CHOLERA
A Preventable Pandemic
Cholera is a gastro-intestinal infection caused by a bacterium called Vibrio Cholerae. Despite the hundreds of "serogroups" of the cholera bacteria, V. Cholerae serogroups O1 and O139 are the only ones known to cause major outbreaks and epidemics. These strains produce a toxin that affects the lining of the intestines.
Cholera is spread mostly by water and food that has been contaminated with excrement containing the bacteria. Undercooked seafood is also a common source. Interestingly, approximately 100 million bacteria must typically be ingested to cause cholera in a normal healthy adult.
Symptoms of cholera may range from none, to mild, to severe and include watery diarrhea, vomiting and muscle cramps. Severe dehydration, electrolyte imbalance, and shock can occur in a few hours. Cholera has been nicknamed the "blue death" because a person's skin often turns bluish-gray from the extreme loss of fluids. Of those who come in contact with the bacteria, only 20% develop cholera. The disease is treated with antibiotics, electrolytes, and fluid replacement.
Cholera affects an estimated 3 - 5 million people worldwide and causes 30,000 - 130,000 deaths per year. It occurs chronically in certain parts of the world but also occurs in outbreaks. In 1881, Cholera became the first disease outbreak to officially be declared a global pandemic after several waves had killed more than 1.5 million people across the world.
It is unclear exactly when cholera first appeared, but ancient Indian and Greek texts from 5th century BCE describe cholera-like illnesses. The first documented account of cholera is from India, in 1543, when the disease, referred to as "moryxy" by the locals, claimed many lives.
Seven cholera pandemics have occurred over the last 200 years, between 1817 and 1975.
The first pandemic appeared in 1817, in Jessore, India, from where it spread to the rest of Asia along trade routes.
The second pandemic began in 1829, again in India, but this time spreading beyond Asia, into Europe. Cholera reached London in 1832. Britain implemented measures to help curb the spread of the disease, including implementing quarantines and creating local boards of health. Nevertheless, the public became overwhelmed with fear of the disease and distrustful of authority, primarily doctors. Unbalanced media reports led them to believe that a disproportionate number of people were dying in the hospital. There were speculations that the sick were being killed by doctors to advance medical research. This led to several riots in Liverpool. That same year, cholera reached the Americas.