Cholera in non-U.S. Healthcare Settings

What to know

Healthcare providers working in healthcare settings outside of the United States should be trained on certain measures to prevent cholera infections and control the spread of the disease.

Healthcare provider washing his hands with soap and water.

Recommendation details

To keep cholera from spreading, healthcare providers working in settings outside of the United States should be trained on certain measures, including washing hands, disposing of human waste safely, and disinfecting surfaces. Note: Chemoprophylaxis with antibiotics is not indicated for healthcare providers.

When treating patients with cholera, all healthcare providers:

  • Should wash their hands with soap and safe water before and after contact with each patient.
  • If soap and clean water aren't available, use an alcohol-based hand sanitizer (ABHS) with at least 60% alcohol.
  • Use 0.05% chlorine solution to disinfect hands only if soap and safe water or ABHS are not available.

Several chlorine solutions can be used to disinfect surfaces. The following solutions are based on using unscented household bleach with 5–6 % active chlorine.

  • 2% chlorine
    • Make by mixing 3 parts of water and 2 of parts bleach (or 400 ml of bleach in 1 litre of water).
    • Use for disinfecting surfaces touched by the vomit, poop, or body of a person who is sick with or has died from cholera.
  • 0.2% chlorine
    • Make by mixing 9 parts of water and 1 part of bleach (or 40 ml of bleach in 1 litre of water).
    • Use for disinfecting surfaces within an entire cholera ward, toilets, showers, and bathing units; laundry; kitchen; and morgue. This solution should be used on all cholera beds or cots, bedding and linens; clothing; personal protective equipment (PPE) such as gloves, aprons, and goggles; waste containers and covers; food utensils, containers and dishes; and vehicles used for transporting patients.
  • 0.05% chlorine
    • Made by mixing 9 parts water and 1 part 0.5% chlorine solution (or 10 ml of bleach in 1 litre of water)
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Content Source:
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)