After an incubation period of 24-48 h, pts develop painless watery diarrhea and vomiting that can cause profound, rapidly progressive dehydration and death within hours.
Volume loss can be >250 mL/kg in the first day.
Stool has a characteristic “rice-water” appearance: gray cloudy fluid with flecks of mucus; no blood; and a fishy, inoffensive odor.