Artifact 8
Corey Johnston
4/7/19
BI-245X-01
Cholera: A Crappy & Lethal Disease
When discussing Cholera, there are many societal and cultural factors that increased its virulence and its ability to spread throughout the world. Colonization, trade, and urbanization all helped this disease leave its mark around the world, as it created 7 pandemics within the last 2 centuries. In the 16thcentury, Cholera was first documented in India. As Britain began to spread its empire, it led to the colonization of India. As such, British explorers and leaders helped to bring this disease back to Europe and at a deadly cost. Also, a huge part in the spread of cholera was through trade. As exploration reached its peak and countries began to understand the values of various parts of the world, trade became a booming industry. The first cholera pandemic occurred from an outbreak in Calcutta, India. This disease was spread along trade routes to China, Japan, the Philippines, Africa, Central Asia, and Russia. This disease soon came to a halt out of the blue. However, it began to creep its way back and led to a second pandemic in Russia, where it soon spread rampantly throughout Europe. Here, Irish immigrants brought this disease across the Atlantic to Canada and New York. It continually spread to the west coast and even onto Mexico. The third pandemic is known to be the most lethal and left a huge mark in Africa, U.S., Middle East, Europe, and India. The London pandemic is known to be considered within this category. London suffered awful living conditions. The city wreaked of stench and people blamed the disease on this miasma. Urbanization in London created worse conditions. This city was heavily populated and relied on the Thames river for water supply. They had poor sanitation and oftentimes dumped their sewage directly into the river from which they drank from. There were also cesspools in their cellars that built up and they cleaned these out by dumping the sewage into the river. People thought that the low-income population became infected more because there were accustomed to the stench and “the ‘moral depravity’ of poor people weakened their constitutions so they were more vulnerable to disease.”
There were also factors that limited the spread of this disease. If people did not drink from contaminated water supplies, they were not susceptible. If there were high levels of sanitation methods used on food and water, people did not get sick. This is why sanitation improvements and public health infrastructure was so important and why it is important to this day. Public outhouses that stopped the bacteria from reaching water supplies was essential. Boiling water, cleansing hands, and cleansing food are all important concepts that were needed to stop the spread of this disease. That is why this disease tends to isolate itself in poor countries, because there are little measures that can be carried out to prevent the spread of this disease, e.g., India’s lack of bathrooms available to households. Also, there is a type of cholera biotype that wreaks havoc among the world. The El Tor biotype is a much hardier organism because it can survive long periods of time in aquatic environments. It also leads to mild symptoms or no symptoms which helps it gain an edge by allowing it to spread as people are able to travel. This helps it rapidly spread from one place to another.
Then, John Snow came along. He developed a hypothesis that contaminated water was the cause of the disease, and if this were so, then people getting their water from Lambeth Company, which got its water from a less polluted region of water, would have a lower mortality rate. He began to calculate death rates based on water supply and used his “spot map” to sort of pin-point which well looked to be the verdict. He found that the well on Broad St. had the most deaths surrounding it. He also was able to pinpoint the starting point of the disease by discussing with a priest, Henry Whitehead. Whitehead knew the community, knew about their lives, who got sick, and led Snow to the conclusion that this all started from a sick baby whose diaper contaminated the well. Their studies led to the new science of epidemiology, and expressed the role of public health to the world. Also, an Italian researcher by the name of Filippo Pacini identified the culprit as Vibrio cholera, a comma shaped gram-negative bacteria. He did autopsies on dead bodies and found the comma-shaped bacillus. He published several papers on his work but nobody paid attention to it because it directly contradicted the miasma theory. He described the symptoms of the disease and described ways to prevent it through intravenous injection of salt and water. He would later be recognized for his publications and efforts to put an end to this disease. Robert Koch later named the bacteria, Vibrio cholera. He also conducted autopsies of people who died from this disease and found the comma-shaped bacteria in the intestinal mucosa of the deceased. He was later able to isolate the bacteria and found that animals were not susceptible to the disease. The miasma theory was finally laid to rest.
In Haiti, a cholera outbreak took its toll on the population. In 2010, after the devastating Earthquake that hit, the El Tor biotype emerged. Scientists suggested that this biotype was probably brought over from humanitarian efforts from other countries. About a million people died from this disease and then flooding hit and intensified the outbreak. All of these issues have spiked because there has been a lack of sanitation and a lack of ways to manage feces. Humanitarian efforts have been made to provide people here with food, shelter, and clean water. Then efforts have been made to provide vaccines to these individuals as well as ways ensure they get chlorinated water and develop ways to store clean water. There have also been facilities built and supplied with rehydration fluids, antibiotics, and zinc. There has also been an increased urge for the oral cholera vaccine (OCV) to be administered to the public. Surveillance systems were also established for an improved response to any outbreak. All of these measures have helped to slow down the cholera outbreak, but without further attention and medical assurance, cholera will still be a recurrent episode in the community. It has been shown that the outbreak has slowed down substantially, and in 2018, only 3,786 cases were reported, which is a decline of about 72% just from 2017. Like I mentioned above, there still needs to be more done to get rid of this disease altogether.
Like Haiti, cholera has had its effect on other countries like Yemen and Iraq. These incidents spur from problems associated with war and weather. In Yemen, before war devastated its lands, it was ranked as one of the poorest countries in the world. Hospitals and clinics have been destroyed and infections have taken its toll on the community, exemplifying this is its most recent cholera outbreak. Also, a water treatment plant was blown and this has helped the spread of these diseases. In East Africa, heavy rains and mudslides carry the cholera bacteria to remote places that can could get worse with El Nino conditions. It can stay in areas of little water and spread with flowing water. These are just a few brief examples of why action needs to be taken place to help those who have been infected with these diseases.