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Cholera
Classification and external resources

Scanning Electron Microscope image of Vibrio cholerae
ICD-10 AA00.htm+ A00 00 .,
ICD-9 001
DiseasesDB 29089
MedlinePlus 000303
eMedicine med/351
MeSH D002771
.Cholera, sometimes known as Asiatic or epidemic cholera, is an infectious gastroenteritis caused by enterotoxin-producing strains of the bacterium Vibrio cholerae.^ Cholera is a diarrhoeal disease caused by infection of the intestine with the bacterium Vibrio cholerae .
  • www.Doctors-Pro.com - ,Topics ,Cholera 19 January 2010 8:49 UTC www.doctors-pro.com [Source type: FILTERED WITH BAYES]

^ Asiatic cholera, acute infectious disease caused by strains of the bacterium Vibrio cholerae that have been infected by bacteriophages .
  • cholera Facts, information, pictures | Encyclopedia.com articles about cholera 19 January 2010 8:49 UTC www.encyclopedia.com [Source type: Academic]

^ Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae.
  • www.Doctors-Pro.com - ,Topics ,Cholera 19 January 2010 8:49 UTC www.doctors-pro.com [Source type: FILTERED WITH BAYES]

[1][2] .Transmission to humans occurs through eating food or drinking water contaminated with Vibrio cholerae from other cholera patients.^ Cholera is a bacterial disease usually spread through contaminated water.
  • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

^ Cholera occurs where sanitation, food and water hygiene are poor.
  • Cholera | Doctor | Patient UK 19 January 2010 8:49 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

^ Bacteria – Vibrio Cholerae due to contaminated food, water and droplets.
  • Home Remedies for Cholera - Treatment & Cure - Natural Remedy for Cholera – Cholera Diet 19 January 2010 8:49 UTC natural-homeremedies.com [Source type: FILTERED WITH BAYES]

.The major reservoir for cholera was long assumed to be humans themselves, but considerable evidence exists that aquatic environments can serve as reservoirs of the bacteria.^ It was long assumed to be humans, but some evidence suggests that it is the aquatic environment.

^ The major reservoir for cholera was long assumed to be humans themselves, but considerable evidence exists that aquatic environments can serve as reservoirs of the bacteria.
  • Cholera Epidemic - Kosmix : Reference, Videos, Images, News, Shopping and more... 19 January 2010 8:49 UTC www.kosmix.com [Source type: General]

^ Although the reservoir has always been assumed to be humans, there is some evidence of an aquatic reservoir.
  • Cholera | Doctor | Patient UK 19 January 2010 8:49 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

.Vibrio cholerae is a Gram-negative bacterium that produces cholera toxin, an enterotoxin, whose action on the mucosal epithelium lining of the small intestine is responsible for the disease's most salient characteristic, exhaustive diarrhea.^ Cholera is a diarrhoeal disease caused by infection of the intestine with the bacterium Vibrio cholerae .
  • www.Doctors-Pro.com - ,Topics ,Cholera 19 January 2010 8:49 UTC www.doctors-pro.com [Source type: FILTERED WITH BAYES]

^ The cholera bacterium and toxin .
  • cholera (pathology) -- Britannica Online Encyclopedia 19 January 2010 8:49 UTC www.britannica.com [Source type: Academic]

^ Mechanism of action of cholera toxin.
  • Journal of Clinical Investigation -- The human, societal, and scientific legacy of cholera 19 January 2010 8:49 UTC www.jci.org [Source type: Academic]

[1] .In its most severe forms, cholera is one of the most rapidly fatal illnesses known.^ In its extreme manifestation, cholera is one of the most rapidly fatal illnesses known.

^ Cholera is treatable and in many situations, MSF teams are able to limit the case fatality rate to less than one percent.

^ It's a disease that affects the bowels and in its most severe form is characterized by acute watery diarrhoea that can lead to immediate death through severe dehydration and kidney failure.
  • Cholera: News & Videos about Cholera - CNN.com 19 January 2010 8:49 UTC topics.cnn.com [Source type: News]

.A healthy person's blood pressure may drop to hypotensive levels within an hour of the onset of symptoms; infected patients may die within three hours if medical treatment is not provided.^ A healthy person may become hypotensive within an hour of the onset of symptoms and may die within 2-3 hours if no treatment is provided.

^ In its most severe forms, cholera is one of the most rapidly fatal illnesses known, and a healthy person's blood pressure may drop to hypotensive levels within an hour of the onset of symptoms; infected patients may die within three hours if medical treatment is More From Wikipedia » Related in the Kosmos .
  • Cholera Epidemic - Kosmix : Reference, Videos, Images, News, Shopping and more... 19 January 2010 8:49 UTC www.kosmix.com [Source type: General]

^ Dehydration can develop with remarkable rapidity, within hours after the onset of symptoms.
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

[1] .In a common scenario, the disease progresses from the first liquid stool to shock in 4 to 12 hours, with death following in 18 hours to several days, unless oral (or, in more serious cases, intravenous) rehydration therapy is provided.^ Less severe cases can be managed on an outpatient basis with oral rehydration.
  • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

^ Oral rehydration treatment (ORT) and rapid intravenous rehydration therapy (RIT) avoid deaths in most cases.
  • http://www.colorado.edu/geography/gcraft/warmup/cholera/cholera.bak11 19 January 2010 8:49 UTC www.colorado.edu [Source type: FILTERED WITH BAYES]

^ Intravenous rehydration therapy: a legacy of cholera .
  • Journal of Clinical Investigation -- The human, societal, and scientific legacy of cholera 19 January 2010 8:49 UTC www.jci.org [Source type: Academic]

[3][4]
.It is estimated that most cases of cholera are unreported due to poor surveillance systems, particularly in Africa.^ The actual number of global cases is likely to be much higher with under reporting and the limitations of surveillance systems contributing to fewer reported cases [4].
  • NaTHNaC | Cholera Information Sheet, Health Professionals 19 January 2010 8:49 UTC www.nathnac.org [Source type: News]

^ Cholera has often risen to epidemic proportions in sub-Saharan Africa and South Asia , particularly in India and Bangladesh.
  • cholera (pathology) -- Britannica Online Encyclopedia 19 January 2010 8:49 UTC www.britannica.com [Source type: Academic]

^ Cholera Eltor Prepared by: Leancris A. Conde BSN III-B Bicol University College of Nursing Cholera is a worldwide disease with an estimated incidence of more than five million cases per year, most of which occur in Asia and Africa, with 8% of cases requiring hospitalization.
  • Cholera Eltor 19 January 2010 8:49 UTC www.slideshare.net [Source type: FILTERED WITH BAYES]

.Fatality rates are 5% of total cases in Africa, and less than 1% elsewhere.^ Where good treatment is readily accessible, the case fatality rate is less than 1%.
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

^ Cholera is treatable and in many situations, MSF teams are able to limit the case fatality rate to less than one percent.

