<P> Cholera is caused by a number of types of Vibrio cholerae, with some types producing more severe disease than others . It is spread mostly by unsafe water and unsafe food that has been contaminated with human feces containing the bacteria . Undercooked seafood is a common source . Humans are the only animal affected . Risk factors for the disease include poor sanitation, not enough clean drinking water, and poverty . There are concerns that rising sea levels will increase rates of disease . Cholera can be diagnosed by a stool test . A rapid dipstick test is available but is not as accurate . </P> <P> Prevention methods against cholera include improved sanitation and access to clean water . Cholera vaccines that are given by mouth provide reasonable protection for about six months . They have the added benefit of protecting against another type of diarrhea caused by E. coli . The primary treatment is oral rehydration therapy--the replacement of fluids with slightly sweet and salty solutions . Rice - based solutions are preferred . Zinc supplementation is useful in children . In severe cases, intravenous fluids, such as Ringer's lactate, may be required, and antibiotics may be beneficial . Testing to see which antibiotic the cholera is susceptible to can help guide the choice . </P> <P> Cholera affects an estimated 3--5 million people worldwide and causes 28,800--130,000 deaths a year . Although it is classified as a pandemic as of 2010, it is rare in the developed world . Children are mostly affected . Cholera occurs as both outbreaks and chronically in certain areas . Areas with an ongoing risk of disease include Africa and south - east Asia . The risk of death among those affected is usually less than 5% but may be as high as 50% . No access to treatment results in a higher death rate . Descriptions of cholera are found as early as the 5th century BC in Sanskrit . The study of cholera in England by John Snow between 1849 and 1854 led to significant advances in the field of epidemiology . </P> <P> The primary symptoms of cholera are profuse diarrhea and vomiting of clear fluid . These symptoms usually start suddenly, half a day to five days after ingestion of the bacteria . The diarrhea is frequently described as "rice water" in nature and may have a fishy odor . An untreated person with cholera may produce 10 to 20 litres (3 to 5 US gal) of diarrhea a day . Severe cholera, without treatment, kills about half of affected individuals . If the severe diarrhea is not treated, it can result in life - threatening dehydration and electrolyte imbalances . Estimates of the ratio of asymptomatic to symptomatic infections have ranged from 3 to 100 . Cholera has been nicknamed the "blue death" because a person's skin may turn bluish - gray from extreme loss of fluids . </P>

Where is cholera most likely to be found
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