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Why can untreated cholera lead to death within hours?

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A woman in a pink dress receives medical treatment from nurses administering an IV at a crowded hospital in Saint-Marc, Haiti. — cholera A woman with cholera being treated by nurses at St. Nicholas Hospital in Saint-Marc, Haiti, 2010.

Untreated cholera can lead to death within hours because of the rapid and extreme loss of fluids and electrolytes from the body.12

When the Vibrio cholerae bacterium infects the small intestine, it secretes an enterotoxin that binds to the lining of the intestinal cells. This toxin locks a cellular pumping mechanism in the "on" position, which regulates the movement of water and salts between the intestine and the circulatory system.3

As a result, the body experiences a massive outflow of fluid—sometimes reaching up to one liter per hour—into the intestinal tract. This leads to sudden, profuse diarrhea and rapid dehydration, causing blood pressure to fall and the pulse to become faint. Without prompt intervention to replace these lost fluids and salts, the resulting physiological collapse can be fatal in a very short period.31