Cholera is a severe, highly infectious form of watery diarrhoea which is common in undeveloped countries. Cholera occurs in epidemics as has happened in some areas of South Africa in recent years. It is caused by a bowel infection with Vibrio cholerae. The stools in cholera as typically watery with small pieces (flecks) of mucus (‘rice water stools’). Cholera can rapidly lead to dehydration and death, even in adults. Always think of cholera if there is a local epidemic, especially with severe dehydration in an older child.