^ From the onset of the epidemic in January 1991 through September 1, 1994, a total of 1,041,422 cases and 9,642 deaths (overall case-fatality rate: 0.9%) were reported from countries in the Western Hemisphere to the Pan American Health Organization.

[5]

Contents

Treatment

Cholera patient being treated by medical staff in 1992.
.In most cases cholera can be successfully treated with oral rehydration therapy (ORT).^ Oral rehydration treatment (ORT) and rapid intravenous rehydration therapy (RIT) avoid deaths in most cases.
  • http://www.colorado.edu/geography/gcraft/warmup/cholera/cholera.bak11 19 January 2010 8:49 UTC www.colorado.edu [Source type: FILTERED WITH BAYES]

^ Intravenous rehydration therapy: a legacy of cholera .
  • Journal of Clinical Investigation -- The human, societal, and scientific legacy of cholera 19 January 2010 8:49 UTC www.jci.org [Source type: Academic]

^ Approximately 80 - 90% of patients can be successfully treated by oral rehydration.
  • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

.ORT is highly effective, safe, and simple to administer: prompt replacement of water and electrolytes is the principal treatment for cholera, as dehydration and electrolyte depletion occur rapidly.^ This herbal treatment for cholera is very effective.
  • Home Remedies for Cholera - Treatment and Cure for Cholera 19 January 2010 8:49 UTC home-remedies-treatment.com [Source type: FILTERED WITH BAYES]

^ Rice water is a best treatment for cholera .
  • Home Remedies for Cholera - Treatment and Cure for Cholera 19 January 2010 8:49 UTC home-remedies-treatment.com [Source type: FILTERED WITH BAYES]

^ Cholera toxins cause a massive out (more) pouring of electrolyte-rich isotonic fluid into the bowel and can lead to volume depletion and shock.
  • Scientific Literature on Infectious Diseases Related to TropIKA.net 19 January 2010 8:49 UTC search.bvsalud.org [Source type: Academic]

.In situations where commercially produced ORT sachets are too expensive or difficult to obtain, alternative homemade solutions using various formulas of water, sugar, table salt, baking soda, and fruit offer less expensive methods of electrolyte repletion.^ Rapid fluid replacement with a balanced solution of sugar, electrolytes and water (oral rehydration salts) should be started urgently [3, 9].
  • NaTHNaC | Cholera Information Sheet, Health Professionals 19 January 2010 8:49 UTC www.nathnac.org [Source type: News]

^ Patients can be treated with oral rehydration solution, a prepackaged mixture of sugar and salts to be mixed with water and drunk in large amounts.

^ In addition, the government sponsored awareness campaigns in northeastern areas to persuade citizens to wash produce thoroughly and use chlorine to decontaminate the water.
  • Cholera Epidemic Fears Rise 19 January 2010 8:49 UTC www.iwpr.net [Source type: News]

.In severe cholera cases with significant dehydration, the administration of intravenous rehydration solutions may be necessary.^ Cholera causes severe diarrhea and dehydration.
  • Cholera 19 January 2010 8:49 UTC www.cnn.com [Source type: FILTERED WITH BAYES]
  • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

^ This may be done orally, but severely dehydrated cases may require intravenous administration.
  • NaTHNaC | Cholera Information Sheet, Health Professionals 19 January 2010 8:49 UTC www.nathnac.org [Source type: News]

^ In severe cases, uncorrected dehydration can be fatal.
  • Tufts Medical Center - Cholera 19 January 2010 8:49 UTC www.tufts-nemc.org [Source type: Academic]

.Antibiotics shorten the course of the disease and reduce the severity of the symptoms; however, oral rehydration therapy remains the principal treatment.^ Antibiotic medications may help shorten the course of the disease.
  • Tufts Medical Center - Cholera 19 January 2010 8:49 UTC www.tufts-nemc.org [Source type: Academic]

^ Antibiotics shorten the course and diminish the severity of the illness, but they are not as important as rehydration.
  • Cholera (Vibrio cholerae) 19 January 2010 8:49 UTC www.drlera.com [Source type: FILTERED WITH BAYES]
  • Cholera (Vibrio cholerae) 19 January 2010 8:49 UTC www.tjclarkminerals.com [Source type: FILTERED WITH BAYES]

^ Fatality rates have declined further because of better treatment and, in particular, increasingly available oral rehydration therapy, which was introduced during the early 1970s but became widely available in many parts of the world in the 1980s.
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

.Tetracycline is typically used as the primary antibiotic, although some strains of V. cholerae have shown resistance.^ Cholera vaccine will reduce antibiotic use.
  • Scientific Literature on Infectious Diseases Related to TropIKA.net 19 January 2010 8:49 UTC search.bvsalud.org [Source type: Academic]

^ Although there are strains of O1 and O139 which do not produce CT and do not produce cholera and there are strains of non-O1/non-O139 which do produce CT and cholera, there is no evidence that non-O1/non-O139 strains are involved in epidemics.
  • Department of Health and Ageing - Cholera laboratory case definition 19 January 2010 8:49 UTC www.health.gov.au [Source type: Academic]

^ Most antibiotics and chemotherapeutic agents have no value in cholera therapy, although a few (e.g.

.Other antibiotics that have been proven effective against V. cholerae include cotrimoxazole, erythromycin, doxycycline, chloramphenicol, and furazolidone.^ There is not effective antibiotic of vaccine against it .

^ Antimicrobial susceptibility testing of bacterial isolates showed that Ciprofloxacin (97.85%) was found to be the most effective antibiotic followed by Tetracycline (92.34%), Erythromycin (92.34%), Norfloxacin (93.34%), Cholramphenicol, Ampicillim, but Cotrimoxazole were found to be resistant to all isolated Vibrio cholerae.
  • Scientific Literature on Infectious Diseases Related to TropIKA.net 19 January 2010 8:49 UTC search.bvsalud.org [Source type: Academic]

^ Antibiotics Chloramphenicol Co-trimoxazole Doxycycline Electrolyte Electrolyte Erythromycin Furazolidone Intravenous therapy Norfloxacin Quinolone Tetracycline Oral rehydration therapy more...
  • Cholera Epidemic - Kosmix : Reference, Videos, Images, News, Shopping and more... 19 January 2010 8:49 UTC www.kosmix.com [Source type: General]

[6] .Fluoroquinolones such as norfloxacin also may be used, but resistance has been reported.^ Tetracycline , doxycycline , norfloxacin , ciprofloxacin and furazolidone may be used.
  • Cholera | Doctor | Patient UK 19 January 2010 8:49 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

[7]
.Rapid diagnostic assay methods are available for the identification of multi-drug resistant V. cholerae.^ The coagglutination test is found to be simple, reliable and rapid method for the diagnosis of cholera .

