Cholera
Cholera | |
---|---|
Other names | Asiatic cholera, epidemic cholera |
Prognosis | Less than 1% mortality rate with proper treatment, untreated mortality rate 50–60% |
Frequency | 3–5 million people a year[2] |
Deaths | 28,800 (2015)[7] |
Cholera (
Cholera is caused by a number of
Prevention methods against cholera include improved sanitation and access to
The primary treatment for affected individuals is
Cholera continues to affect an estimated 3–5 million people worldwide and causes 28,800–130,000 deaths a year.
Signs and symptoms
The primary symptoms of cholera are profuse diarrhea and vomiting of clear fluid.[17] These symptoms usually start suddenly, half a day to five days after ingestion of the bacteria.[18] The diarrhea is frequently described as "rice water" in nature and may have a fishy odor.[17] An untreated person with cholera may produce 10 to 20 litres (3 to 5 US gal) of diarrhea a day.[17] Severe cholera, without treatment, kills about half of affected individuals.[17] If the severe diarrhea is not treated, it can result in life-threatening dehydration and electrolyte imbalances.[17] Estimates of the ratio of asymptomatic to symptomatic infections have ranged from 3 to 100.[19] Cholera has been nicknamed the "blue death"[20] because a person's skin may turn bluish-gray from extreme loss of fluids.[21]
Fever is rare and should raise suspicion for secondary infection. Patients can be lethargic and might have sunken eyes, dry mouth, cold clammy skin, or wrinkled hands and feet.
Cause
Transmission
Cholera bacteria have been found in shellfish and plankton.[17]
People infected with cholera often have diarrhea, and disease transmission may occur if this highly liquid stool, colloquially referred to as "rice-water", contaminates water used by others.[23] A single diarrheal event can cause a one-million fold increase in numbers of V. cholerae in the environment.[24] The source of the contamination is typically other people with cholera when their untreated diarrheal discharge is allowed to get into waterways, groundwater or drinking water supplies. Drinking any contaminated water and eating any foods washed in the water, as well as shellfish living in the affected waterway, can cause a person to contract an infection. Cholera is rarely spread directly from person to person.[25][note 1]
V. cholerae also exists outside the human body in natural water sources, either by itself or through interacting with
Both toxic and non-toxic strains exist. Non-toxic strains can acquire toxicity through a temperate bacteriophage.[28]
Susceptibility
About 100 million bacteria must typically be ingested to cause cholera in a normal healthy adult.
The
Mechanism
When consumed, most bacteria do not survive the acidic conditions of the human stomach.[31] The few surviving bacteria conserve their energy and stored nutrients during the passage through the stomach by shutting down protein production. When the surviving bacteria exit the stomach and reach the small intestine, they must propel themselves through the thick mucus that lines the small intestine to reach the intestinal walls where they can attach and thrive.[31]
Once the cholera bacteria reach the intestinal wall, they no longer need the flagella to move. The bacteria stop producing the protein flagellin to conserve energy and nutrients by changing the mix of proteins that they express in response to the changed chemical surroundings. On reaching the intestinal wall, V. cholerae start producing the toxic proteins that give the infected person a watery diarrhea. This carries the multiplying new generations of V. cholerae bacteria out into the drinking water of the next host if proper sanitation measures are not in place.[32]
The
Microbiologists have studied the genetic mechanisms by which the V. cholerae bacteria turn off the production of some proteins and turn on the production of other proteins as they respond to the series of chemical environments they encounter, passing through the stomach, through the mucous layer of the small intestine, and on to the intestinal wall.[34] Of particular interest have been the genetic mechanisms by which cholera bacteria turn on the protein production of the toxins that interact with host cell mechanisms to pump chloride ions into the small intestine, creating an ionic pressure which prevents sodium ions from entering the cell. The chloride and sodium ions create a salt-water environment in the small intestines, which through osmosis can pull up to six liters of water per day through the intestinal cells, creating the massive amounts of diarrhea. The host can become rapidly dehydrated unless treated properly.[35]
By inserting separate, successive sections of V. cholerae DNA into the DNA of other bacteria, such as E. coli that would not naturally produce the protein toxins, researchers have investigated the mechanisms by which V. cholerae responds to the changing chemical environments of the stomach, mucous layers, and intestinal wall. Researchers have discovered a complex cascade of regulatory proteins controls expression of V. cholerae virulence determinants.[36] In responding to the chemical environment at the intestinal wall, the V. cholerae bacteria produce the TcpP/TcpH proteins, which, together with the ToxR/ToxS proteins, activate the expression of the ToxT regulatory protein. ToxT then directly activates expression of virulence genes that produce the toxins, causing diarrhea in the infected person and allowing the bacteria to colonize the intestine.[34] Current[when?] research aims at discovering "the signal that makes the cholera bacteria stop swimming and start to colonize (that is, adhere to the cells of) the small intestine."[34]
Genetic structure
Amplified fragment length polymorphism fingerprinting of the pandemic isolates of V. cholerae has revealed variation in the genetic structure. Two clusters have been identified: Cluster I and Cluster II. For the most part, Cluster I consists of strains from the 1960s and 1970s, while Cluster II largely contains strains from the 1980s and 1990s, based on the change in the clone structure. This grouping of strains is best seen in the strains from the African continent.[37]
Antibiotic resistance
In many areas of the world,
Diagnosis
A rapid dipstick test is available to determine the presence of V. cholerae.[38] In those samples that test positive, further testing should be done to determine antibiotic resistance.[38] In epidemic situations, a clinical diagnosis may be made by taking a patient history and doing a brief examination. Treatment via hydration and over-the-counter hydration solutions can be started without or before confirmation by laboratory analysis, especially where cholera is a common problem.[41]
Stool and swab samples collected in the acute stage of the disease, before antibiotics have been administered, are the most useful specimens for laboratory diagnosis. If an epidemic of cholera is suspected, the most common causative agent is V. cholerae O1. If V. cholerae serogroup O1 is not isolated, the laboratory should test for V. cholerae O139. However, if neither of these organisms is isolated, it is necessary to send stool specimens to a reference laboratory.[citation needed]
Infection with V. cholerae O139 should be reported and handled in the same manner as that caused by V. cholerae O1. The associated diarrheal illness should be referred to as cholera and must be reported in the United States.[42]
Prevention
The World Health Organization (WHO) recommends focusing on prevention, preparedness, and response to combat the spread of cholera.[35] They also stress the importance of an effective surveillance system.[35] Governments can play a role in all of these areas.
