Cholera Epidemics

8 Key excerpts on "Cholera Epidemics"

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  Exploring Medical Anthropology

  • Donald Joralemon(Author)
  • 2017(Publication Date)
  • Routledge

    (Publisher)

  At the end of January in 1991, several years after my research on Peruvian curers had ended, there were reports of an increase in diarrheal illness in Candelaria, another coastal village just north of Peru’s capital, Lima. Laboratory tests revealed the presence of the cholera bacterium. This was the twentieth century’s first appearance in South America of one of history’s most deadly epidemic agents. Within two weeks, 12,000 cases were recorded along the full 2,000 km of Peru’s coast. The epidemic moved rapidly into the Peruvian highlands and then crossed national borders to affect Ecuador, Colombia, and Brazil. It continued to spread throughout Latin America in the following two years, making almost one million people sick and killing nearly 9,000 (Guthmann 1995). Researchers speculate that cholera may now be a permanent part of Latin America’s epidemiological profile.

  Epidemics offer particularly vivid demonstrations of the interconnections between biological, social, and cultural components in the human experience of disease. For many of the historically significant epidemics (e.g., smallpox, the bubonic plague, leprosy, tuberculosis, and cholera), there is substantial scientific knowledge about the organisms responsible for the diseases, about the means of transmission, and about treatment and prevention. The links between epidemics and social factors like urbanization, poverty, migration, and others are usually well known today. Finally, because epidemics can be so devastating to human communities, they provide ample opportunity for cultural interpretations as afflicted populations struggle to make sense of their suffering.

  In this and the next chapter, I show how the biological, social, and cultural dimensions of the Peruvian cholera outbreak were represented in published accounts. Cholera can alternatively be understood as a well-adapted bacterium, as a symptom of societal collapse, or as a conspiracy against the poor. But first, it is necessary to know something of the history of cholera and of the investigations into its treatment and prevention.

  History and Biology of Cholera

  Cholera is an acute dehydrating diarrheal disease caused by toxigenic Vibrio cholerae

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  Significance, Prevention and Control of Food Related Diseases

  • Hussaini Anthony Makun(Author)
  • 2016(Publication Date)
  • IntechOpen

    (Publisher)

  Seven major pandemics of cholera have occurred since 1817 [3, 6]. Historians believe that the impact of Cholera Epidemics on the cultural evolution of Western Europe, was far reaching and it altered the social matrix of European culture. During the nineteenth century cholera was not only considered a terrifying disease, but was also a challenge to national identity and national economy [7]. John Snow performed pioneer work on cholera in London in the 1800s. He established an association between cholera transmission and contaminated water [4]. He discovered the method of prevention and control of cholera by tracing its source back to drinking water. Due to his work on the Soho cholera outbreak in 1854, John Snow has become a legend in epidemi‐ ology [5]. Later, in 1883, Robert Koch described the causative agent for cholera as a curved bacillus, V. cholerae [3]. In 1892, a major cholera outbreak occurred in Germany, killing 10,000 people. It was found to be caused by a defect in the design in the German waste removal system [7]. Seven cholera pandemics occurred during the nineteenth and twentieth centuries. The seventh pandemic began in Indonesia in 1961, reached West Africa in 1970 and the Americas in 1991 [3, 6]. In the United States of America, the risk of cholera is very low. However, in 2005, the floods caused by Hurricane Katrina, created the fear of a cholera epidemic for the first time in a century. The US Centers for Disease Control and Surveillance had 11 confirmed cases of people becoming ill from Vibrio sp. infection. However, only one of those cases had V. cholerae , which was not from the two epidemic-causing serogroups, i.e., O1 and O139 [5]. 1.2. General burden of cholera on human population Cholera is an indicator of a lack of social development and is a global threat to public health.