^ Development and evaluation of a multiplex PCR assay for rapid detection of toxigenic Vibrio cholerae O1 and O139.
  • Department of Health and Ageing - Cholera laboratory case definition 19 January 2010 8:49 UTC www.health.gov.au [Source type: Academic]

^ Article Language: English Abstract: OBJECTIVES: To evaluate performance characteristics and ease of use of the new commercially available Crystal VC Rapid Dipstick (VC) test (Span Diagnostics, India) for Vibrio cholerae O1 and O139.
  • Scientific Literature on Infectious Diseases Related to TropIKA.net 19 January 2010 8:49 UTC search.bvsalud.org [Source type: Academic]
  • Scientific Literature on Infectious Diseases Related to TropIKA.net 19 January 2010 8:49 UTC search.bvsalud.org [Source type: Academic]

[8] .New generation antimicrobials have been discovered which are effective against V. cholerae in in vitro studies.^ Preventing cholera There is at present no effective vaccine against cholera.
  • Médecins Sans Frontières International Homepage 19 January 2010 8:49 UTC www.msf.org [Source type: FILTERED WITH BAYES]

^ Antibodies directed against subunit B neutralized the biological activity of cholera toxin in vitro in the S49 mouse lymphosarcoma assay .

^ Furthermore, the story of cholera continues to inform us about how we should more effectively view emergent and resurgent infectious disease hazards more generally.

[9]
The success of treatment is significantly affected by the speed and method of treatment. .If cholera patients are treated quickly and properly, the mortality rate is less than 1%; however, with untreated cholera, the mortality rate rises to 50–60%.^ If left untreated, cholera has a 25-50% mortality rate.
  • Scientific Literature on Infectious Diseases Related to TropIKA.net 19 January 2010 8:49 UTC search.bvsalud.org [Source type: Academic]

^ But with effective treatment, mortality is less than 1%.
  • Cholera, Making Sense of ... at azodium 19 January 2010 8:49 UTC www.azodium.com [Source type: FILTERED WITH BAYES]

^ Untreated cholera frequently results in high (50-60%) mortality rates.

[10][11]

Diagnosis

.In epidemic situations, a clinical diagnosis is made by taking a history of symptoms from the patient and by a brief examination only.^ The objective of this study was to examine the incidence of V. Cholera e Infection and associated clinical symptoms in household contacts of patients with Cholera and to identify risk factors for development of severe dehydration in this cohort.
  • View Pathway: Cholera - Infection 19 January 2010 8:49 UTC apropos.mcw.edu [Source type: Academic]

^ Perceptive clinical observations by physicians caring for patients during the 1832 cholera epidemic in London led to the first recorded use of intravenous rehydration therapy ( 7 ).
  • Journal of Clinical Investigation -- The human, societal, and scientific legacy of cholera 19 January 2010 8:49 UTC www.jci.org [Source type: Academic]

^ CONCLUSION: The higher sensitivity of the clinical and epidemiological cholera diagnosis criterion in patients aged five years or more found in the study support its application during epidemics periods .

.Treatment is usually started without or before confirmation by laboratory analysis of specimens.^ Such specimens were usually hand carried by the responsible investigators, historically the surest and safest means for rapid sharing of valuable specimens and accompanying documentation between laboratories ( 6 ).
  • Journal of Clinical Investigation -- The human, societal, and scientific legacy of cholera 19 January 2010 8:49 UTC www.jci.org [Source type: Academic]

^ Neither the treatment of individual cases nor the notification of suspected cases needs laboratory confirmation of the presence of Vibrio cholerae 01.
  • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

^ The first case of laboratory-confirmed cholera occurred in a resident of a neighborhood other than Esturro, who presented to the Cholera Treatment Center on January 12, 2004.
  • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

.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.^ Specimens should be collected before antibiotic treatment.
  • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

^ It's a disease that affects the bowels and in its most severe form is characterized by acute watery diarrhoea that can lead to immediate death through severe dehydration and kidney failure.
  • Cholera: News & Videos about Cholera - CNN.com 19 January 2010 8:49 UTC topics.cnn.com [Source type: News]

^ The diagnosis of cholera is confirmed by clinical evaluation and the isolation of the V. cholerae from cultures grown with samples of fresh stool from an infected individual.
  • CIGNA - Cholera 19 January 2010 8:49 UTC www.cigna.com [Source type: Academic]

.If an epidemic of cholera is suspected, the most common causative agent is Vibrio 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.^ The organism has been characterized as V. cholerae O139 "Bengal".
  • Cholera (Vibrio cholerae) 19 January 2010 8:49 UTC www.tjclarkinc.com [Source type: Academic]

^ Of the vibrios that are clinically significant to humans, Vibrio cholerae, the agent of cholera, is the most important.

^ Cholera is caused by enterotoxin producing V. cholerae of serogroups O1 and O139 (sometimes referred to as the ‘Bengal’ strain).

.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.^ Cholera is an infection associated with poverty.
  • http://www.colorado.edu/geography/gcraft/warmup/cholera/cholera.bak11 19 January 2010 8:49 UTC www.colorado.edu [Source type: FILTERED WITH BAYES]

^ OCHA said cases and fatalities of cholera - an acute intestinal infection caused by contaminated food or water - have decreased substantially in areas where aid agencies are present.
  • Cholera // Current 19 January 2010 8:49 UTC current.com [Source type: FILTERED WITH BAYES]

^ Only V. cholerae O1 was thought to cause epidemic cholera until a non- O1 V. cholerae belonging to serogroup O139 was isolated during an epidemic in India in 1992 and subsequently spread worldwide Cholera has an unusual ability to exhibit both epidemic and endemic epidemiology.
  • Department of Health and Ageing - Cholera laboratory case definition 19 January 2010 8:49 UTC www.health.gov.au [Source type: Academic]

[12]
.A number of special media have been employed for the cultivation for cholera vibrios.^ Zooplankton that inhabit cold waters may carry large number of cholera vibrios on their bodies.
  • http://www.colorado.edu/geography/gcraft/warmup/cholera/cholera.bak11 19 January 2010 8:49 UTC www.colorado.edu [Source type: FILTERED WITH BAYES]

^ The vaccine will be used for active immunization against Vibrio cholerae Bengal and other bacterial species expressing similar surface polysaccharides.
  • Cholera (Vibrio cholerae) 19 January 2010 8:49 UTC www.tjclarkinc.com [Source type: Academic]

^ The vaccine will be used for active immunization against Vibrio cholerae O139 and other bacterial species expressing similar surface polysaccharides.

