Ulcerations develop within 24 to 48 hours. Fatality occurs between 48 and 72 hours if no treatment is pursued; however, at higher temperatures death may occur within hours. Other symptoms may accompany the disease, including lethargy, color loss, redness around the infection site, loss of appetite and twitching or rubbing the body against objects.

The bacteria usually enter fish through gills, mouth, or small wounds, and is prevalent where high s exist, or where conditions may be stressful due to overcrowding or low dissolved oxygen levels in the water column. The bacteria can persist in water for up to 32 days when the hardness is 50 ppm or more. Minerals are however essential for fish and often the reduction or removal of such minerals in treatment for Columnaris would affect fish mineral uptake and thus affect: oxygen utilization, osmotic regulation, metabolic processes, among may other biological processes and poor minerals (GH) may be a contributing cause to the advancement in severity of this disease, as deficits can increase vulnerability to opportunistic infections (citations).

Disease cures are almost always more expensive and less effective than simple prevention measures. Often precautions involve maintaining a stable aquarium that is adjusted for the specific species of fish that are kept and not over-crowding a tank or over-feeding the fish. Common preventive strategies include avoiding the introduction of infected fish, invertebrates or plants by quarantining new additions before adding them to an established tank, and discarding water from external sources rather than mixing it with clean water. Similarly, foods for herbivorous fish such as lettuce or cucumbers should be washed before being placed in the tank. Containers that do not have water filters or pumps to circulate water can also increase stress to fish. Other stresses on fish and tanks can include certain chemicals, soaps and detergents, and impacts to tank walls causing shock waves that can damage fish.

Ornamental fish kept in aquariums are susceptible to numerous diseases. Due to their generally small size and the low cost of replacing diseased or dead fish, the cost of testing and treating diseases is often seen as more trouble than the value of the fish.

Due to the artificially limited volume of water and high concentration of fish in most aquarium tanks, communicable diseases often affect most or all fish in a tank. An improper nitrogen cycle, inappropriate aquarium plants and potentially harmful freshwater invertebrates can directly harm or add to the stresses on ornamental fish in a tank. Despite this, many diseases in captive fish can be avoided or prevented through proper water conditions and a well-adjusted ecosystem within the tank.