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.
Wayside cross (cholera cross), 1866, in Stolzembourg, north-eastern Luxembourg, to remember the cholera epidemic
Cholera was evidently a common enough fact of life in Luxembourg at one point for the witticism "Schnaps ass gudd géint d'Cholera" — "Liquor works well against cholera" — to enter common parlance.[1]
The outbreak of 1866 was the last in the country. The various instances of cholera in the 19th century left several physical reminders in Luxembourg in the form of chapels and wayside crosses, as a memorial to the many victims.
Origins
Originating from Asia, cholera entered Europe through the Caspian Sea or the Mediterranean, arriving either through France, with Marseille as the gateway, or through the German ports of the Baltic and the North Sea.[2]
Cholera outbreaks were doubly spectacular, both in terms of the number of victims and the suddenness of the attacks and their resolution. A person who was healthy one day could die of cholera the next. Recovery could be just as sudden, with the dying person suddenly regaining strength.[2]
The first cholera pandemic occurred in the Bengal region of India, near Calcutta (now Kolkata), starting in 1817 through 1824. The disease dispersed from India to Southeast Asia, the Middle East, Europe, and Eastern Africa through trade routes.[3] The second pandemic lasted from 1826 to 1837 and particularly affected North America and Europe, due to the result of advancements in transportation and global trade, and increased human migration, including soldiers.[4] The third pandemic erupted in 1846, persisted until 1860, extended to North Africa, and reached South America, for the first time specifically affecting Brazil. The fourth pandemic lasted from 1863 to 1875, and spread from India to Naples and Spain, and to the United States in 1873.
Outbreaks
The first appearance of cholera in Luxembourg was in August 1827, with victims mainly in the city of Luxembourg.[2]
1832
"The Cholera of Palermo of 1835" (lithograph), 1864
The second appearance was in 1832, spreading across Europe from Russia and Germany, causing about 20,000 deaths in Paris alone. The centre of the epidemic was in Luxembourg City, particularly the Grund quarter and the nearby communes of Eich and Hollerich, that is the areas with a poorer population. Outside the capital and its environs, there were 29 deaths in Habay-la-Neuve, 8 in Remich and 7 in Dudelange.[2]
1849
The third epidemic occurred in 1849, with less virulence, mainly affecting the Moselle region, Echternach, and for unknown reasons, the village of Crauthem.[2]
1854
The year 1854, marked by famine, was also afflicted by cholera originating from Denmark and Northern Germany. Cases first appeared in August in Bertrange, followed by 70 deaths in Bissen. Arlon was particularly affected, with 138 victims in a population of 5,000. The epidemic ended in October.[2]
Similar to the 1832 epidemic in Luxembourg, the poorest neighborhoods of Arlon, around Hetschegas, with narrow and not always well cleaned streets, were the epicenter of the disease.[2]
The origin of cholera was unknown, but a sophisticated name was given to the unknown: the "deleterious miasma". Various remedies were suggested, including juniper cure, intensive tobacco use among military personnel, and large fires in the streets and fumigations in rooms, all to combat "the miasma." When cholera devastated Bavaria in 1854, the priest Sébastien Kneip, renowned for fresh water cures, also recommended them against cholera, apparently with success. While fresh water applications did not harm the cholera vibrio, at least fresh water, or bodily cleanliness, reduced the risk of infection.[2]
1865-1866
Gravestone of schoolteacher Franz Kneip, passed away 7 July 1866 of cholera in Hosingen, northern Luxembourg
The next outbreak occurred in 1865-1866.