Water, sanitation and hygiene
Although cholera may be life-threatening, prevention of the disease is normally straightforward if proper
Effective sanitation practices, if instituted and adhered to in time, are usually sufficient to stop an epidemic. There are several points along the cholera transmission path at which its spread may be halted:[45]
- Sterilization: Proper disposal and treatment of all materials that may have come into contact with the feces of other people with cholera (e.g., clothing, bedding, etc.) are essential. These should be if possible. Hands that touch cholera patients or their clothing, bedding, etc., should be thoroughly cleaned and disinfected with chlorinated water or other effective antimicrobial agents.
- human excreta. Provision of sanitation and hygiene is an important preventative measure.[35] Open defecation, release of untreated sewage, or dumping of fecal sludge from pit latrines or septic tanks into the environment need to be prevented.[46] In many cholera affected zones, there is a low degree of sewage treatment.[47][48] Therefore, the implementation of dry toilets that do not contribute to water pollution, as they do not flush with water, may be an interesting alternative to flush toilets.[49]
- Sources: Warnings about possible cholera contamination should be posted around contaminated water sources with directions on how to decontaminate the water (boiling, chlorination etc.) for possible use.
- Water purification: All water used for drinking, washing, or cooking should be sterilized by either boiling, chlorination, ozone water treatment, ultraviolet light sterilization (e.g., by solar water disinfection), or antimicrobial filtration in any area where cholera may be present. Chlorination and boiling are often the least expensive and most effective means of halting transmission. Cloth filters or sari filtration, though very basic, have significantly reduced the occurrence of cholera when used in poor villages in Bangladesh that rely on untreated surface water. Better antimicrobial filters, like those present in advanced individual water treatment hiking kits, are most effective. Public health education and adherence to appropriate sanitation practices are of primary importance to help prevent and control transmission of cholera and other diseases.
Handwashing with soap or ash after using a toilet and before handling food or eating is also recommended for cholera prevention by WHO Africa.[50]
-
Dumping ofcholera after the Haiti earthquake in 2010, killing thousands.
-
Example of a urine-diverting dry toilet in a cholera-affected area in Haiti. This type of toilet stops transmission of disease via the fecal-oral route due to water pollution.
-
Cholera hospital in Dhaka, showing typical "cholera beds".
Surveillance
Surveillance and prompt reporting allow for containing cholera epidemics rapidly. Cholera exists as a seasonal disease in many endemic countries, occurring annually mostly during rainy seasons. Surveillance systems can provide early alerts to outbreaks, therefore leading to coordinated response and assist in preparation of preparedness plans. Efficient surveillance systems can also improve the risk assessment for potential cholera outbreaks. Understanding the seasonality and location of outbreaks provides guidance for improving cholera control activities for the most vulnerable.[51] For prevention to be effective, it is important that cases be reported to national health authorities.[17]
Vaccination
Spanish physician
Persons who survive an episode of cholera have long-lasting immunity for at least 3 years (the period tested.)
