Cholera Outbreaks

Recounts the history and effects of cholera outbreaks, describes how the disease spreads, and offers information about treatments and threats in the modern world.

This book combines evidence from natural and social sciences to examine the impact on Africa of seven cholera pandemics since 1817, particularly the current impact of cholera on such major countries as Senegal, Angola, Mozambique, Congo, Zimbabwe and South Africa. Myron Echenberg highlights the irony that this once-terrible scourge, having receded from most of the globe, now kills thousands of Africans annually - Africa now accounts for more than 90 percent of the world's cases and deaths - and leaves many more with severe developmental impairment. Responsibility for the suffering caused is shared by Western lending and health institutions and by often venal and incompetent African leadership. If the threat of this old scourge is addressed with more urgency, great progress in the public health of Africans can be achieved.

Reveals how the crisis of Zimbabwe's cholera outbreak of 2008-9 had profound implications for political institutions and citizenship.

The most feared attribute of the human pathogen Vibrio cholerae is its ability to cause outbreaks that spread like wildfire, completely overwhelming public health systems and causing widespread suffering and death. This volume starts with a description of the contrasting patterns of outbreaks caused by the classical and El Tor biotypes of V. cholerae. Subsequent chapters examine cholera outbreaks in detail, including possible sources of infection and molecular epidemiology on three different continents, the emergence of new clones through the bactericidal selection process of lytic cholera phages, the circulation and transmission of clones of the pathogen during outbreaks and novel approaches to modeling cholera outbreaks. A further contribution deals with the application of the genomic sciences to trace the spread of cholera epidemics and how this information can be used to control cholera outbreaks. The book closes with an analysis of the potential use of killed oral cholera vaccines to stop the spread of cholera outbreaks.

Throughout the nineteenth century, cholera was a global scourge against human populations. Practitioners had little success in mitigating the symptoms of the disease, and its causes were bitterly disputed. What experts did agree on was that the environment played a crucial role in the sites where outbreaks occurred. In this book, Michael Zeheter offers a probing case study of the environmental changes made to fight cholera in two markedly different British colonies: Madras in India and Quebec City in Canada. The colonial state in Quebec aimed to emulate British precedent and develop similar institutions that allowed authorities to prevent cholera by imposing quarantines and controlling the disease through comprehensive change to the urban environment and sanitary improvements. In Madras, however, the provincial government sought to exploit the colony for profit and was reluctant to commit its resources to measures against cholera that would alienate the city's inhabitants. It was only in 1857, after concern rose in Britain over the health of its troops in India, that a civilizing mission of sanitary improvement was begun. As Zeheter shows, complex political and economic factors came to bear on the reshaping of each colony's environment and the urgency placed on disease control.

In October 2010, nine months after the massive earthquake that devastated Haiti, a second disaster began to unfold—soon to become the world's largest cholera epidemic in modern times. In a country that had never before reported cholera, the epidemic mysteriously and simultaneously appeared in river communities of central Haiti, eventually triggering nearly 800,000 cases and 9,000 deaths. What had caused the first cases of cholera in Haiti in recorded history? Who or what was the deadly agent of origin? Why did it explode in the agricultural-rich delta of the Artibonite River? When answers were few, rumors spread, causing social and political consequences of their own. Wanting insight, the Haitian government and French embassy requested epidemiological assistance from France. A few weeks into the epidemic, physician and infectious disease specialist Renaud Piarroux arrived in Haiti.In Deadly River, Ralph R. Frerichs tells the story of the epidemic—of a French disease detective determined to trace its origins so that he could help contain the spread and possibly eliminate the disease—and the political intrigue that has made that effort so difficult. The story involves political maneuvering by powerful organizations such as the United Nations and its peacekeeping troops in Haiti, as well as by the World Health Organization and the U.S. Centers for Disease Control. Frerichs explores a quest for scientific truth and dissects a scientific disagreement involving world-renowned cholera experts who find themselves embroiled in intellectual and political turmoil in a poverty-stricken country.Frerichs's narrative highlights how the world’s wealthy nations, nongovernmental agencies, and international institutions respond when their interests clash with the needs of the world’s most vulnerable people. The story poses big social questions and offers insights not only on how to eliminate cholera in Haiti but also how nations, NGOs, and international organizations such as the UN and CDC deal with catastrophic infectious disease epidemics.

In seven major cholera pandemics beginning in 1817, the "King of Terrors" has claimed hundreds of thousands of lives. The deadly effects of the so-called "disease of filth" spared no one, no matter their station in life--and today cholera is more prevalent than at any time throughout history. This book traces the history of the disease and the experience of those who suffered its ravages, using their own words from hundreds of newspapers and letters whenever possible. In so doing, the speculations, missteps, sidetracks and prevailing fears are emphasized. The authors describe the agonizingly slow march of progress toward discovering the causes and the treatment of symptoms. Along the way, the heroes of past and present are introduced: men and women who fought for their beliefs--at times against vitriolic and powerful opponents, including the medical authorities of their day.

During the mid- to late 19th century, Detroit and the American Midwest were the sites of five major cholera epidemics. The first of these, the 1832 outbreak, was of particular significance--an unexpected consequence of the Black Hawk War. In order to suppress the Native American uprising then taking place in regions around present-day Illinois, General Winfield Scott had been ordered by President Andrew Jackson to transport his troops from Virginia to the Midwest. While passing through New York State the men were exposed to cholera, transmitting the disease to the population of Detroit once they reached that city. As a result, cholera was established as an endemic disease in the upper Midwest. Further outbreaks took place in 1834, 1849, 1854 and 1866, ultimately resulting in the deaths of hundreds of individuals. This book is the story of those outbreaks and the efforts to control them.