They are classified as follows:

Holding or transport media

.
  1. Venkataraman-Ramakrishnan (VR) medium: This medium has 20g Sea Salt Powder and 5g Peptone dissolved in 1L of distilled water.
  2. Cary-Blair medium: This is the most widely-used carrying medium.^ From the Cary-Blair medium, the swabs were plated directly onto thiosulfate citrate bile salts sucrose agar and tellurite taurocholate gelatin agar.
    • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

    ^ The rectal swabs were transported every 12 hours in Cary-Blair medium at room temperature to the study laboratory.
    • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

    ^ The most commonly used selective media for V. cholerae are alkaline peptone water (APW) and thiosulphate citrate bile salt sucrose (TCBS) agar.
    • Department of Health and Ageing - Cholera laboratory case definition 19 January 2010 8:49 UTC www.health.gov.au [Source type: Academic]

    This is a buffered solution of sodium chloride, sodium thioglycollate,sodium phosphate and calcium chloride at pH 8.4.
  3. Autoclaved sea water

Enrichment media

  1. Alkaline peptone water at pH 8.6
  2. Monsur's taurocholate tellurite peptone water at pH 9.2

Plating media

.
  1. Alkaline bile salt agar (BSA): The colonies are very similar to those on nutrient agar.
  2. Monsur's gelatin Tauro cholate trypticase tellurite agar (GTTA) medium: Cholera vibrios produce small translucent colonies with a greyish black centre.
  3. TCBS medium: This the mostly widely used medium.^ But those are mostly the very young and the very old.
    • Retch-22: Laos in the time of cholera - Salon.com 19 January 2010 8:49 UTC www.salon.com [Source type: General]

    ^ Monsur KA. A highly selective gelatin-taurocholate-tellurite medium for the isolation of Vibrio cholerae.
    • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

    ^ ARTICLE from the Encyclopædia Britannica pathology an acute infection of the small intestine caused by the bacterium Vibrio cholerae and characterized by extreme diarrhea with rapid and severe depletion of body fluids and salts.
    • cholera (pathology) -- Britannica Online Encyclopedia 19 January 2010 8:49 UTC www.britannica.com [Source type: Academic]

    .This medium contains thiosulphate, citrate, bile salts and sucrose.^ From the Cary-Blair medium, the swabs were plated directly onto thiosulfate citrate bile salts sucrose agar and tellurite taurocholate gelatin agar.
    • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

    ^ V. cholerae is a non-fastidious species, able to grow on a wide variety of bacteriological media including blood, MacConkey and thiosulphate citrate bile salt (TCBS) agars.
    • Department of Health and Ageing - Cholera laboratory case definition 19 January 2010 8:49 UTC www.health.gov.au [Source type: Academic]

    ^ The most commonly used selective media for V. cholerae are alkaline peptone water (APW) and thiosulphate citrate bile salt sucrose (TCBS) agar.
    • Department of Health and Ageing - Cholera laboratory case definition 19 January 2010 8:49 UTC www.health.gov.au [Source type: Academic]

    Cholera vibrios produce flat 2–3 mm in diameter, yellow nucleated colonies.
Direct microscopy of stool is not recommended as it is unreliable. .Microscopy is preferred only after enrichment, as this process reveals the characteristic motility of Vibrios and its inhibition by appropriate antiserum.^ V. cholerae O1 demonstrates a characteristic spiral motility that is inhibited by O1 agglutinating antisera.
  • Department of Health and Ageing - Cholera laboratory case definition 19 January 2010 8:49 UTC www.health.gov.au [Source type: Academic]

.Diagnosis can be confirmed as well as serotyping done by agglutination with specific sera.^ Confirmation of the identity of presumptive V. cholerae requires serotype O1 agglutinating antisera and salt-supplemented substrate utilisation tests.
  • Department of Health and Ageing - Cholera laboratory case definition 19 January 2010 8:49 UTC www.health.gov.au [Source type: Academic]

Epidemiology

Prevention

.Although cholera may be life-threatening, prevention of the disease is normally straightforward if proper sanitation practices are followed.^ This will prevent the cholera disease form happening.
  • Home Remedies for Cholera - Cholera Natural Treatment - Herbal Cure for Cholera 19 January 2010 8:49 UTC www.herbalcureindia.com [Source type: FILTERED WITH BAYES]

^ Although cholera can be life-threatening, it is easily prevented and treated.
  • Cholera (Vibrio cholerae) 19 January 2010 8:49 UTC www.drlera.com [Source type: FILTERED WITH BAYES]

^ We have come a long way to the integrative point of view that Vibrio cholerae, the causative organism of the disease cholera, is a normal component of the ecosystem—an organism that can never be eradicated but only controlled.
  • NSF - OLPA - Dr. Rita R. Colwell - "Cholera and the Environment: A Classic Modelfor Human Pathogens in the Environment", Symposium: From Outside to Inside: Environmental Microorganisms as Human Pathogens, American Association for the Advancement of Science Annual Meeting, Seattle, Washington, February 14, 2004 19 January 2010 8:49 UTC www.nsf.gov [Source type: FILTERED WITH BAYES]

.In the first world, due to nearly universal advanced water treatment and sanitation practices, cholera is no longer a major health threat.^ Rice water is a best treatment for cholera .
  • Home Remedies for Cholera - Treatment and Cure for Cholera 19 January 2010 8:49 UTC home-remedies-treatment.com [Source type: FILTERED WITH BAYES]

^ In the United States, because of advanced water and sanitation systems, cholera is not a major threat; however, everyone, especially travelers, should be aware of how the disease is transmitted and what can be done to prevent it.
  • Cholera Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 19 January 2010 8:49 UTC www.wrongdiagnosis.com [Source type: Academic]

^ The reasons for this are uncertain, but standards of living had risen and many communities had made major changes in sanitation practices and established permanent boards of health.
  • Open Collections Program: Contagion, Cholera Epidemics in the 19th Century 19 January 2010 8:49 UTC ocp.hul.harvard.edu [Source type: Academic]

.The last major outbreak of cholera in the United States occurred in 1910-1911.[13][14] Travelers should be aware of how the disease is transmitted and what can be done to prevent it.^ The last major outbreak in the United States occurred in 1911.
  • Cholera 19 January 2010 8:49 UTC www.cnn.com [Source type: FILTERED WITH BAYES]
  • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]
  • Cholera 19 January 2010 8:49 UTC www.cnnstudentnews.cnn.com [Source type: FILTERED WITH BAYES]

