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.
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. Quarantine considerations are often one aspect of border control.
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, 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 even non-living 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, in part because of his work in tracing the source of a cholera outbreak in Soho, London, in 1854, which he curtailed by removing the handle of a water pump. Snow's findings inspired the adoption of anaesthesia as well as 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 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. 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 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 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 Mashonaland East 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.
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.
