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NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.

CSTE Position Statement(s)

  • 09-ID-03

Clinical Description

An illness characterized by diarrhea and/or vomiting; severity is variable.

Laboratory Criteria For Diagnosis

  • Isolation of toxigenic (i.e., cholera toxin-producing) Vibrio cholerae O1 or O139 from stool or vomitus, OR
  • Serologic evidence of recent infection

Case Classification


A clinically compatible illness that is laboratory confirmed


Illnesses caused by strains of V. cholerae other than toxigenic V. cholerae O1 or O139 should not be reported as cases of cholera. The etiologic agent of a case of cholera should be reported as either V. cholerae O1 or V. cholerae O139. Only confirmed cases should be reported to National Notifiable Diseases Surveillance System (NNDSS) by state health departments.

In addition to reporting through the National Notifiable Diseases Surveillance System (NNDSS), CDC requests that states collect and report the information on the standard form for Cholera and Other Vibrio Illness Surveillance (COVIS), available at: CDC intends to integrate the COVIS form into the National Electronic Diseases Surveillance System (NEDSS) in the future. Reporting sites should use the COVIS reporting form until the integration is successfully implemented.

CDC requests that all Vibrio isolates be forwarded to the Enteric Diseases Laboratory Branch (EDLB) for characterization. EDLB (specifically the Epidemic Investigations Laboratory) requests that state public health labs immediately forward all suspect V. cholerae isolates for serogrouping and cholera toxin testing as well as biotype and antimicrobial susceptibility testing.

The 1996 case definition appearing on this page was re-published in the 2009 CSTE position statement 09-ID-03. Thus, the 1996 and 2010 versions of the case definition are identical.

Related Case Definition(s)