Healthcare workers initially distinguish cholera from other diarrheal diseases through key clinical clues: the dramatic volume and "rice-water" appearance of the stool, the absence of severe cramping or fever, and the rapid progression to dehydration. While other infections like ETEC or salmonella can cause similar symptoms, the speed and severity of water loss in cholera are often unmatched.
The role of diagnostic testing, primarily stool culture or rapid tests, is vital for public health surveillance rather than for immediate individual patient care. A confirmed lab test provides definitive evidence of Vibrio cholerae, which triggers official outbreak alerts, guides targeted interventions like water source safety, and informs vaccination campaigns. However, because cholera can kill within hours, the initiation of rehydration therapy must be immediate and is based on clinical suspicion, never delayed for a test result.