One injectable vaccine was found to be effective for two to three years. The protective efficacy was 28% lower in children less than five years old.[62] However, as of 2010[update], it has limited availability.[2] Work is under way to investigate the role of mass vaccination.[63] The WHO recommends immunization of high-risk groups, such as children and people with HIV, in countries where this disease is endemic.[2] If people are immunized broadly, herd immunity results, with a decrease in the amount of contamination in the environment.[38]
WHO recommends that oral cholera vaccination be considered in areas where the disease is endemic (with seasonal peaks), as part of the response to outbreaks, or in a humanitarian crisis during which the risk of cholera is high.[64] Oral Cholera Vaccine (OCV) has been recognized as an adjunct tool for prevention and control of cholera. The World Health Organization (WHO) has prequalified three bivalent cholera vaccines—Dukoral (SBL Vaccines), containing a non-toxic B-subunit of cholera toxin and providing protection against V. cholerae O1; and two vaccines developed using the same transfer of technology—ShanChol (Shantha Biotec) and Euvichol (EuBiologics Co.), which have bivalent O1 and O139 oral killed cholera vaccines.[65] Oral cholera vaccination could be deployed in a diverse range of situations from cholera-endemic areas and locations of humanitarian crises, but no clear consensus exists.[66]
Sari filtration
Developed for use in Bangladesh, the "sari filter" is a simple and cost-effective appropriate technology method for reducing the contamination of drinking water. Used sari cloth is preferable but other types of used cloth can be used with some effect, though the effectiveness will vary significantly. Used cloth is more effective than new cloth, as the repeated washing reduces the space between the fibers. Water collected in this way has a greatly reduced pathogen count—though it will not necessarily be perfectly safe, it is an improvement for poor people with limited options.[67] In Bangladesh this practice was found to decrease rates of cholera by nearly half.[68] It involves folding a sari four to eight times.[67] Between uses the cloth should be rinsed in clean water and dried in the sun to kill any bacteria on it.[69] A nylon cloth appears to work as well but is not as affordable.[68]
Treatment
Continued eating speeds the recovery of normal intestinal function. The WHO recommends this generally for cases of diarrhea no matter what the underlying cause.[70] A CDC training manual specifically for cholera states: "Continue to breastfeed your baby if the baby has watery diarrhea, even when traveling to get treatment. Adults and older children should continue to eat frequently."[71]
Fluids
The most common error in caring for patients with cholera is to underestimate the speed
and volume of fluids required.
If commercially produced oral rehydration solutions are too expensive or difficult to obtain, solutions can be made. One such recipe calls for 1 liter of boiled water, 1/2 teaspoon of salt, 6 teaspoons of sugar, and added mashed banana for potassium and to improve taste.[75]
Electrolytes
As there frequently is initially acidosis, the potassium level may be normal, even though large losses have occurred.[17] As the dehydration is corrected, potassium levels may decrease rapidly, and thus need to be replaced.[17] This may be done by consuming foods high in potassium, like bananas or coconut water.[76]
Antibiotics
Antibiotic treatments for one to three days shorten the course of the disease and reduce the severity of the symptoms.[17] Use of antibiotics also reduces fluid requirements.[77] People will recover without them, however, if sufficient hydration is maintained.[38] The WHO only recommends antibiotics in those with severe dehydration.[76]
Antibiotics improve outcomes in those who are both severely and not severely dehydrated.[80] Azithromycin and tetracycline may work better than doxycycline or ciprofloxacin.[80]
Zinc supplementation
In Bangladesh zinc supplementation reduced the duration and severity of diarrhea in children with cholera when given with antibiotics and rehydration therapy as needed. It reduced the length of disease by eight hours and the amount of diarrhea stool by 10%.[81] Supplementation appears to be also effective in both treating and preventing infectious diarrhea due to other causes among children in the developing world.[81][82]
Prognosis
If people with cholera are treated quickly and properly, the mortality rate is less than 1%; however, with untreated cholera, the mortality rate rises to 50–60%.[17][1]
For certain genetic strains of cholera, such as the one present during the
Epidemiology
Cholera affects an estimated 2.8 million people worldwide, and causes approximately 95,000 deaths a year (uncertainty range: 21,000–143,000) as of 2015[update].[84][85] This occurs mainly in the developing world.[86]
In the early 1980s, death rates are believed to have still been higher than three million a year.[17] It is difficult to calculate exact numbers of cases, as many go unreported due to concerns that an outbreak may have a negative impact on the tourism of a country.[38] As of 2004, cholera remained both epidemic and endemic in many areas of the world.[17]
Recent major outbreaks are the
Although much is known about the mechanisms behind the spread of cholera, researchers still do not have a full understanding of what makes cholera outbreaks happen in some places and not others. Lack of treatment of human feces and lack of treatment of drinking water greatly facilitate its spread. Bodies of water have been found to serve as a reservoir of infection, and seafood shipped long distances can spread the disease.
Cholera had disappeared from the
History of outbreaks
The word cholera is from Greek: χολέρα kholera from χολή kholē "bile". Cholera likely has its origins in the Indian subcontinent as evidenced by its prevalence in the region for centuries.[17]
References to cholera appear in the European literature as early as 1642, from the Dutch physician Jakob de Bondt's description in his De Medicina Indorum.[93] (The "Indorum" of the title refers to the East Indies. He also gave first European descriptions of other diseases.) But at the time, the word "cholera" was historically used by European physicians to refer to any gastrointestinal upset resulting in yellow diarrhea. De Bondt thus used a common word already in regular use to describe the new disease. This was a frequent practice of the time. It was not until the 1830s that the name for severe yellow diarrhea changed in English from "cholera" to "cholera morbus" to differentiate it from what was then known as "Asiatic cholera", or that associated with origins in India and the East.
Early outbreaks in the Indian subcontinent are believed to have been the result of crowded, poor living conditions, as well as the presence of pools of
The
The
The
The
The
The seventh pandemic originated in 1961 in Indonesia and is marked by the emergence of a new strain, nicknamed El Tor, which still persists (as of 2018[update][100]) in developing countries.[101] This pandemic had initially subsided about 1975 and was thought to have ended, but, as noted, it has persisted. There were a rise in cases in the 1990s and since.
Cholera became widespread in the 19th century.