Beginning
The first epidemic broke out in Mamer on 5 November 1865, and also shortly thereafter in Clemency.[5] From then on, its progress was marked by macabre highpoints: it raged relentlessly in Eich, and the fortress of Luxembourg, as well as the small village of Gilsdorf.[5] In Echternach, the second-biggest city of the country at the time, 100 people died of cholera within 2 months.[5] Diekirch broke records, with 31 cholera deaths in one single day, and 252 during the epidemic.[5]
In late April 1866, hopes were arising that the epidemic was fading away.[5]
Second phase
These cautious hopes came to an end in June, when the epidemic started its second offensive. Wiltz, in the hitherto unharmed Oesling region, was now overwhelmed.[6] It also spread like wildfire in the Moselle region. No community there was spared, with the most casualties in the town of Remich and the villages of Gostingen and Remerschen.[6] Similarly, the cholera epidemic returned with a vengeance in Luxembourg city and its neighbouring areas. Esch, which had previously escaped major misfortune, saw many deaths.[6]
End and aftermath
Memorial to 105 victims of cholera in 1866 in Remerschen, south-eastern Luxembourg
By November 1866, the grim episode was coming to an end, and by December it was definitely eradicated.[6] Within a year, the disease had taken the lives of 3,500 Luxembourgers,[6] about 1,8% of the population at the time.[7] The total number of infected was around 8,000-10,000.[6]
This outbreak left many chapels in the countryside as a testament to the disaster.[2] Another relic was the Cholerasbrak, ("cholera shacks") which existed around 1900 on the Glacis of Luxembourg to serve as an isolation site.[2] This was at the end of the Boulevard Emmanuel Servais, where the modern extensions of the Lycée Robert Schuman are now located; these were quarantine "shacks", erected in 1866, to shelter and isolate the cholera-infected a short distance away from the city; luckily they never had to be put to use for this purpose.[8] Nor did the Villa Amberg, in the Municipal Park, which had similarly been turned into an isolation house in case of need.[9]
After 1866
The epidemic of 1866 was the last in the country.[2] Although its nature was still unknown, cholera now retreated in the face of progress in hygiene through bodily cleanliness and the construction of sewers and water pipes.[2]
Finally, in 1883, Robert Koch isolated the cholera vibrio. It was revealed that the germs were found in the vomit and feces of the sick. Infection occurred either directly, especially through the soiled hands of doctors, nurses, and laundresses, or indirectly through the use of water contaminated by the excretions of cholera patients. Until then, precautions had been focused on the corpses of cholera victims, which had to be buried immediately and in tar-coated coffins.[2]
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.
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 or drinking contaminated water.
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.
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.
Sir Joseph William Bazalgette CB was a British civil engineer. As Chief Engineer of London's Metropolitan Board of Works, his major achievement was the creation of a sewerage system for central London which was instrumental in relieving the city of cholera epidemics, while beginning to clean the River Thames. He later designed Hammersmith Bridge.
Filippo Pacini was an Italian anatomist, posthumously famous for isolating the cholera bacterium Vibrio cholerae in 1854, well before Robert Koch's more widely accepted discoveries 30 years later.
Forêts was a department of the French First Republic, and later the First French Empire, in present-day Belgium, Luxembourg, and Germany. Its name, meaning 'forests', comes from the Ardennes forests. It was formed on 24 October 1795, after the Austrian Netherlands had been annexed by France on 1 October. Before annexation, the territory was part of the Duchy of Luxembourg and small parts of the Duchy of Bouillon. Its capital was Luxembourg City.
Henry Whitehead was a Church of England priest and the assistant curate of St Luke's Church in Soho, London, during the 1854 cholera outbreak.
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 many British soldiers, 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, more quickly, than any other epidemic disease in the 19th 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 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. 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 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.
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.
Nicolas Adames was the first Bishop of Luxembourg.
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 1832 Sligo cholera outbreak was a severe outbreak of cholera in the port town of Sligo in northwestern Ireland.
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 Notre-Dame Cemetery in Luxembourgish more commonly the Nikloskierfecht, or "St. Nicholas Graveyard", is located in the Limpertsberg quarter of Luxembourg City. It is the largest of the 14 cemeteries and graveyards managed by the Service Cimetières of the City of Luxembourg.
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