Cholera is an infection of the small intestine by some strains of the bacterium Vibrio cholerae. Symptoms may range from none, to mild, to severe. The classic symptom is large amounts of watery diarrhea lasting a few days. Vomiting and muscle cramps may also occur. Diarrhea can be so severe that it leads within hours to severe dehydration and electrolyte imbalance. This may result in sunken eyes, cold skin, decreased skin elasticity, and wrinkling of the hands and feet. Dehydration can cause the skin to turn bluish. Symptoms start two hours to five days after exposure.
A pandemic is an epidemic of an infectious disease that has a sudden increase in cases and spreads across a large region, for instance multiple continents or worldwide, affecting a substantial number of individuals. Widespread endemic diseases with a stable number of infected individuals such as recurrences of seasonal influenza are generally excluded as they occur simultaneously in large regions of the globe rather than being spread worldwide.
A quarantine is a restriction on the movement of people, animals, and goods which is intended to prevent the spread of disease or pests. It is often used in connection to disease and illness, preventing the movement of those who may have been exposed to a communicable disease, yet do not have a confirmed medical diagnosis. It is distinct from medical isolation, in which those confirmed to be infected with a communicable disease are isolated from the healthy population.
An epidemic is the rapid spread of disease to a large number of hosts in a given population within a short period of time. For example, in meningococcal infections, an attack rate in excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic.
The miasma theory is an abandoned medical theory that held that diseases—such as cholera, chlamydia, or the Black Death—were caused by a miasma, a noxious form of "bad air", also known as night air. The theory held that epidemics were caused by miasma, emanating from rotting organic matter. Though miasma theory is typically associated with the spread of contagious diseases, some academics in the early nineteenth century suggested that the theory extended to other conditions as well, e.g. one could become obese by inhaling the odor of food.
The Chicago 1885 cholera epidemic myth is a persistent urban legend, stating that 90,000 people in Chicago died of typhoid fever and cholera in 1885. Although the story is widely reported, these deaths did not occur.
Globalization, the flow of information, goods, capital, and people across political and geographic boundaries, allows infectious diseases to rapidly spread around the world, while also allowing the alleviation of factors such as hunger and poverty, which are key determinants of global health. The spread of diseases across wide geographic scales has increased through history. Early diseases that spread from Asia to Europe were bubonic plague, influenza of various types, and similar infectious diseases.
The first cholera pandemic (1817–1824), also known as the first Asiatic cholera pandemic or Asiatic cholera, began near the city of Calcutta and spread throughout South Asia and Southeast Asia to the Middle East, Eastern Africa and the Mediterranean coast. While cholera had spread across India many times previously, this outbreak went further; it reached as far as China and the Mediterranean Sea before subsiding. Millions of people died as a result of this pandemic, including approximately 10,000 troops in British service, which attracted European attention. This was the first of several cholera pandemics to sweep through Asia and Europe during the 19th and 20th centuries. This first pandemic spread over an unprecedented range of territory, affecting almost every country in Asia.
The second cholera pandemic (1826–1837), also known as the Asiatic cholera pandemic, was a cholera pandemic that reached from India across Western Asia to Europe, Great Britain, and the Americas, as well as east to China and Japan. Cholera caused more deaths than any other epidemic disease in the 19th century, and as such, researchers consider it a defining epidemic disease of the century. The medical community now believes cholera to be exclusively a human disease, spread through many means of travel during the time, and transmitted through warm fecal-contaminated river waters and contaminated foods. During the second pandemic, the scientific community varied in its beliefs about the causes of cholera.
The third cholera pandemic (1846–1860) was the third major outbreak of cholera originating in India in the 19th century that reached far beyond its borders, which researchers at University of California, Los Angeles (UCLA) believe may have started as early as 1837 and lasted until 1863. In the Russian Empire, more than one million people died of cholera. In 1853–1854, the epidemic in London claimed over 10,000 lives, and there were 23,000 deaths for all of Great Britain. This pandemic was considered to have the highest fatalities of the 19th-century epidemics.
