Information for Patients
Cholera is a bacterial infection that causes diarrhea. The cholera bacterium is usually found in water or food that has been contaminated by feces (poop). Cholera is rare in the US. You may get it if you travel to parts of the world with poor water and sewage treatment. Outbreaks can also happen after disasters. The disease is not likely to spread directly from person to person.
Cholera infections are often mild. Some people don't have any symptoms. If you do get symptoms, they usually start 2 to 3 days after infection. The most common symptom is watery diarrhea.
In some cases, the infection can be severe, causing lots of watery diarrhea, vomiting, and leg cramps. Because you quickly lose body fluids, you are at risk for dehydration and shock. Without treatment, you could die within hours. If you think that you might have cholera, you should get medical care right away.
Doctors diagnose cholera with a stool sample or rectal swab. Treatment is the replacement of the fluid and salts that you lost through the diarrhea. This is usually with a rehydration solution that you drink. People with severe cases may need an I.V. to replace the fluids. Some of them may also need antibiotics. Most people who get fluid replacement right away will recover.
There are vaccines to prevent cholera. One of them is available for adults in the U.S. Very few Americans need it, because most people do not visit areas that have an active cholera outbreak.
There are also simple steps you can take to help to prevent cholera infection:
- Use only bottled or purified water for drinking, washing dishes, making ice cubes, and brushing your teeth
- If you do use tap water, boil it or use iodine tablets
- Wash your hands often with soap and clean water
- Make sure that the cooked food you eat is fully cooked and served hot
- Avoid unwashed or unpeeled raw fruits and vegetables
Centers for Disease Control and Prevention
General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.
Index of Diseases and Injuries Definitions
- And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
- Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
- Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
- Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
- NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
- See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
- See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
- 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.