Cholera
Reportable by Laboratories and ProvidersAbout this Reportable Disease
Infectious agent: Vibrio cholerae serogroup toxigenic strains O1 or O139
Description of illness: Symptoms of cholera are acute diarrhea, ranging from mild to severe. In severe disease, profuse watery diarrhea, vomiting, leg cramps, and rapid loss of body fluids can lead to dehydration, shock, and death if no treatment is received.
Interactive Disease Data
Laboratory Reporting
Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.
- Manually report results to TDH by faxing or mailing a completed PH-1600 form to your local health department, or faxing to the state health office at (615) 741-3857
- Automatically submit results to TDH via electronic laboratory reporting (ELR), which automates the process of sharing data with TDH using interoperability standards.
- See the ELR Onboarding Handbook for details on the onboarding process, checklist, frequently asked questions, business rules, message format, and vocabulary.
- To initiate the ELR onboarding process with TDH, register in the Trading Partner Registration (TPR) system TPR provides documentation for Promoting Interoperability (PI) attestation and milestone letters to document onboarding progress. Contact MU.Health@tn.gov for assistance.
- Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
- Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.
Information about this Reportable Disease for Healthcare Providers
Clinical Summary
Cholera is an intestinal infection caused by the bacterium Vibrio cholerae, primarily spread through contaminated water and food.
The disease can range from mild or asymptomatic infection to severe acute illness with profuse watery diarrhea and rapid dehydration.
Common signs and symptoms include “rice‑water” stools, vomiting, muscle cramps, low blood pressure, and in severe cases, shock.
Treatment focuses on rapid rehydration with oral rehydration salts or intravenous fluids; antibiotics are used in severe cases.
Cholera vaccines (e.g., Vaxchora in the U.S.) can help prevent infection, but safe water, proper sanitation, and hygiene remain critical.
Healthcare Provider Reporting
Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.
Providers must report cases of all diseases and conditions listed through one of these methods:
• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857
• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.
• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.
Information about this Reportable Disease for the Public
What it is
Cholera is an acute diarrheal illness caused by the bacterium Vibrio cholerae, spread mainly through contaminated water and food.
It can lead to severe dehydration and death if untreated.
Risk is highest in places with inadequate sanitation or unsafe drinking water.
Only one vaccine (Vaxchora) is licensed in the U.S., for ages 2-64 traveling to areas of active transmission.
Other oral cholera vaccines (e.g., Dukoral, Euvichol‑Plus) are WHO-approved but not available in the U.S
Types
There’s no formal “phase” classification for cholera vaccine use; rather, recommendations depend on who and where is being vaccinated.
The U.S. vaccine (Vaxchora) is a single-dose, live oral vaccine meant for travelers to cholera-affected areas.
The World Health Organization recommends oral cholera vaccines (OCVs) either for outbreak control, humanitarian crises, or endemic high-risk areas.
In outbreak settings, some countries may use a single-dose regimen to extend limited vaccine supply (though this provides shorter duration of protection).
Boosters or repeated vaccination schedules have not been firmly established in the U.S. for Vaxchora.
Signs and Symptoms
Sudden onset of profuse watery diarrhea, often described as “rice-water” stools, vomiting, and rapid dehydration.
Severe cases may progress to shock and death if fluids and electrolytes are not replaced promptly.
Because the vaccine doesn’t guarantee 100% protection, vaccinated individuals should still practise safe drinking water and hygiene.
Symptoms may appear within hours to days of exposure, depending on bacterial load and host factors
In a travel context, the vaccine may reduce risk of moderate-to-severe cholera rather than eliminate all risk.
Treatment
The mainstay of treatment for cholera is rapid rehydration, preferably with oral rehydration salts (ORS) or intravenous fluids in severe cases.
Antibiotics may be used in selected patients to shorten the duration of diarrhea and bacterial shedding.
Vaccination is a preventive measure, not a substitute for safe water, sanitation, hygiene, or prompt treatment if disease occurs.
In travel and outbreak settings, combining vaccination + preventive behaviours offers the best protection.
Health care providers should counsel travelers about the vaccine, its limitations (e.g., does not protect from other waterborne diseases), and reinforce hygiene measures.
This Page Last Updated: March 25, 2026 at 8:53 PM