The fifth cholera pandemic (1881–1896) was the fifth major international outbreak of cholera in the 19th century. The endemic origin of the pandemic, as had its predecessors, was in the Ganges Delta in West Bengal. While the Vibrio cholerae bacteria had not been able to spread to western Europe until the 19th century, faster and improved modes of modern transportation, such as steamships and railways, reduced the duration of the journey considerably and facilitated the transmission of cholera and other infectious diseases. During the fourth 1863–1875 cholera pandemic, the third International Sanitary Conference convened in 1866 in Constantinople had identified religious pilgrimages to be "the most powerful of all causes" of cholera and again Hindu and Muslim pilgrimages were an important factor in the spread of the disease.
The seventh cholera pandemic is the seventh major outbreak of cholera beginning in 1961 and continuing to the present. Cholera has become endemic in many countries. In 2017, WHO announced a global strategy aiming to end the pandemic by 2030.
The Broad Street cholera outbreak was a severe outbreak of cholera that occurred in 1854 near Broad Street in Soho, London, England, and occurred during the 1846–1860 cholera pandemic happening worldwide. This outbreak, which killed 616 people, is best known for the physician John Snow's study of its causes and his hypothesis that germ-contaminated water was the source of cholera, rather than particles in the air. This discovery came to influence public health and the construction of improved sanitation facilities beginning in the mid-19th century. Later, the term "focus of infection" started to be used to describe sites, such as the Broad Street pump, in which conditions are favourable for transmission of an infection. Snow's endeavour to find the cause of the transmission of cholera caused him to unknowingly create a double-blind experiment.
The history of Native American disease and epidemics is fundamentally composed of two elements: indigenous diseases and those brought by settlers to the Americas from the Old World.
Seven cholera pandemics have occurred in the past 200 years, with the first pandemic originating in India in 1817. The seventh cholera pandemic is officially a current pandemic and has been ongoing since 1961, according to a World Health Organization factsheet in March 2022. Additionally, there have been many documented major local cholera outbreaks, such as a 1991–1994 outbreak in South America and, more recently, the 2016–2021 Yemen cholera outbreak.
The second plague pandemic was a major series of epidemics of plague that started with the Black Death, which reached medieval Europe in 1346 and killed up to half of the population of Eurasia in the next four years. It followed the first plague pandemic that began in the 6th century with the Plague of Justinian, but had ended in the 8th century. Although the plague died out in most places after 1353, it became endemic and recurred regularly. A series of major epidemics occurred in the late 17th century, and the disease recurred in some places until the late 18th century or the early 19th century. After this, a new strain of the bacterium gave rise to the third plague pandemic, which started in Asia around the mid-19th century.
Diseases and epidemics of the 19th century included long-standing epidemic threats such as smallpox, typhus, yellow fever, and scarlet fever. In addition, cholera emerged as an epidemic threat and spread worldwide in six pandemics in the nineteenth century.
The cholera epidemics in Spain were a series of morbid cholera outbreaks that occurred from the first third of the 19th century until the end of the same century in the large cities of Spain. In total, some 800,000 people died during the four pandemics that occurred in Spain during that century. However, cholera was one of several contagious diseases that struck the country. Suffice it to say that the Spanish population in 1800 was 11.5 million people and was characterized by a high birth and death rate. The successive pandemics that the country suffered caused an economic recession, as well as an opportunity for profound change in health and hygiene in Spain. It was not free of controversy, both for the use of the vaccines created by Jaime Ferrán y Clúa and for the ways of combating the disease, as well as for the policies used to deal with it. It is worth mentioning that the terror caused in the population, due to the deaths caused, was the cause of popular revolts and social instability.
The first major cholera outbreak in Luxembourg was in 1827, with further outbreaks in 1832, 1849, 1854 and 1865. Due to population growth, poverty and poor hygiene conditions, outbreaks were relatively frequent in Luxembourg in the 19th century.
