EPIDEMIOLOGY OF CHOLERA



The word cholera is from Greek: cholera from khole “bile”. Cholera likely has its origins in the Indian subcontinent: it has been prevalent in the Ganges dealt since ancient times. The disease first spread by trade routes (land and sea) to Russia in 1817, then to Western Europe, and from Europe to North America. Seven cholera pandemics have occurred in the past 200 years, with the seventh originating in Indonesia in 1961.

       Cholera affects an estimated 3-5 million people world wide. It causes 100,000-130,000 deaths annual 92010 report). In the 1980’s death rates were believed to be greater than 3 million because most cases were not reported due to the negative effect in will have on the tourism industry of the country.
            Cholera is both epidemic and endemic in may areas of the world. Cholera likely has its origin the Indo-Pakistan subcontinent. Its prevalence is more around the deltas of Ganges and Brehmaputra rivers. There has been seven cholera pandemic in the past 200 years. The fist one was in Bengal region of India in 1817-1824 while the last one was in Indonesia in 1961 and it spread through the whole of Africa into the Mediterranean, Europe and even to the gulf coast of the USA.
            A particular strain the EI Tor type has been proved capable of speedy and extensive spread over much wider areas than the classical type. The EI Tor strain displaced the classical strain. In Calcuta in 1964, there was only one case of classical cholera for every 10 or more cases of the EI Tor cholera. This is due to the elimination of the classical strain by the EI Tor strain within a few hours both in vitro and in vivo.
            Cholera epidemic occurs in refugee camps and elsewhere in Africa. The massive migration of Rwandan Hutus refugees to Zaire resulted in massive cholera outbreak in 1994, 30,000 people were involved with crude mortality rates of 19.5-31.2 per 10,000.
            Cholera rose from a local disease to become of the most fatal ailments of the 19th century killing millions of people. More than one million people died in Russia between 1847 and 1851; 150,000 Americans died during the second pandemic between 1900- 1920; and up to 8 million people died in India. Cholera was the first reportable disease in the United States. In England, John snow was the first to identify the importance of contaminated water in its cause in 1854. an Epidemic of cholera  subsided after the handle of suspected contaminated well was removed.
            After the 2010 earthquake, an outbreak swept over Haiti. The number of deaths have been difficult to verify due to the fact that most people do not have enough money to go to the hospital and are dying at home. An estimated 470,000 cases of this infection has been reported in this third world country. After one year, this marks the worst cholera outbreak in recent history, as well as the best documented cholera outbreak in modern public health. Famous people believed to have died of cholera include:

·                    Charles X, King of France (d. 1836)
·                    James K. Polk, eleventh president of the United States (d. 1831
Carl von Clausewitz, Prussian soldier and German military theorist (d. 1831)         
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