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  Cholera

  The Victorian Plague

  • Amanda J Thomas(Author)
  • 2019(Publication Date)
  • Pen & Sword History

    (Publisher)

  CHAPTER 1

  An Ancient Disease:The history and epidemiology of cholera

  Before the discovery of antibiotics in the twentieth century, there was a general acceptance that an illness or infection might prove fatal. Epidemics of diseases such as typhoid fever, tuberculosis, measles, diphtheria and whooping cough were much feared, and despite the discovery of the smallpox vaccine at the end of the eighteenth century, its use was not widespread and many still died from the disease. Yet no single outbreak of any disease was seen in quite the same light as the Black Death of the fourteenth century, which was still vivid in the popular imagination during the nineteenth century.

  The prospect of another unknown foreign disease with the ability to ravage the entire population caused considerable unrest in 1820s Britain. Cholera too was seen as a pestilence, breaking out without warning, dispatching its victims painfully and at speed. In addition, just as the plague could be identified by characteristic swellings, or buboes, so cholera left its own deadly mark, rendering sufferers emaciated, with a blue tinge to their skin.

  Cholera is ancient in origin and is probably the dehydrating, diarrhoeal disease described in old Chinese and Hindu texts, and by writers such as Hippocrates and Caelius Aurelianus.1 The pathogenic strain of cholera regarded with most dread has been known by several names. These included spasmodic cholera, Asiatic cholera and cholera morbus, which was the term used in 1629 by the Dutch physician Bontius, to describe the outbreak in Jakarta, Indonesia:

  ‘Besides the diseases above treated of as endemic in this country, the Cholera Morbus is extremely frequent; in the Cholera, hot bilious matter, irritating the stomach and intestines, is incessantly, and copiously discharged by the mouth and anus. It is a disorder of the most acute kind, and therefore requires immediate application. The principal cause of it, next to a hot and moist disposition of the air, is an intemperate indulgence of eating fruits; which, as they are generally green, and obnoxious to putrefaction, irritate and oppress the stomach by their superfluous humidity, and produce an æruginous bile … those who are seized with this disorder generally die, and that so quickly, as in the space of twenty-four hours at most.’

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  Poverty and Sickness in Modern Europe

  Narratives of the Sick Poor, 1780-1938

  • Andreas Gestrich, Elizabeth Hurren, Steven King, Andreas Gestrich, Elizabeth Hurren, Steven King(Authors)
  • 2012(Publication Date)
  • Continuum

    (Publisher)

  5 Poverty and epidemics: Perceptions of the poor at times of Cholera in Germany and Spain, 1830s–1860s Beate Althammer Introduction

  ‘Asiatic’ cholera caused shockwaves when it first appeared on the European borders in the early 1830s. Originally this epidemic disease had only been known on the Indian subcontinent, and although it had begun to spread over large parts of Asia and the Near East in the early nineteenth century, European worries had not yet arisen. Europe, a fortress of progress and civilization, so many had believed, would not be affected by the nasty and dirty sickness from the swamps of Bengal. But when cholera broke out in Russian Poland and crossed to the eastern provinces of Prussia in 1831, public concern was enormous, even in regions much further to the west. Rumours were disseminated, public prayers held. Hundreds of books, pamphlets and newspaper articles were published on this new threat that frightened and at the same time fascinated the collective imagination. Cholera seemed to be not just another normal malady, but rather an approaching disaster, something like a new form of plague. It developed very fast and violently. The symptoms were drastic and revolting. Half of those falling sick died, often within hours. Authorities developed frantic countermeasures but were seemingly unable to stop the disease. For the medical profession it was a severe setback: none of the many propagated preventive and therapeutic remedies really helped, and – until after the bacteriological turn of the 1880s – no agreement could be achieved about causation or transmission.

