Cholera

During the initial stages of rehydration, careful fluid balance and cardiovascular monitoring are essential. After the initial 2- to 4-hour catch-up rehydration period, hourly losses should be replaced millilitre for millilitre. Pulse and blood pressure should stabilise during this period. Once patients are stabilised, the natural course of the disease is to abate after a mean of 5 days but is 2 to 3 days shorter if appropriate antibiotics are used. Rectal purging losses should be recorded to allow hourly fluid replacement. Serial stool culture is not recommended once a diagnosis is made.