In the past, vessels flew a yellow quarantine flag if any crew members or passengers had cholera. No one aboard a vessel flying a yellow flag would be allowed ashore for an extended period, typically 30 to 40 days.[107]
Historically many different claimed remedies have existed in folklore. Many of the older remedies were based on the miasma theory, that the disease was transmitted by bad air. Some believed that abdominal chilling made one more susceptible, and flannel and cholera belts were included in army kits.[108] In the 1854–1855 outbreak in Naples, homeopathic camphor was used according to Hahnemann.[109].Dr Hahnemann laid down three main remedies that would be curative in that disease; in early and simple cases camphor; in later stages with excessive cramping, cuprum or with excessive evacuations and profuse cold sweat, veratrum album. These are the Trio Cholera remedies used by homoeopaths around the world.[110] T. J. Ritter's Mother's Remedies book lists tomato syrup as a home remedy from northern America. Elecampane was recommended in the United Kingdom, according to William Thomas Fernie.[111] The first effective human vaccine was developed in 1885, and the first effective antibiotic was developed in 1948.
Cholera cases are much less frequent in developed countries where governments have helped to establish water sanitation practices and effective medical treatments.[112] In the 19th century the United States, for example, had a severe cholera problem similar to those in some developing countries. It had three large cholera outbreaks in the 1800s, which can be attributed to Vibrio cholerae's spread through interior waterways such as the Erie Canal and the extensive Mississippi River valley system, as well as the major ports along the Eastern Seaboard and their cities upriver.[113] The island of Manhattan in New York City touches the Atlantic Ocean, where cholera collected from river waters and ship discharges just off the coast. At this time, New York City did not have as effective a sanitation system as it developed in the later 20th century, so cholera spread through the city's water supply.[114]
Cholera morbus is a historical term that was used to refer to gastroenteritis rather than specifically to what is now defined as the disease of cholera.[15]
-
Emperor Pedro II of Brazil visiting people with cholera in 1855.
-
Hand bill from the New York City Board of Health, 1832—the outdated public health advice demonstrates the lack of understanding of the disease and its causative factors.
Research
One of the major contributions to fighting cholera was made by the physician and pioneer medical scientist
The bacterium was isolated in 1854 by Italian anatomist Filippo Pacini,[119] but its exact nature and his results were not widely known. In the same year, the Catalan Joaquim Balcells i Pascual discovered the bacterium.[120][121] In 1856 António Augusto da Costa Simões and José Ferreira de Macedo Pinto, two Portuguese researchers, are believed to have done the same.[120][122]
Between the mid-1850s and the 1900s, cities in developed nations made massive investment in clean water supply and well-separated sewage treatment infrastructures. This eliminated the threat of cholera epidemics from the major developed cities in the world. In 1883, Robert Koch identified V. cholerae with a microscope as the bacillus causing the disease.[123]
More recently, in 2002, Alam, et al., studied stool samples from patients at the
Global Strategy
In 2017, the WHO launched the "Ending Cholera: a global roadmap to 2030" strategy which aims to reduce cholera deaths by 90% by 2030.[129] The strategy was developed by the Global Task Force on Cholera Control (GTFCC) which develops country-specific plans and monitors progress.[130] The approach to achieve this goal combines surveillance, water sanitation, rehydration treatment and oral vaccines.[129] Specifically, the control strategy focuses on three approaches: i) early detection and response to outbreaks to contain outbreaks, ii) stopping cholera transmission through improved sanitation and vaccines in hotspots, and iii) a global framework for cholera control through the GTFCC.[129]
The WHO and the GTFCC do not consider global cholera eradication a viable goal.[131] Even though humans are the only host of cholera, the bacterium can persist in the environment without a human host.[132] While global eradication is not possible, elimination of human to human transmission may be possible.[132] Local elimination is possible, which has been underway most recently during the 2010s Haiti cholera outbreak. Haiti aims to achieve certification of elimination by 2022.[133]
The GTFCC targets 47 countries, 13 of which have established vaccination campaigns.[89]
Society and culture
Health policy
In many developing countries, cholera still reaches its victims through contaminated water sources, and countries without proper sanitation techniques have greater incidence of the disease.
Similarly, South Africa's cholera outbreak was exacerbated by the government's policy of privatizing water programs. The wealthy elite of the country were able to afford safe water while others had to use water from cholera-infected rivers.[136]
According to
According to Colwell, the quality and inclusiveness of a country's health care system affects the control of cholera, as it did in the
Besides contributing to an effective or declining public health care system and water sanitation treatments, government can have indirect effects on cholera control and the effectiveness of a response to cholera.[142] A country's government can impact its ability to prevent disease and control its spread. A speedy government response backed by a fully functioning health care system and financial resources can prevent cholera's spread. This limits cholera's ability to cause death, or at the very least a decline in education, as children are kept out of school to minimize the risk of infection.[142] Inversely, poor government response can lead to civil unrest and cholera riots.[143]
Notable cases
- Tchaikovsky's death has traditionally been attributed to cholera, most probably contracted through drinking contaminated water several days earlier.[144] Tchaikovsky's mother died of cholera,[145] and his father became sick with cholera at this time but made a full recovery.[146] Some scholars, however, including English musicologist and Tchaikovsky authority David Brown and biographer Anthony Holden, have theorized that his death was a suicide.[147]
- This marks the worst cholera outbreak in recent history, as well as the best documented cholera outbreak in modern public health.
- Adam Mickiewicz, Polish poet and novelist, is thought to have died of cholera in Istanbul in 1855.