^ Cholera epidemic of 1873 in the United States .
  • Cholera Online: A Modern Pandemic in Texts and Images - View the Images 19 January 2010 8:49 UTC www.nlm.nih.gov [Source type: Reference]

^ In the United States, because of advanced water and sanitation systems, cholera is not a major threat; however, everyone, especially travelers, should be aware of how the disease is transmitted and what can be done to prevent it.
  • Cholera Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 19 January 2010 8:49 UTC www.wrongdiagnosis.com [Source type: Academic]

.Effective sanitation practices, if instituted and adhered to in time, are usually sufficient to stop an epidemic.^ In areas with inadequate sanitation, a cholera epidemic cannot be stopped immediately, and there are no signs that the epidemic in the Americas will end soon.
  • Cholera (Vibrio cholerae) 19 January 2010 8:49 UTC www.drlera.com [Source type: FILTERED WITH BAYES]

There are several points along the cholera transmission path at which its spread may be (and should be) halted:
.
Cholera hospital in Dhaka, showing typical cholera beds.
  • Sterilization: Proper disposal and treatment of infected fecal waste water produced by cholera victims and all contaminated materials (e.g.^ All these beds are filled with cholera victims.
    • Mugabe tries to hide cholera death toll - Times Online 19 January 2010 8:49 UTC www.timesonline.co.uk [Source type: News]

    ^ It is contracted by the ingestion of water or food contaminated by the feces of cholera victims, but since the bacteria remains with a majority of patients for two weeks or less, there is rarely a vector or carrier in the usual sense.

    ^ It was further observed that carriers are responsible for the transmission of V.cholerae infection to other family members by contaminating unprotected stored water and cooked food with their infected fingers.
    • http://www.icmr.nic.in/niced.htm 19 January 2010 8:49 UTC www.icmr.nic.in [Source type: Academic]

    clothing, bedding, etc) is essential. .All materials that come in contact with cholera patients should be sterilized by washing in hot water using chlorine bleach if possible.^ The characteristic cholera stool is an opaque white liquid that is not malodorous and often is described as having a rice water appearance (ie, in color and consistency, it resembles water that has been used to wash or cook rice).
    • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

    ^ Mohammed, a dentist in Baghdad and author of the blog Last Of Iraqis , wrote about the possibility of cholera in the city as he described and photographed the changes in water coming from the tap in his home: .
    • Think Progress » Chlorine Restrictions Due To Security Concerns Help Fuel Spread Of Cholera In Iraq 19 January 2010 8:49 UTC thinkprogress.org [Source type: News]

    ^ Despite control strategies, including improved case management, water-chlorination campaigns, and dissemination of health-education messages, the burden of cholera has remained high.
    • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

    .Hands that touch cholera patients or their clothing, bedding, etc, should be thoroughly cleaned and disinfected with chlorinated water or other effective anti-microbial agents.
  • Sewage: anti-bacterial treatment of general sewage by chlorine, ozone, ultra-violet light or other effective treatment before it enters the waterways or underground water supplies helps prevent undiagnosed patients from inadvertently spreading the disease.
  • Sources: Warnings about possible cholera contamination should be posted around contaminated water sources with directions on how to decontaminate the water (boiling, chlorination etc.^ Cholera is a bacterial disease usually spread through contaminated water.
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    ^ The most important methods of prevention and control of cholera are clean water supplies and adequate sewage disposal.
    • CIGNA - Cholera 19 January 2010 8:49 UTC www.cigna.com [Source type: Academic]

    ^ Contaminated drinking water is the most common source of cholera infection.
    • Cholera 19 January 2010 8:49 UTC www.cnn.com [Source type: FILTERED WITH BAYES]
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]
    • Cholera 19 January 2010 8:49 UTC www.cnnstudentnews.cnn.com [Source type: FILTERED WITH BAYES]

    ) for possible use.
  • .
  • Water purification: All water used for drinking, washing, or cooking should be sterilized by either boiling, chlorination, ozone water treatment, ultra-violet light sterilization, or anti-microbal filtration in any area where cholera may be present.^ Rice water is a best treatment for cholera .
    • Home Remedies for Cholera - Treatment and Cure for Cholera 19 January 2010 8:49 UTC home-remedies-treatment.com [Source type: FILTERED WITH BAYES]

    ^ Drinking untreated water or eating poorly cooked seafood in endemic areas carries a high risk.
    • Cholera | Doctor | Patient UK 19 January 2010 8:49 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

    ^ Always purify the water first by boiling, filtration or other proven methods.
    • Cholera 19 January 2010 8:49 UTC www.cnn.com [Source type: FILTERED WITH BAYES]
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    .Chlorination and boiling are often the least expensive and most effective means of halting transmission.^ The simplest and most cost effective method is chlorination of water in the storage container using household bleach.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    .Cloth filters, though very basic, have significantly reduced the occurrence of cholera when used in poor villages in Bangladesh that rely on untreated surface water.^ A bacterial illness linked to the lack of safe drinking water and inadequate sewage facilities, cholera can kill swiftly if untreated.
    • Cholera claims at least 680 in Ethiopia, aid groups say 19 January 2010 8:49 UTC nazret.com [Source type: General]

    ^ Cholera occurs where sanitation, food and water hygiene are poor.
    • Cholera | Doctor | Patient UK 19 January 2010 8:49 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

    ^ A matched-pair case-control study was conducted in the village at the height of the epidemic (18-24 November), and the investigation revealed that the consumption of water from the Gumpies River was significantly more common among cholera patients than among matched controls .

    .Better anti-microbial filters like those present in advanced individual water treatment hiking kits are most effective.^ For most patients, treatment with oral rehydration is sufficient; however, when safe water or oral rehydration salts are not available, case fatality rates can be very high.
    • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

    ^ The housing conditions in the expanding industrial towns of South and North-East Wales were, like those of the Midlands and Northern England, the legacy of unrestrained individualism.
    • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

    ^ The simplest and most cost effective method is chlorination of water in the storage container using household bleach.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    Public health education and adherence to appropriate sanitation practices are of primary importance to help prevent and control transmission of cholera and other diseases.
.A vaccine for cholera is available in some countries, but prophylactic usage is not currently recommended for routine use by the Centers for Disease Control and Prevention (CDC).^ This will prevent the cholera disease form happening.
  • Home Remedies for Cholera - Cholera Natural Treatment - Herbal Cure for Cholera 19 January 2010 8:49 UTC www.herbalcureindia.com [Source type: FILTERED WITH BAYES]

^ Cholera vaccination is NOT recommended, and vaccines currently available DO NOT help in controlling cholera because of the following reasons: .
  • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

^ The VC test on stool samples was conducted on-site; samples were subsequently stored in Cary-Blair transport media and sent to the Centers for Disease Control and Prevent (more) ion for diagnostic testing by culture and polymerase chain reaction (PCR).
  • Scientific Literature on Infectious Diseases Related to TropIKA.net 19 January 2010 8:49 UTC search.bvsalud.org [Source type: Academic]

[15] .During recent years, substantial progress has been made in developing new oral vaccines against cholera.^ The oral vaccines are made from a live attenuated strains of V. cholerae.

