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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 that lasts 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.
Vibrio cholerae is a species of Gram-negative, facultative anaerobe and comma-shaped bacteria. The bacteria naturally live in brackish or saltwater where they attach themselves easily to the chitin-containing shells of crabs, shrimp, and other shellfish. Some strains of V. cholerae are pathogenic to humans and cause a deadly disease called cholera, which can be derived from the consumption of undercooked or raw marine life species.
El Tor is a particular strain of the bacterium Vibrio cholerae, the causative agent of cholera. Also known as V. cholerae biotype eltor, it has been the dominant strain in the seventh global cholera pandemic. It is distinguished from the classic strain at a genetic level, although both are in the serogroup O1 and both contain Inaba, Ogawa and Hikojima serotypes. It is also distinguished from classic biotypes by the production of hemolysins.
Vibrio is a genus of Gram-negative bacteria, possessing a curved-rod (comma) shape, several species of which can cause foodborne infection, usually associated with eating undercooked seafood. Being highly salt tolerant and unable to survive in fresh water, Vibrio spp. are commonly found in various salt water environments. Vibrio spp. are facultative anaerobes that test positive for oxidase and do not form spores. All members of the genus are motile. They are able to have polar or lateral flagellum with or without sheaths. Vibrio species typically possess two chromosomes, which is unusual for bacteria. Each chromosome has a distinct and independent origin of replication, and are conserved together over time in the genus. Recent phylogenies have been constructed based on a suite of genes.
In infectious disease ecology and epidemiology, a natural reservoir, also known as a disease reservoir or a reservoir of infection, is the population of organisms or the specific environment in which an infectious pathogen naturally lives and reproduces, or upon which the pathogen primarily depends for its survival. A reservoir is usually a living host of a certain species, such as an animal or a plant, inside of which a pathogen survives, often without causing disease for the reservoir itself. By some definitions a reservoir may also be an environment external to an organism, such as a volume of contaminated air or water.
Vibrio parahaemolyticus (V. parahaemolyticus) is a curved, rod-shaped, Gram-negative bacterium found in the sea and in estuaries which, when ingested, may cause gastrointestinal illness in humans. V. parahaemolyticus is oxidase positive, facultatively aerobic, and does not form spores. Like other members of the genus Vibrio, this species is motile, with a single, polar flagellum.
Exogenous bacteria are microorganisms introduced to closed biological systems from the external world. They exist in aquatic and terrestrial environments, as well as the atmosphere. Microorganisms in the external environment have existed on Earth for 3.5 billion years. Exogenous bacteria can be either benign or pathogenic. Pathogenic exogenous bacteria can enter a closed biological system and cause disease such as Cholera, which is induced by a waterborne microbe that infects the human intestine. Exogenous bacteria can be introduced into a closed ecosystem as well, and have mutualistic benefits for both the microbe and the host. A prominent example of this concept is bacterial flora, which consists of exogenous bacteria ingested and endogenously colonized during the early stages of life. Bacteria that are part of normal internal ecosystems, also known as bacterial flora, are called Endogenous Bacteria. A significant amount of prominent diseases are induced by exogenous bacteria such as gonorrhea, meningitis, tetanus, and syphilis. Pathogenic exogenous bacteria can enter a host via cutaneous transmission, inhalation, and consumption.
The discovery of disease-causing pathogens is an important activity in the field of medical science. Many viruses, bacteria, protozoa, fungi, helminthes and prions are identified as a confirmed or potential pathogen. In the United States, a Centers for Disease Control program, begun in 1995, identified over a hundred patients with life-threatening illnesses that were considered to be of an infectious cause, but that could not be linked to a known pathogen. The association of pathogens with disease can be a complex and controversial process, in some cases requiring decades or even centuries to achieve.
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 fourth cholera pandemic of the 19th century began in the Ganges Delta of the Bengal region and traveled with Muslim pilgrims to Mecca. In its first year, the epidemic claimed 30,000 of 90,000 pilgrims. Cholera spread throughout the Middle East and was carried to the Russian Empire, Europe, Africa, and North America, in each case spreading via travelers from port cities and along inland waterways.
The fifth cholera pandemic (1881–1896) was the fifth major international outbreak of cholera in the 19th century. It spread throughout Asia and Africa, and reached parts of France, Germany, Russia, and South America. It claimed 200,000 lives in Russia between 1893 and 1894; and 90,000 in Japan between 1887 and 1889. The 1892 outbreak in Hamburg, Germany was the biggest European outbreak; about 8,600 people died in that city. Although many residents held the city government responsible for the virulence of the epidemic, it continued with practices largely unchanged. This was the last serious European cholera outbreak of the century.