- Sadi Carnot, physicist, a pioneer of thermodynamics (d. 1832)[149]
- Charles X, King of France (d. 1836)[150]
- James K. Polk, eleventh president of the United States (d. 1849)[151]
- Carl von Clausewitz, Prussian soldier and German military theorist (d. 1831)[152]
- Elliot Bovill, Chief Justice of the Straits Settlements (1893)[153]
- electricity supplysystem, contracted cholera in 1873 at the age of 17. He was bedridden for nine months, and near death multiple times, but survived and fully recovered.
In popular culture
Unlike
- The 1889 novel Mastro-don Gesualdo by Giovanni Verga presents the course of a cholera epidemic across the island of Sicily, but does not show the suffering of those affected.[155]
- In Thomas Mann's novella Death in Venice, first published in 1912 as Der Tod in Venedig, Mann "presented the disease as emblematic of the final 'bestial degradation' of the sexually transgressive author Gustav von Aschenbach." Contrary to the actual facts of how violently cholera kills, Mann has his protagonist die peacefully on a beach in a deck chair. Luchino Visconti's 1971 film version also hid from the audience the actual course of the disease.[155] Mann's novella was also made into an opera by Benjamin Britten in 1973, his last one, and into a ballet by John Neumeier for his Hamburg Ballet company, in December 2003.*
- hussars, caught up in the 1832 cholera epidemic in Provence. In 1995, it was made into a film of the same name directed by Jean-Paul Rappeneau.[156]
- In Gabriel Garcia Márquez's 1985 novel Love in the Time of Cholera, cholera is "a looming background presence rather than a central figure requiring vile description."[155] The novel was adapted in 2007 for the film of the same name directed by Mike Newell.
Country examples
Zambia
In Zambia, widespread cholera outbreaks have occurred since 1977, most commonly in the capital city of Lusaka.[157] In 2017, an outbreak of cholera was declared in Zambia after laboratory confirmation of Vibrio cholerae O1, biotype El Tor, serotype Ogawa, from stool samples from two patients with acute watery diarrhea. There was a rapid increase in the number of cases from several hundred cases in early December 2017 to approximately 2,000 by early January 2018.[158] With intensification of the rains, new cases increased on a daily basis reaching a peak on the first week of January 2018 with over 700 cases reported.[159]
In collaboration with partners, the Zambia Ministry of Health (MoH) launched a multifaceted public health response that included increased chlorination of the Lusaka municipal water supply, provision of emergency water supplies, water quality monitoring and testing, enhanced surveillance, epidemiologic investigations, a cholera vaccination campaign, aggressive case management and health care worker training, and laboratory testing of clinical samples.[158]
The Zambian Ministry of Health implemented a reactive one-dose Oral Cholera Vaccine (OCV) campaign in April 2016 in three Lusaka compounds, followed by a pre-emptive second-round in December.[160]
India
The city of
Democratic Republic of Congo
In
Explanatory notes
References
- ^ a b c Todar K. "Vibrio cholerae and Asiatic Cholera". Todar's Online Textbook of Bacteriology. Archived from the original on 2010-12-28. Retrieved 2010-12-20.
- ^ PMID 20349546. Archived from the original(PDF) on April 13, 2015.
- ^ a b c d e f g "Cholera – Vibrio cholerae infection Information for Public Health & Medical Professionals". Centers for Disease Control and Prevention. January 6, 2015. Archived from the original on 20 March 2015. Retrieved 17 March 2015.
- ^ .
- ^ PMID 22748592.
- ^ a b "Cholera – Vibrio cholerae infection Treatment". Centers for Disease Control and Prevention. November 7, 2014. Archived from the original on 11 March 2015. Retrieved 17 March 2015.
- ^ PMID 27733281.
- ISBN 978-1-4358-9437-2. Archivedfrom the original on 2016-12-03.
- ^ "Sources of Infection & Risk Factors". Centers for Disease Control and Prevention. November 7, 2014. Archived from the original on 12 March 2015. Retrieved 17 March 2015.
- ^ "Diagnosis and Detection". Centers for Disease Control and Prevention. February 10, 2015. Archived from the original on 15 March 2015. Retrieved 17 March 2015.
- ^ "Cholera Fact Sheet". www.health.ny.gov. 2017. Retrieved 2020-05-26.
- ^ PMID 30184117.
- ^ "Cholera's seven pandemics". CBC. 9 May 2008. Retrieved 15 July 2018.
- ^ "Cholera – Vibrio cholerae infection". Centers for Disease Control and Prevention. October 27, 2014. Archived from the original on 17 March 2015. Retrieved 17 March 2015.
- ^ ISBN 978-0-226-72676-2. Archivedfrom the original on 2015-11-09.
- ISBN 978-0-7637-0060-7. Archivedfrom the original on 2016-12-03.
- ^ S2CID 208793200.
- PMID 23201968.
- S2CID 4408759.
- PMC 2171164.
- ISBN 978-0-8133-4384-6.
- ^ Rita Colwell. Oceans, Climate, and Health: Cholera as a Model of Infectious Diseases in a Changing Environment. Rice University: James A Baker III Institute for Public Policy. Archived from the originalon 2013-10-26. Retrieved 2013-10-23.
- ISBN 978-0-8385-8529-0.
