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 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 germ theory of disease is the currently accepted scientific theory for many diseases. It states that microorganisms known as pathogens or "germs" can cause disease. These small organisms, which are too small to be seen without magnification, invade humans, other animals, and other living hosts. Their growth and reproduction within their hosts can cause disease. "Germ" refers to not just a bacterium but to any type of microorganism, such as protists or fungi, or other pathogens that can cause disease, such as viruses, prions, or viroids. Diseases caused by pathogens are called infectious diseases. Even when a pathogen is the principal cause of a disease, environmental and hereditary factors often influence the severity of the disease, and whether a potential host individual becomes infected when exposed to the pathogen. Pathogens are disease-carrying agents that can pass from one individual to another, both in humans and animals. Infectious diseases are caused by biological agents such as pathogenic microorganisms as well as parasites.
John Snow was an English physician and a leader in the development of anaesthesia and medical hygiene. He is considered one of the founders of modern epidemiology and early germ theory, in part because of his work in tracing the source of a cholera outbreak in London's Soho, which he identified as a particular public water pump. Snow's findings inspired fundamental changes in the water and waste systems of London, which led to similar changes in other cities, and a significant improvement in general public health around the world.
The Epidemic Intelligence Service (EIS) is a program of the United States' Centers for Disease Control and Prevention (CDC). The modern EIS is a two-year, hands-on post-doctoral training program in epidemiology, with a focus on field work.
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 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 2008 Zimbabwean cholera outbreak was an epidemic of cholera affecting much of Zimbabwe from August 2008 until June 2009. The outbreak began in Chitungwiza in Harare Metropolitan Province in August 2008, then spread throughout the country so that by December 2008, cases were being reported in all 10 provinces. In December 2008, The Zimbabwean government declared the outbreak a national emergency and requested international aid. The outbreak peaked in January 2009 with 8,500 cases reported per week. Cholera cases from this outbreak were also reported in neighboring countries South Africa, Malawi, Botswana, Mozambique, and Zambia. With the help of international agencies, the outbreak was controlled, and by July 2009, after no cases had been reported for several weeks, the Zimbabwe Ministry of Health and Child Welfare declared the outbreak over. In total, 98,596 cases of cholera and 4,369 deaths were reported, making this the largest outbreak of cholera ever recorded in Zimbabwe. The large scale and severity of the outbreak has been attributed to poor sanitation, limited access to healthcare, and insufficient healthcare infrastructure throughout Zimbabwe.
Although a variety of infectious diseases existed in the Americas in pre-Columbian times, the limited size of the populations, smaller number of domesticated animals with zoonotic diseases, and limited interactions between those populations hampered the transmission of communicable diseases. One notable infectious disease that may be of American origin is syphilis. Aside from that, most of the major infectious diseases known today originated in the Old World. The American era of limited infectious disease ended with the arrival of Europeans in the Americas and the Columbian exchange of microorganisms, including those that cause human diseases. European infections and epidemics had major effects on Native American life in the colonial period and nineteenth century, especially.
Cholera Hospital was established on June 24, 1854, at Franklin Street in New York City. The institution was built to treat cholera patients who were denied admittance to City Hospital in Manhattan during an onset of the disease in the summer of 1854. The Mayor of New York, Jacob Westervelt, and the New York City Commissioners, took control of the building at 105 Franklin Street in anticipation of an eminent cholera epidemic. A few weeks afterward a second hospital for cholera patients was opened at a schoolhouse on Mott Street in Manhattan. A book published by a New York physician in 1835 shows that a hospital called the Duane-Street Cholera Hospital existed in New York as early as 1835, but the relationship between the Duane Street hospital and the Cholera Hospital at Franklin Street is unclear.
Cefn Golau is a disused cholera cemetery situated on a narrow mountain ridge in the county borough of Blaenau Gwent, and located between Rhymney and Tredegar in south-east Wales. A suburb of Tredegar and a nearby feeder reservoir have the same name. The graves date from 1832 to 1855 with many for August and September 1849.
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.
As of 24 September 2012, a cholera outbreak in Sierra Leone had caused the deaths of 392 people. It was the country's largest outbreak of cholera since first reported in 1970 and the deadliest since the 1994–1995 cholera outbreak. The outbreak has also affected Guinea, which shares a reservoir near the coast. This was the largest cholera outbreak in Africa in 2012.
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.
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.
The Epidemic Diseases Act, 1897 is a law which was first enacted to tackle bubonic plague in Mumbai in former British India. The law is meant for containment of epidemics by providing special powers that are required for the implementation of containment measures to control the spread of the disease.
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.