The seventh cholera pandemic is the seventh major outbreak of cholera and occurred principally from the years 1961 to 1975, but the strain involved persists to the present. WHO and some other authorities believe this should be considered as an ongoing pandemic. As stated in its cholera factsheet dated 30 March 2022, the World Health Organization (WHO) continues to define this outbreak as a current pandemic, and with cholera having become endemic in many countries. In 2017, WHO announced a global strategy aiming to end this pandemic by 2030.
The Waterborne Disease and Outbreak Surveillance System (WBDOSS) is a national surveillance system maintained by the U.S. Centers for Disease Control and Prevention (CDC). The WBDOSS receives data about waterborne disease outbreaks and single cases of waterborne diseases of public health importance in the United States and then disseminates information about these diseases, outbreaks, and their causes. WBDOSS was initiated in 1971 by CDC, the Council of State and Territorial Epidemiologists (CSTE), and the Environmental Protection Agency (EPA). Data are reported by public health departments in individual states, territories, and the Freely Associated States. Although initially designed to collect data about drinking water outbreaks in the United States, WBDOSS now includes outbreaks associated with recreational water, as well as outbreaks associated with water that is not intended for drinking (non-recreational) and water for which the intended use is unknown.
The 2010s Haiti cholera outbreak was the first modern large-scale outbreak of cholera—a disease once considered beaten back largely due to the invention of modern sanitation. The disease was reintroduced to Haiti in October 2010, not long after the disastrous earthquake earlier that year, and since then cholera has spread across the country and become endemic, causing high levels of both morbidity and mortality. Nearly 800,000 Haitians have been infected by cholera, and more than 9,000 have died, according to the United Nations (UN). Cholera transmission in Haiti today is largely a function of eradication efforts including WASH, education, oral vaccination, and climate variability. Early efforts were made to cover up the source of the epidemic, but thanks largely to the investigations of journalist Jonathan M. Katz and epidemiologist Renaud Piarroux, it is widely believed to be the result of contamination by infected United Nations peacekeepers deployed from Nepal. In terms of total infections, the outbreak has since been surpassed by the war-fueled 2016–2021 Yemen cholera outbreak, although the Haiti outbreak is still one of the most deadly modern outbreaks. After a three-year hiatus, new cholera cases reappeared in October 2022.
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.
Shah Mohammad Faruque is a professor in the School of Environment and Life Sciences at Independent University Bangladesh (IUB). He is widely recognized for his research in Vibrio cholerae, the bacterium which causes the epidemic diarrhoeal disease Cholera. Among other positions, previously he was a professor at BRAC University; director of the Genomics Centre at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), and formerly director of the Centre for Food and Water Borne Diseases in ICDDR,B. His areas of research interest include microbial genomics, bacteriophages, environmental microbiology, ecology, and evolution of bacterial pathogens, particularly those associated with waterborne and foodborne diseases. Faruque is primarily known for his work in genomics, epidemiology and ecology of the cholera pathogen, and its bacteriophages.
A cholera epidemic began in Nashville, Tennessee, in January 1849 and caused many deaths in the city in 1849 and 1850.
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 third plague pandemic emerged in China in the mid-nineteenth century and spread worldwide in the 1890s.
An outbreak of cholera began in Yemen in October 2016. The outbreak peaked in 2017 with over 2,000 reported deaths in that year alone. In 2017 and 2019, war-torn Yemen accounted for 84% and 93% of all cholera cases in the world, with children constituting the majority of reported cases. As of November 2021, there have been more than 2.5 million cases reported, and more than 4,000 people have died in the Yemen cholera outbreak, which the United Nations deemed the worst humanitarian crisis in the world at that time. However, the outbreak has substantially decreased by 2021, with a successful vaccination program implemented and only 5,676 suspected cases with two deaths reported between January 1 and March 6 of 2021.
In October 2022, an outbreak of cholera began in Lebanon. It is likely the result of a serious outbreak in neighboring Syria, which is itself traced back to contaminated water in the Euphrates.
References
- ↑ "Person who died in Kentucky during the 1833 Cholera Epidemic". www.usgennet.org. Retrieved 2018-11-20.
- 1 2 "General Information | Cholera | CDC". www.cdc.gov. 2018-05-11. Retrieved 2018-11-20.
- ↑ Pyle, G. F. (2010-09-03). "The Diffusion of Cholera in the United States in the Nineteenth Century". Geographical Analysis. 1 (1): 59–75. doi: 10.1111/j.1538-4632.1969.tb00605.x . ISSN 0016-7363. PMID 11614509.