- ^ "Cholera Biology and Genetics | NIH: National Institute of Allergy and Infectious Diseases". www.niaid.nih.gov. 7 February 2011. Retrieved 2017-12-05.
- ^ "General Information - Cholera". CDC. 2020-08-05. Retrieved 2021-03-11.
- ^ PMID 19756008.
- PMID 18949027.
- PMC 1717096.
- ^ Prevention and control of cholera outbreaks: WHO policy and recommendations Archived 2011-11-22 at the Wayback Machine, World Health Organization, Regional Office for the Eastern Mediterranean, undated but citing sources from '07, '04, '03, '04, and '05.
- PMID 8827370.
- ^ PMID 25996593.
- PMID 29968551.
- S2CID 8669389.
- ^ PMID 2052618.
- ^ a b c d "Cholera Fact Sheet", World Health Organization. who.int Archived 2012-05-05 at the Wayback Machine. Retrieved November 5, 2013.
- PMID 29315383.
- PMID 11773113.
- ^ S2CID 23145226.
- ISBN 978-1-904455-18-9.
- ISBN 978-1-904455-33-2.
- ^ "Cholera - Diagnosis and treatment - Mayo Clinic". www.mayoclinic.org. Retrieved 2022-09-04.
- ^ "Laboratory Methods for the Diagnosis of Epidemic Dysentery and Cholera" (PDF). Centers for Disease Control and Prevention. 1999. Archived (PDF) from the original on 2017-06-23. Retrieved 2017-06-30.
- ^ "CHOLERA KILLS BOY; EIGHTH DEATH HERE; All Other Suspected Cases Now in Quarantine and Show No Alarming Symptoms". The New York Times. 18 July 1911.
- ^ "More Cholera in Port". The Washington Post. October 10, 1910. Archived from the original on December 16, 2008. Retrieved 2008-12-11.
A case of cholera developed today in the steerage of the Hamburg-American liner Moltke, which has been detained at quarantine as a possible cholera carrier since Monday last. Dr. A.H. Doty, health officer of the port, reported the case tonight with the additional information that another cholera patient from the Moltke is under treatment at Swinburne Island.
- ^ "Cholera". www.who.int. Retrieved 2020-08-20.
- ISBN 978-0-203-88162-0.
- ISBN 978-94-009-1515-2.
- ISBN 978-1-118-78699-4.
- ^ Gili E (9 June 2015). "Starting a poop to compost movement". Deutsche Welle.
- ^ "Cholera and food safety" (PDF). World Health Organization. Archived from the original (PDF) on 2017-08-21. Retrieved 2017-08-20.
- ^ "Cholera: prevention and control". Health topics. WHO. 2008. Archived from the original on 2008-12-14. Retrieved 2008-12-08.
- ^ "Others — Timelines — History of Vaccines". Archived from the original on February 11, 2015.
{{cite web}}
: CS1 maint: unfit URL (link) - ^ PMID 6759570.
- ^ PMID 7039738.
- ^ S2CID 42075270.
- PMID 25177492.
- ^ haffkineinstitute.org Archived 2015-09-24 at the Wayback Machine
- ^ "Waldemar Haffkine: The vaccine pioneer the world forgot". BBC News. 2020-12-11. Retrieved 2021-01-20.
- ^ PMID 21412922.
- ^ "Is a vaccine available to prevent cholera?". CDC disease info: Cholera. 2010-10-22. Archived from the original on 2010-10-26. Retrieved 2010-10-24.
- ^ "FDA Product Approval: View All". Archived from the original on April 15, 2017.
- PMID 20687062.
- ^ "Cholera vaccines". Health topics. WHO. 2008. Archived from the original on 2010-02-16. Retrieved 2010-02-01.
- .
- PMID 21283611.
- PMID 26494426.
- ^ ISBN 978-1-60327-265-0. Archivedfrom the original on 2015-11-07.
- ^ ISBN 978-0-7637-6622-1. Archivedfrom the original on 2015-11-06.
- ISBN 978-1-111-79701-0. Archivedfrom the original on 2015-11-07.
- ^ ISBN 978-92-4-159318-2.
- ^ "Community Health Worker Training Materials for Cholera Prevention and Control" (PDF). Centers for Disease Control and Prevention. Archived (PDF) from the original on 2017-07-02.
- ^ "globalhealthcenter.umn.edu" (PDF). Archived from the original (PDF) on December 3, 2013.
- ^ The Civil War That Killed Cholera Archived 2013-12-20 at the Wayback Machine, foreignpolicy.com.
- ^ "Sugary drinks 'worsen vomit bug'". BBC News. 22 April 2009.
- ^ "Oral Rehydration Solutions: Made at Home". The Mother and Child Health and Education Trust. 2010. Archived from the original on 2010-11-24. Retrieved 2010-10-29.
- ^ a b "First steps for managing an outbreak of acute diarrhea" (PDF). World Health Organization Global Task Force on Cholera Control. Archived (PDF) from the original on August 5, 2014. Retrieved November 23, 2013.
- ^ Cholera Treatment (Report). Centers for Disease Control and Prevention (CDC). November 28, 2011. Archived from the original on March 11, 2015.
- ^ "Cholera treatment". Molson Medical Informatics. 2007. Archived from the original on 6 November 2012. Retrieved 2008-01-03.
- PMID 16246383.
- ^ PMID 24944120.