  Historians have written extensively on cholera, but at least in German historiography – which has turned to the subject later than its British or French counterparts – the focus remains limited. Several studies have described the first outbreak in eastern Prussia in the summer of 1831, state policy to contain it and reactions of the population during the initial turbulent month of cholera-hysteria.1 Other studies have been devoted to the famous Hamburg epidemic of 1892, the last in Germany, during which perceptions and reactions were already strongly influenced by the new bacteriological paradigm.2 But very little attention has been paid to the period inbetween.3 Reflecting this lacunae, the picture of German, and especially Prussian, policies to control epidemic disease has been distorted. Drawing on Ackerknecht’s theory that there was an affinity between conservative regimes and contagionist disease control on the one hand, Liberal convictions and anti-contagionist explanations of epidemic disease on the other,4 Prussia is commonly presented as a classic example of poor public-health planning. Right up until the most recent contribution to German cholera history, the study of Olaf Briese,5

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  Disease in the History of Modern Latin America

  From Malaria to AIDS

  • Diego Armus(Author)
  • 2003(Publication Date)
  • Duke University Press Books

    (Publisher)

  Because of these reasons, the health expectations of the population changed after the cholera epidemic. Many Peruvians realized that taking care of the sick was an individual and family responsibility and expected less from the state. ∑∏ Notes 1 The interaction between medicine and politics in Cholera Epidemics is ana-lyzed in a number of remarkable historical works; see Charles E. Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866 (Chicago: Univer-sity of Chicago Press, 1962); Margaret Pelling, Cholera, Fever and English Medicine (Oxford: Oxford University Press, 1978); François Delaporte, Disease and Civilization: The Cholera in Paris, 1832 (Cambridge: MIT Press, 1986); Richard Evans, Hamburg: Death, Society and Politics in the Cholera Years, 1810–1910 (Oxford: Oxford University Press, 1987); Esteban Rodrí-guez Ocaña, El Cólera de 1834 en Granada: Enfermedad Catastrófica y Crisis Social (Granada: Universidad de Granada, 1983); David Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India (Berkeley: University of California Press, 1993). 2 The Pan American Health Organization reported 366,017 cases of cholera in 1991. Of these, 88 percent were from Peru; ‘‘Cholera Situation in the Amer-icas,’’ Epidemiological Bulletin of the Pan American Health Organization 12.1 (1991): 1–7. 3 Robert Tauxe, Luis Seminario, Roberto Tapia, and Mario Libel, ‘‘The Latin American Epidemics,’’ in I. Kaye Wachsmuth, Paul A. Blake, and Orjan Olsvik, eds., Vibrio cholerae and Cholera: Molecular to Global Perspectives (Wash-ington, D.C.: American Society of Microbiology, 1994), 321–44, on 324. 4 Robert V. Tauxe and Paul A. Blake, ‘‘Letter from Peru, Epidemic Cholera in Latin America,’’ Journal of the American Medical Association 267.10 (1992): 1388–90.

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  Duel Without End

  Mankind's Battle with Microbes

  • Stig S. Frøland, John Irons(Authors)
  • 2022(Publication Date)
  • Reaktion Books

    (Publisher)

  In the first phase of the pandemic a number of countries in East Asia were hit, but the disease also travelled westwards to India and the Middle East, and followed ‘old’ paths into the Soviet Union and from the Arabian Peninsula to East Africa. But now a number of countries in West Africa were also hard hit, via passengers arriving by air from Asia. Spain, Portugal and Italy were next in line.

  In 1991, thirty years after the pandemic had begun, the cholera bacterium struck with violent force in Latin America, first in Peru, but then spreading to several other countries. By the end of the year there were 391,000 cases in Latin America, equivalent to two thirds of all the cholera cases in the world.

  This latest pandemic also differed from earlier ones in that there was now far greater knowledge about cholera, particularly when it comes to prevention and treatment.126 We now know that simply administering a large amount of fluid has a striking effect on recovery from this intestinal infection. For that reason, the case fatality rate from cholera is now far lower, perhaps 2 or 3 per cent as against 50 per cent in earlier times. Even so, cholera has a firm stronghold in many places around the world outside India: it has become what is called endemic. More or less widespread local epidemics break out at regular intervals at various places in the world whenever the now well-known ecological and environmental factors are favourable.127 Examples are Haiti, where cholera broke out in 2010 after the destruction caused by the earthquake, and Yemen, which has an ongoing epidemic in the wake of the war there.

