Water contaminated with human faeces is the main means of cholera transmission, either directly (through drinking contaminated water) or indirectly (through eating contaminated food). Contaminated food preparation areas and using contaminated water in preparing food are also a source of infection. As too is sharing toilets with infected persons and not practicing good hand hygiene (washing hands thoroughly with soap and purified water).
Note the following:
• Water can be contaminated at its source, during storage or during use.
• Food can become contaminated when it comes into contact with contaminated water. Vegetables that have been fertilised with human excreta (nightsoil) or "freshened" with contaminated water also become contaminated. Fish (particularly shellfish) sourced from contaminated water and eaten raw or insufficiently cooked may also cause infection.
• Soiled hands can also contaminate clean drinking water and food.