For years, cholera has been feared by many due to its potency and symptoms. Cholera is one of the most severe diseases and its symptoms can kill a person in just one day. Muscle cramps, diarrhea, vomiting, and shock can lead to death within 24 hours. Le cholera has caused seven pandemics, killed millions, and has forced countries to improve sanitation and health programs. Vibrio cholerae is a water- or food-borne disease that survives long periods of time in standing water with the potential to be rapidly transmitted to a host. Unwashed food or water are potential vectors as well as handling sewage without proper PPE (personal protective equipment) or sanitary measures. Its first pandemic broke in Calcutta in 1816 and was rapidly spread through trade to China, Japan, the Philippines, Africa, Asia, and Russia. Its second pandemic carried the disease along immigrant routes from Ireland to North America. Although the disease was made worse by close living quarters and a great influx of poor immigrants, it was not directly caused by the Irish as many Americans believed. Little was known about the bacteria until John Snow published his epidemiological studies during the third pandemic in 1854. Snow studied the transmission and helped relate the disease to contaminated water while William Farr claimed that the disease spread through bad air- “miasma”- and social conditions played a role in the spread. Both ideas’ claims seemed convincing due to the poor conditions, including the eye-opening fact that many of London’s privies emptied into cellars and cesspools instead of sewer pipes. The use of personal wells in warehouses resulted in small samples of immune workers. Reports of better-tasting water in certain areas in cities raised eyebrows and lead health workers to investigate potential solutions to cholera. Reverend Henry Whitehead helped Snow gather data with his extensive knowledge of the local community; their work together helped convince authorities to remove the handle to an infected water pump, dramatically reducing the amount of deaths. While Snow and Whitehead helped prevention techniques, Filippo Pacini was the first to identify the bacteria under a microscope and the devastating symptoms of it. At the same time, Robert Koch correctly identified the same bacteria, supporting both Pacini and Snow’s ideas (Hinks, 2020). Although Koch and Pacini’s work was widely ignored, it helped support Snow’s idea and lead to changes in social and sanitary programs, slowly reducing the severity of the many pandemics that would come.
While the cause, transmission, and prevention of cholera was discovered in the 19th century, cholera has remained a deadly disease with a 1% mortality rate. The rise of cholera in poor countries such as Zimbabwe, Mozambique, Haiti, and Yemen cause for concern as epidemics continue to rise. Cholera’s mortality rate in Zimbabwe is an outstanding 5.7% while in Haiti there are over 600,000 reported cases (Hinks, 2020) (CDC, 2020). Many of the cases in these countries come from the poor health practices such as Haiti’s excrement removal by workers with no access to protective equipment (Hersher, 2017). In India, women are shamed for using the toilet and must use the woods, exposing them to cholera, other disease, molestation and rape, and attacks from animals. Campaigns advocate the creation of women-only toilets (Sachdev, 2017). Haiti’s outbreak thrives in the Artibonite River and natural disasters. The 2016 Hurricane Matthew resulted in poverty and destroyed homes. The cholera rate increased and left the country shell-shocked with disease. In Zimbabwe, water collection practices include taking water from cholera-infested rivers, small pools, and rainwater in the streets. Despite the gloomy outlook, new sanitation practices in many countries have improved safely managed services from 28% to 45%. 23 countries reduced open defecation rates to below 1%. The population using safely managed services increased from 61% to 71% (WHO, 2019). Still, 1 in 3 people lack safe drinking water and over half the population lacks safe sanitation (Unicef, 2019). Globally, sanitation needs to be practiced and access to clean drinking water is a must. Without these, cholera will never be stopped and soon another pandemic will occur.
References:
CDC. Cholera- Vibrio cholerae infection. 2020
Hersher, Rebecca. Haiti’s ‘Bayakou’: Hauling Away Human Excrement By Hand. NPR. 2017.
Hinks, Eileen. Cholera. PowerPoint. 2020
Iver, Louise. Eliminating Cholera Transmission in Haiti. The New England Journal of Medicine. 2017.
Sachdev, Chhavi. Watch Women Shame Men Who Pee In Public. NPR. 2017.
Unicef. Progress on household drinking water, sanitation and hygiene, 2000-2017. 2019.
WHO. Progress on household drinking water, sanitation and hygiene. 2019.