^ Thus, these components in particular are pivotal in developing a progressive vaccine against cholera.
  • Scientific Literature on Infectious Diseases Related to TropIKA.net 19 January 2010 8:49 UTC search.bvsalud.org [Source type: Academic]

^ The old cholera injection vaccine was of dubious value and lasted just 6 months but a new oral, killed whole cell vaccine is much better.
  • Cholera | Doctor | Patient UK 19 January 2010 8:49 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

.Two oral cholera vaccines, which have been evaluated with volunteers from industrialized countries and in regions with endemic cholera, are commercially available in several countries: a killed whole-cell V. cholerae O1 in combination with purified recombinant B subunit of cholera toxin and a live-attenuated live oral cholera vaccine, containing the genetically manipulated V. cholerae O1 strain CVD 103-HgR. The appearance of V. cholerae O139 has influenced efforts in order to develop an effective and practical cholera vaccine since none of the currently available vaccines is effective against this strain.^ [CrossRef] [Web of Science] [Medline] Holmgren J, Berquist C. Oral B subunit–killed whole-cell cholera vaccine.
  • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

^ A commercially available live varicella vaccine (Oka strain) and cholera toxin or its B subunit were administered simultaneously via the nasal route .

^ A live oral candidate vaccine strain has been recently developed and is currently undergoing clinical trials.
  • http://www.icmr.nic.in/niced.htm 19 January 2010 8:49 UTC www.icmr.nic.in [Source type: Academic]

[12] .The newer vaccine (brand name: Dukoral), an orally administered inactivated whole cell vaccine, appears to provide somewhat better immunity and have fewer adverse effects than the previously available vaccine.^ The effect of the 2 g dose was significantly better than that with the 1 g dose .

^ Both vaccines appear to provide  somewhat better immunity and fewer side-effects than the previously available vaccine.

^ The old cholera injection vaccine was of dubious value and lasted just 6 months but a new oral, killed whole cell vaccine is much better.
  • Cholera | Doctor | Patient UK 19 January 2010 8:49 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

[15] .This safe and effective vaccine is available for use by individuals and health personnel.^ Vaccines against cholera are available but are not 100 percent effective; booster injections are required every 6 months.
  • CIGNA - Cholera 19 January 2010 8:49 UTC www.cigna.com [Source type: Academic]

^ Control may depend on the widespread use of an effective vaccine .

^ The outbreak provided a unique opportunity to evaluate the practicality of use and effectiveness of this vaccine .

Work is under way to investigate the role of mass vaccination.[16]
.Sensitive surveillance and prompt reporting allow for containing cholera epidemics rapidly.^ Statistical report of the epidemic cholera in Jamaica.
  • Cholera Online: A Modern Pandemic in Texts and Images - By Location 19 January 2010 8:49 UTC www.nlm.nih.gov [Source type: Academic]

^ Environmental surveillance forms one of the most important part in the control and preparedness of the cholera epidemic.
  • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

^ According to these regulations National Health Authorities should report the first suspected cases of cholera to the World Health Organisation as rapidly as possible.
  • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

.Cholera exists as a seasonal disease in many endemic countries, occurring annually mostly during rainy seasons.^ Cholera can be an endemic, epidemic, or a pandemic disease.
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

^ The likely contributory factors are that (1) most cases occur in remote areas of developing countries where definitive diagnosis is not possible, (2) reporting systems often are nonexistent in such areas, (3) the stigma of reporting cholera has direct consequences on commercial trade and tourism, and (4) many countries with endemic cholera do not report at all.
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

^ Its report concluded: “It is very likely with the current water and sanitation problems in the country, low capacity of the government to deal with the outbreak, glaring gaps in response, coupled with the rainy season that has started, cholera outbreaks could get catastrophic and claim many more lives.” .
  • Mugabe tries to hide cholera death toll - Times Online 19 January 2010 8:49 UTC www.timesonline.co.uk [Source type: News]

.Surveillance systems can provide early alerts to outbreaks, therefore leading to coordinated response and assist in preparation of preparedness plans.^ Establish a high-quality surveillance system for early detecting and effective monitoring of cholera cases Train key health personnel to effectively monitor and manage cholera cases.
  • IOM - Scaling Up IOM's Cholera Response in Zimbabwe 19 January 2010 8:49 UTC www.iom.int [Source type: FILTERED WITH BAYES]

^ As the lead agency, coordinate cholera-response activities with fellow agencies, local authorities and others .
  • IOM - Scaling Up IOM's Cholera Response in Zimbabwe 19 January 2010 8:49 UTC www.iom.int [Source type: FILTERED WITH BAYES]

^ Therefore, T-B cell interactions leading to mucosal as opposed to serum IgA responses are uniquely regulated and appear to represent separate events .

.Efficient surveillance systems can also improve the risk assessment for potential cholera outbreaks.^ Establish a high-quality surveillance system for early detecting and effective monitoring of cholera cases Train key health personnel to effectively monitor and manage cholera cases.
  • IOM - Scaling Up IOM's Cholera Response in Zimbabwe 19 January 2010 8:49 UTC www.iom.int [Source type: FILTERED WITH BAYES]

^ Cholera outbreak in Southern Tanzania: Risk factors and patterns of transmission.
  • Waterfowl—The Missing Link in Epidemic and Pandemic Cholera Dissemination? 19 January 2010 8:49 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ This study identifies environmental risk factors for cholera in an endemic area of Bangladesh using a geographic information systems (GIS) approach .

.Understanding the seasonality and location of outbreaks provide guidance for improving cholera control activities for the most vulnerable.^ Despite control strategies, including improved case management, water-chlorination campaigns, and dissemination of health-education messages, the burden of cholera has remained high.
  • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

^ If your area water is contaminated, you have control to do something about it in most instances and that would be the first home remedy for cholera .
  • Cholera Home Remedies - Cholera Treatment - Natural Remedies & Cure for Cholera 19 January 2010 8:49 UTC www.natural-homeremedies.org [Source type: FILTERED WITH BAYES]

^ Organization and implementation of cholera control interventions} ; Onishchenko GG et al.; Data on emergent epidemiological analysis of the cholera outbreak in Kazan are presented .