  Miasmas or contagion from person to person?

  When the cholera bacterium arrived in Europe and North America at the beginning of the nineteenth century, it came, so to speak, to a table ready laid. The sanitary conditions in the towns, which since the early Middle Ages had been extremely poor, became even worse during the Industrial Revolution.128

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  Epidemiology and Demography in Public Health

  • Japhet Killewo, Kristian Heggenhougen, Stella R. Quah(Authors)
  • 2010(Publication Date)
  • Academic Press

    (Publisher)

  Rather the opposite happened: In a discrediting confusing presentation, he made a number of enemies by accusing colleagues of indolence and negligence. Still, he had con-ducted an elegant experiment with convincing results, shedding light on the etiology of an important disease long before the dawn of the bacteriological era. Cholera, Right or Wrong To many epidemiologists, John Snow’s fight against chol-era represents the foundation of modern epidemiology (Sigerist, 1956; Natvig, 1964). Cholera is assumed to have been endemic in India in historic time, but was unknown in Europe until the nineteenth century when Europe was hit by a series of pandemics. The first started around 1830, causing an estimated 1.5 million deaths (Gotfredsen, 1964). To the population in Europe, this first wave of cholera demonstrated that the disease repre-sented a most serious threat to the community. However, knowledge of the etiology of the disease was scarce. Obviously, cholera was an epidemic disease, but whether it spread from person to person or was a result of miasma diffusing up from a contaminated ground, the ancient etiological concept, was uncertain. An apparent failure of quarantine to constitute an effective measure against the spread of the disease suggested the latter etiological mechanism. Thus, when the second pandemic hit, lasting from 1846 to 1861, no effective preventive measure existed. Europe remained unprepared, and the challenge to epidemiology and public health was enormous. In 1848, John Snow (1813–58) ( Figure 11 ) was working as a general Figure 10 I. Semmelweis (location unknown; source: www.dasErste.de). 10 History of Epidemiology practitioner in London when an epidemic of cholera occurred among his patients. In a publication of 1849, Snow presented his observations of the distribution of the disease according to time, place, age, gender, and occupation.

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  The Health of the Commonwealth

  A Brief History of Medicine, Public Health, and Disease in Pennsylvania

  • James E. Higgins(Author)
  • 2020(Publication Date)
  • Pennsylvania Historical Association

    (Publisher)

  Researchers suspect that cholera killed most of the workers, while a combination of anti-Irish/anti-Catholic sentiment and the terror of cholera spreading to families near the worksite doomed the others. Two other epidemics of cholera swept Pennsylvania in 1849 and 1866, and the years between epidemics rarely saw the state completely free of the disease. From a biomedical perspective, an outbreak in 1854 in the town of Lancaster provides a window into the changes occurring in medical thought with respect to disease causation, as well as the maturation of Pennsylvania medicine. When the Lancaster outbreak began in late summer, physicians from Philadelphia investigated the epidemic. It appeared clear to some of the investigators that the disease was brought to Lancaster from other places, for instance the town of Columbia, Pennsylvania, which experienced a violent outbreak of the disease mere weeks before the outbreak in Lancaster began, as well as Cleveland, Ohio, where members of a family in Lancaster jour-neyed to care for kin infected in that city’s 1854 epidemic. 5 It was, concluded some of the Philadelphia physicians who studied Lancaster’s travails, more likely that people infected others with cholera, rather than that the disease sprang spontaneously from rubbish in the streets or filth in the water. At exactly the same time Lancaster faced cholera, August and September 1854, Dr. John Snow undertook the study of an outbreak in London and traced its spread to a single pump on Broad Street. When he convinced au-thorities to remove the pump handle, the epidemic petered out. Snow’s meth-ods—compiling and tracking cases and deaths, as well as interrogating ac-cepted models of disease causation to gauge their accuracy—are recognized as major steps in epidemiology and in the transformation of thought regard-ing the cause and spread of infectious disease.

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