- ^ a b Cholera-Zinc Treatment (Report). Centers for Disease Control and Prevention (CDC). November 28, 2011. Archived from the original on December 3, 2013.
- PMID 21359029.
- ^ Knox R (10 December 2010). "Toward A New Strategy For Fighting Cholera In Haiti". NPR.
- PMID 26043000.
- S2CID 1541253.
- PMID 12069878.
- ^ Johannes Bruwer (25 June 2017). "The horrors of Yemen's spiralling cholera crisis". BBC.
- ^ Dwyer C. "Yemen Now Faces 'The Worst Cholera Outbreak In The World,' U.N. Says". National Public Radio. Retrieved 25 June 2017.
- ^ ISBN 978-92-4-002916-3.
- PMID 7691740.
- ^ a b c "Cholera worldwide overview". www.ecdc.europa.eu. May 30, 2023.
- ^ "Cholera - Haiti". www.who.int. Retrieved 1 February 2023.
- ^ "All Entries by BONDT, Jacob de, Jacobus Bontius: HistoryofMedicine.com". www.historyofmedicine.com. Retrieved 2019-07-23.
- ^ ISBN 978-0-226-72677-9.
- ^ "Cholera's seven pandemics Archived 2016-03-02 at the Wayback Machine". CBC News. October 22, 2010.
- ISBN 978-1-85109-658-9.
- ^ McNeill WH, Plagues and People, p. 268.
- ^ McNeil J. Something New Under The Sun: An Environmental History of the Twentieth Century World (The Global Century Series).
- ^ Richard Evans: Death in Hamburg: Society and Politics in the Cholera Years, 1830–1910. London 1987
- ^ "Cholera – Vibrio cholerae infection | Cholera | CDC". www.cdc.gov. 2017-05-16. Retrieved 2018-04-04.
- ISBN 978-0-7425-5705-5.
- S2CID 228940685.
- ISBN 0-333-80254-3
- ISBN 0-674-00473-6
- ISBN 978-0-313-34102-1.
- ISBN 1-85109-658-2
- PMID 12398064.
- PMID 13440256.
- ^ www.legatum.sk Archived 2013-05-14 at the Wayback Machine, The American Homoeopathic Review, Vol. 06 No. 11–12, 1866, pages 401–403
- ^ "Trios in Homeopathic materia medica PART II".
- ^ "Cholera Infantum, Tomatoes Will Relieve". October 13, 2008. Archived from the original on December 24, 2013. Retrieved February 18, 2013.
- ^ "Cholera", World Health Organization. who.int Archived 2013-10-25 at the Wayback Machine
- PMID 11614509.
- S2CID 45016958.
- ^ John Snow, The mode of communication of cholera Archived 2015-11-06 at the Wayback Machine, 2nd ed. (London, England: John Churchill, 1855).
- ^ "John Snow: A Legacy of Disease Detectives". US Centers for Disease Control and Prevention. 14 March 2017. Retrieved 2021-01-20.
- ^ "Father of Modern Epidemiology". www.ph.ucla.edu. Retrieved 2021-01-20.
- ^ "John Snow". History of Vaccines. Archived from the original on 2021-01-28. Retrieved 2021-01-20.
- ^ Pacini F (1854). "Osservazioni microscopiche e deduzioni patologiche sul cholera asiatico" [Microscopic observations and pathological deductions on Asiatic cholera]. Gazzetta Medica Italiana (in Italian). 4 (50): 397–401, 405–412. Archived from the original on 18 November 2015. Reprinted as: Pacini F (1854). Osservazioni microscopiche e deduzioni patologiche sul cholera asiatico (in Italian). Federigo Bencini.
- ^ a b Real Academia de la Historia, ed. (2018). "Joaquín Balcells y Pasqual" (in Spanish). Archived from the original on 2019-07-08. Retrieved 2020-08-01.
- ^ Col·legi Oficial de Metges de Barcelona [in Catalan], ed. (2015). "Joaquim Balcells i Pascual" (in Catalan). Archived from the original on 2020-08-01. Retrieved 2020-08-01.
- ^ da Costa Simões, António Augusto, de Macedo Pinto, José Ferreira (1856). Relatório da Direcção do Hospital de Cholericos de N.S. da Conceição em Coimbra (in Portuguese). Coimbra: Imprensa da Universidade. The link leads to a library catalogue where the book can be found.
- ISBN 978-1-4422-0796-7.
- PMID 7808099.
- PMID 13110052.
- ^ "Sambhu Nath De". Inmemory. Archived from the original on 2019-12-05. Retrieved 2019-12-05.
- ^ "Albert Lasker Clinical Medical Research Award". Lasker Foundation. Archived from the original on September 1, 2017. Retrieved June 30, 2017.
- PMID 12050664.
- ^ a b c "Cholera".
- ^ "Global Task Force on Cholera Control". www.gtfcc.org.
- ^ Ending Cholera a Global Roadmap to 2030 (PDF) (Report). Global Task Force on Cholera Control. 2017. p. 18. Archived (PDF) from the original on 2017-10-18.
- ^ PMID 24415587.
- ^ National Plan for the Elimination of Cholera in Haiti 2013-2022 (PDF). Republic of Haiti, Ministry of Public Health and Population, National Directorate for Water Supply and Sanitation. February 2013. Archived (PDF) from the original on 2018-06-29.