.This will also aid in the developing indicators for appropriate use of oral cholera vaccine.^ The proposed national reference preparations for Inaba and Ogawa may be used for evaluating the antigenic potency of the lot of cholera vaccine produced in Bulgaria as the standard preparation.

^ Vaccinated mice developed a robust antibody response when the vaccine antigen was given together with Cholera toxin adjuvant.
  • View Pathway: Cholera - Life cycle 19 January 2010 8:49 UTC apropos.mcw.edu [Source type: Academic]

^ Mass vaccination with a two-dose oral cholera vaccine in a refugee camp.
  • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

[17]

Susceptibility

.Recent epidemiologic research suggests that an individual's susceptibility to cholera (and other diarrheal infections) is affected by their blood type: those with type O blood are the most susceptible,[18][19] while those with type AB are the most resistant.^ Because of this, far less research is conducted on cholera compared to other health problems afflicting larger populations, like breast cancer or heart disease.

^ Practical observations on the prevailing epidemic called cholera, with advice to the heads of families and others, as to the precautionary and primary domestic treatment to be used in warding off a threatened attack of, and assisting those already affected by the epidemic.
  • Cholera Online: A Modern Pandemic in Texts and Images - By Location 19 January 2010 8:49 UTC www.nlm.nih.gov [Source type: Academic]

^ He suggested that, ’the Medical Officers be instructed not to receive any patients except those as are obviously affected with cholera or with its pulmonary symptoms, leaving any that may labour under fever, dysentery, or other epidemic diseases to be treated in the Fever Hospital.’ The Board decided to carry out these recommendations immediately.
  • Shandon Cholera Hospital 1849 - Waterford County Museum 19 January 2010 8:49 UTC www.waterfordcountymuseum.org [Source type: FILTERED WITH BAYES]

Between these two extremes are the A and B blood types, with type A being more resistant than type B.[citation needed]
.About one million V. cholerae bacteria must typically be ingested to cause cholera in normally healthy adults, although increased susceptibility may be observed in those with a weakened immune system, individuals with decreased gastric acidity (as from the use of antacids), or those who are malnourished.^ This is one of the useful cholera cure.
  • Home Remedies for Cholera - Treatment & Cure - Natural Remedy for Cholera – Cholera Diet 19 January 2010 8:49 UTC natural-homeremedies.com [Source type: FILTERED WITH BAYES]

^ Read more about causes of Cholera .
  • Cholera Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 19 January 2010 8:49 UTC www.wrongdiagnosis.com [Source type: Academic]

^ WHO also advocates Doxycycline for adult cholera.
  • http://www.icmr.nic.in/niced.htm 19 January 2010 8:49 UTC www.icmr.nic.in [Source type: Academic]

.It has also been hypothesized that the cystic fibrosis genetic mutation has been maintained in humans due to a selective advantage: heterozygous carriers of the mutation (who are thus not affected by cystic fibrosis) are more resistant to V. cholerae infections.^ It was further observed that carriers are responsible for the transmission of V.cholerae infection to other family members by contaminating unprotected stored water and cooked food with their infected fingers.
  • http://www.icmr.nic.in/niced.htm 19 January 2010 8:49 UTC www.icmr.nic.in [Source type: Academic]

^ The large movement of people in addition to commercial and trade activities in cross-border areas increases the chances of cholera transmissions from individuals who may have been to cholera-affected areas.
  • IOM - Scaling Up IOM's Cholera Response in Zimbabwe 19 January 2010 8:49 UTC www.iom.int [Source type: FILTERED WITH BAYES]

^ First, the ratio of cases to carriers is much less than in cholera due to classic biotypes (1: 30-100 for El Tor vs. Second, the duration of carriage after infection is longer for the El Tor strain than the classic strains.

[20] .In this model, the genetic deficiency in the cystic fibrosis transmembrane conductance regulator channel proteins interferes with bacteria binding to the gastrointestinal epithelium, thus reducing the effects of an infection.^ Bacteria produce strong toxin Although V. cholerae is the source of cholera infection, the deadly effects of the disease are the result of a potent toxin, called CTX, that the bacteria produce in the small intestine.

^ Thus, the immediate effect of preventing infection was mainly provided by the secondary Ab responses .

Transmission

Drawing of Death bringing the cholera, in Le Petit Journal
.People infected with cholera suffer acute diarrhea.^ Since August, at least 3,623 people have died and 76,127 people have been infected by cholera, a preventable water-borne bacterial illness that causes severe diarrhea, vomiting and dehydration and can lead to death in a matter of days if not treated.
  • Zimbabwe cholera epidemic worsening - CNN.com 19 January 2010 8:49 UTC www.cnn.com [Source type: News]

^ After an incubation period ranging from several hours to 5 days, cholera produces acute, painless, profuse, watery diarrhea and effortless vomiting (without preceding nausea).
  • Symptoms of Cholera - WrongDiagnosis.com 19 January 2010 8:49 UTC www.wrongdiagnosis.com [Source type: General]

^ "There are some people who have diarrhea," she said, "but there is no cholera."
  • Retch-22: Laos in the time of cholera - Salon.com 19 January 2010 8:49 UTC www.salon.com [Source type: General]

.This highly liquid diarrhea, colloquially referred to as "rice-water stool," is loaded with bacteria that can infect water used by other people.^ The characteristic cholera stool is an opaque white liquid that is not malodorous and often is described as having a rice water appearance (ie, in color and consistency, it resembles water that has been used to wash or cook rice).
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

^ Cholera bacteria in people When humans ingest cholera bacteria, they may not become sick themselves, but they still excrete the bacteria in their stool and can pass cholera disease to others through the fecal-oral route.
  • Cholera 19 January 2010 8:49 UTC www.cnn.com [Source type: FILTERED WITH BAYES]
  • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

^ It was further observed that carriers are responsible for the transmission of V.cholerae infection to other family members by contaminating unprotected stored water and cooked food with their infected fingers.
  • http://www.icmr.nic.in/niced.htm 19 January 2010 8:49 UTC www.icmr.nic.in [Source type: Academic]

[1] .Cholera is transmitted through ingestion of water contaminated with the cholera bacterium, usually from feces or other effluent.^ Cholera is a bacterial disease usually spread through contaminated water.
  • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

^ In distillation you only take the pure steam that comes off the water, thus leaving the dead bacteria and other contaminants behind!
  • Cholera (Vibrio cholerae) 19 January 2010 8:49 UTC www.drlera.com [Source type: FILTERED WITH BAYES]

^ It was further observed that carriers are responsible for the transmission of V.cholerae infection to other family members by contaminating unprotected stored water and cooked food with their infected fingers.
  • http://www.icmr.nic.in/niced.htm 19 January 2010 8:49 UTC www.icmr.nic.in [Source type: Academic]

.The source of the contamination is typically other cholera patients when their untreated diarrhea discharge is allowed to get into waterways or into groundwater or drinking water supplies.^ Contaminated drinking water is the most common source of cholera infection.

