vibrio cholerae. We call the disease humans get from drinking water that has been contaminated with those bacteria cholera.

Cholera is an easily preventable (and easily treatable) disease that can kill in a matter of hours by causing intense, dehydrating diarrhea. Though rare in the United States, we have seen the disease make a come-back in places like Africa, Haiti, and Southeast Asia. As mentioned above, it is contracted by ingesting water contaminated with the bacteria Vibrio cholerae. It can be transmitted person-to-person if a person comes in contact with an infected person’s fecal matter and that matter ends up in or near the mouth of the other person. Treatment is rehydration therapy. Cholera is a vaccine-preventable disease.

Quick Facts about Cholera

  • Caused by bacterium called Vibrio cholerae
  • Causes diarrhea and dehydration
  • Can kill in a matter of hours
  • Rare in the US
  • Fecal-oral transmission
  • Can be spread person-to-person
  • Can be prevented with clean drinking water and frequent handwashing in clean water
  • Is vaccine-preventable
  • Can be treated with rehydration therapy

What are the Symptoms?

The symptoms of cholera are severe and include:

  • Profuse, watery diarrhea (often called “rice water stools”)
  • Abdominal cramping
  • Muscle cramping
  • Vomiting
  • Intense thirst
  • Increased heart rate

How Can I Protect Myself Against Cholera?

If you are traveling to an area where cholera has been active, you may want to talk to your doctor about the single-dose, oral vaccine.

Other preventive measures include:

  • Drinking only water that has been properly treated (this includes ice cubes)
  • Frequently washing hands in clean water
  • Peeling fruits and vegetables and washing them in clean water
  • Making sure food (especially seafood) is thoroughly cooked

What if I Get Cholera During my Pregnancy?

Pregnant women are no more likely to get cholera than the general population. If you do think you have contracted cholera, it is very important to get treatment right away. Your body is already working overtime to support your pregnancy. Adding the extra burden of this disease can lead to dire consequences for both mother and baby.

How is Cholera Treated?

The treatment of cholera can be as simple as giving oral rehydration therapy. This is a carefully measured solution of sugar, salts, and clean water. The World Health Organization together with UNICEF has a packet that can be dissolved in water and easily given to someone with the illness to drink. Rehydration may require more than one packet.

If dehydration is severe, the patient may require intravenous (IV) fluids and antibiotics. Additionally, if the patient is a small child (under 5 years old) zinc tablets may be appropriate.

Because cholera spreads through contaminated water, breastfeeding is always encouraged for infants.

Back to John Snow

It wasn’t until many years after John Snow deduced the cause of the illness in Soho that the actual culprit was identified—a comma-shaped bacterium called Vibrio cholerae. Thanks to the epidemiological detective work of John Snow and subsequent scientists, we in the developed world have instant access to water that has been treated and is free of this deadly pathogen.

Janette DeFelice
Dr. Janette DeFelice is a writer currently focusing on how the changing environment affects our health. She holds a Doctor of Medicine degree from Chicago Medical School where she taught clinical and diagnostic skills to beginning medical students, and a Master’s degree in Humanities from the University of Chicago. She also has a Bachelor’s degree in Political Science. Her writing can be seen online at BeTheChangeMom, ChicagoNow, and Medium, and she’s very excited to have published her first novel, Delia Rising: A Ballet in Three Acts. She lives in Chicago’s west suburbs with her school-age twins, her husband, and a family cat named Clara Barton.

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