- ^ "Cholera vaccines. A brief summary of the March 2010 position paper" (PDF). World Health Organization. Retrieved September 19, 2013.
- S2CID 41672119.
- S2CID 24270235.
- ^ PMID 15347857.
- PMID 1500643. Archived from the originalon 2021-08-23. Retrieved 2021-08-23.
- PMID 15780724.
- .
- ^ Pruyt, Eric (26 July 2009). "Cholera in Zimbabwe" (PDF). Delft University of Technology. Archived from the original (PDF) on 20 October 2013.
- ^ S2CID 5267332.
- ^ "AFP: Riot police break up Zimbabwe protests as cholera deaths mount". AFP. Retrieved 25 June 2017.
- ^ Brown, Man and Music, 430–32; Holden, 371; Warrack, Tchaikovsky, 269–270.
- ^ David Brown, Early Years, 46.
- ^ Holden, 23.
- ^ Brown, Man and Music, 431–35; Holden, 373–400.
- PMID 24699938.
- ^ Asimov, Isaac (1982), Asimov's Biographical Encyclopedia of Science and Technology (2nd rev. ed.), Doubleday
- ^ Susan Nagel, Marie Thérèse: Child of Terror, p. 349–350.
- ISBN 978-0-673-99001-3.
- ^ Smith, Rupert, The Utility of Force, Penguin Books, 2006, page 57
- ^ "Notes and News". Selangor Journal. 7 April 1893. p. 1.
- ISBN 0-312-42013-7
- ^ ISBN 978-0-300-19221-6.
- ^ Holden S (17 May 1996). "Film Review – The Horseman on the Roof". The New York Times.
- PMID 32294084.
- ^ PMID 29771877.
- ^ "Emergency Plan of Action Final Report Zambia: Cholera Outbreak Lusaka" (PDF). 1 October 2020. Archived (PDF) from the original on 2021-04-20 – via International Federation of Red Cross and Red Crescent Societies.
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(help) - PMID 31088376.
- PMID 22043439.
- PMID 7620035.
Further reading
- Arnold D (1986). "Cholera and Colonialism in British India". Past & Present. 113 (113): 118–151. PMID 11617906.
- Azizi MH, Azizi F (January 2010). "History of Cholera Outbreaks in Iran during the 19th and 20th Centuries". Middle East Journal of Digestive Diseases. 2 (1): 51–55. PMID 25197514.
- Bilson, Geoffrey. A Darkened House: Cholera in Nineteenth-Century Canada (U of Toronto Press, 1980).
- Cooper DB (1986). "The New 'Black Death': Cholera in Brazil, 1855–1856". Social Science History. 10 (4): 467–488. PMID 11618140.
- Echenberg M (2011). Africa in the Time of Cholera: A History of Pandemics from 1817 to the Present. Cambridge University Press. ISBN 978-0-521-18820-3.
- Evans RJ (1988). "Epidemics and Revolutions: Cholera in Nineteenth-Century Europe". Past & Present. 120 (120): 123–146. PMID 11617908.
- Evans RJ (2005). Death in Hamburg: Society and Politics in the Cholera Years. Penguin. ISBN 978-0-14-303636-4.
- Gilbert, Pamela K. Cholera and Nation: Doctoring the Social Body in Victorian England" (SUNY Press, 2008).
- Hamlin C (2009). Cholera: The Biography. Oxford University Press.
- Huber V (November 2020). "Pandemics and the politics of difference: rewriting the history of internationalism through nineteenth-century cholera". Journal of Global History. 15 (3): 394–407. S2CID 228940685.
- Huber V (June 2006). "The Unification of the Globe by Disease? The International Sanitary Conferences on Cholera, 1851–1894". The Historical Journal. 49 (2): 453–476. S2CID 162994263.
- Jenson D, Szabo V (November 2011). "Cholera in Haiti and Other Caribbean Regions, 19th Century". Emerging Infectious Diseases. 17 (11): 2130–2135. PMID 22099117.
- Kotar SL, Gessler JE (2014). Cholera: A Worldwide History. McFarland. ISBN 978-0-7864-7242-0.
- Kudlick CJ (1996). Cholera in Post-Revolutionary Paris: A Cultural History. Berkeley: University of California Press.
- Legros D (15 October 2018). "Global Cholera Epidemiology: Opportunities to Reduce the Burden of Cholera by 2030". The Journal of Infectious Diseases. 218 (suppl_3): S137–S140. PMID 30184102.
- Mukharji PB (2012). "The 'Cholera Cloud' in the Nineteenth-Century 'British World': History of an Object-Without-an-Essence". Bulletin of the History of Medicine. 86 (3): 303–332. Project MUSE 492086.
- ISBN 978-0-226-72677-9.
- Roth M (1997). "Cholera, Community, and Public Health in Gold Rush Sacramento and San Francisco". Pacific Historical Review. 66 (4): 527–551. JSTOR 3642236.
- Snowden, Frank M. Naples in the Time of Cholera, 1884-1911 (Cambridge UP, 1995).
- Vinten-Johansen, Peter, ed. Investigating Cholera in Broad Street: A History in Documents (Broadview Press, 2020). regarding 1850s in England.
- Vinten-Johansen, Peter, et al. Cholera, chloroform, and the science of medicine: a life of John Snow (2003).