^ The germ can also contaminate food or water supplies.
  • Médecins Sans Frontières International Homepage 19 January 2010 8:49 UTC www.msf.org [Source type: FILTERED WITH BAYES]

^ In 1883, Robert Koch successfully isolated the cholera vibrio from the intestinal discharges of cholera patients and proved conclusively that it was the agent of the disease.

.Any infected water and any foods washed in the water, as well as shellfish living in the affected waterway, can cause an infection.^ It was further observed that carriers are responsible for the transmission of V.cholerae infection to other family members by contaminating unprotected stored water and cooked food with their infected fingers.
  • http://www.icmr.nic.in/niced.htm 19 January 2010 8:49 UTC www.icmr.nic.in [Source type: Academic]

^ T he first epidemic of a waterborne disease probably was caused by an infected caveman relieving himself in waters upstream of his neighbors.
  • Plagues & Epidemics 19 January 2010 8:49 UTC www.theplumber.com [Source type: FILTERED WITH BAYES]

^ Wash your hands thoroughly with hot, soapy water, especially before eating or preparing food, after using the toilet, and when you return from public places.
  • Cholera 19 January 2010 8:49 UTC www.cnn.com [Source type: FILTERED WITH BAYES]
  • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]
  • Cholera 19 January 2010 8:49 UTC www.cnnstudentnews.cnn.com [Source type: FILTERED WITH BAYES]

.Cholera is rarely spread directly from person to person.^ Cholera occasionally spreads to Europe, Japan, Australia, and South America where epidemics can occur any time of the year and affect persons of all ages equally.
  • CIGNA - Cholera 19 January 2010 8:49 UTC www.cigna.com [Source type: Academic]

^ In May 1911 cholera reappeared in Samsun and spread within the Ottoman Empire and 18876 persons were infected with cholera and 12143 of them died .

^ Additional research is needed to evaluate directly the effectiveness of the rBS-WC vaccine among HIV-infected persons and to clarify the interaction, if any, between HIV infection and cholera.
  • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

.V. cholerae harbors naturally in the zooplankton of fresh, brackish, and salt water, attached primarily to their chitinous exoskeleton.^ Only with these discoveries would the cholera bacteria's mode of transmission, primarily through the ingestion of contaminated water and foods, be fully comprehended.
  • The 1832 Cholera Epidemic in New York State 19 January 2010 8:49 UTC www.earlyamerica.com [Source type: FILTERED WITH BAYES]

^ Causes Contaminated water supplies are the main source of cholera infection, although raw shellfish, uncooked fruits and vegetables, and other foods also can harbor cholera bacteria.

^ Water temperature, rainfall, water depth and zooplankton all have a direct impact on cholera in the environment.
  • NSF - OLPA - Dr. Rita R. Colwell - "Cholera and the Environment: A Classic Modelfor Human Pathogens in the Environment", Symposium: From Outside to Inside: Environmental Microorganisms as Human Pathogens, American Association for the Advancement of Science Annual Meeting, Seattle, Washington, February 14, 2004 19 January 2010 8:49 UTC www.nsf.gov [Source type: FILTERED WITH BAYES]

[21] Both toxic and non-toxic strains exist. Non-toxic strains can acquire toxicity through a lysogenic bacteriophage.[22] .Coastal cholera outbreaks typically follow zooplankton blooms, thus making cholera a zoonotic disease.^ It was not till 1817 that the attention of European physicians was specially directed to the disease by the outbreak of a violent epidemic of cholera at Jessore in Bengal.

^ As there are some clear links between the organism, cholera incidence and the sea, it is appropriate that cholera research should examine the nature of coastal population vulnerability to the disease .

^ In this article a brief overview about cholera is followed by an account of one non-governmental organization's approach to management of a cholera outbreak .

Potential human contribution to transmissibility

.Cholera bacteria grown in vitro encounter difficulty subsequently growing in humans without additional stomach acid buffering.^ Recently developed molecular tools for the detection of cholera toxin, pathogenic serogroups, and strain fingerprinting of V. cholerae (e.g., [31] , [32] ) should enable the detection of various V. cholerae strains in birds even without growing the bacteria in culture.
  • Waterfowl—The Missing Link in Epidemic and Pandemic Cholera Dissemination? 19 January 2010 8:49 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ This protective clustering behavior is yet another mechanism for cholera's life cycle in the aquatic environment, which also serves to protect it from stomach acid when ingested by humans.
  • NSF - OLPA - Dr. Rita R. Colwell - "Cholera and the Environment: A Classic Modelfor Human Pathogens in the Environment", Symposium: From Outside to Inside: Environmental Microorganisms as Human Pathogens, American Association for the Advancement of Science Annual Meeting, Seattle, Washington, February 14, 2004 19 January 2010 8:49 UTC www.nsf.gov [Source type: FILTERED WITH BAYES]

^ Under these conditions, human melanocytes could be passaged serially in vitro and grown in quantity .

.In a 2002 study at Tufts University School of Medicine, it was found that stomach acidity is a principal agent that advances epidemic spread.^ CONCLUSION: This study demonstrated that the epidemic spread from the affected provinces in the South and the North of the country.

^ Division of Geriatric Medicine, Department of Medicine, and Division of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA .
  • Journal of Clinical Investigation -- The human, societal, and scientific legacy of cholera 19 January 2010 8:49 UTC www.jci.org [Source type: Academic]

[23] .In their findings, the researchers found that human colonization creates a hyperinfectious bacterial state that is maintained after dissemination and that may contribute to epidemic spread of the disease.^ The cholera infection is usually water-borne, flies also disseminating the disease by contaminating food and milk, and in India where the infection is endemic the movements of pilgrims in the spring and summer months contribute to the occurrence of periodic epidemic exacerbation.
  • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

^ Cholera can be spread as an endemic, epidemic, or pandemic disease.
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

^ Understanding interactions between humans and the agents that cause specific diseases requires sustained research at sites where disease is prevalent.
  • Journal of Clinical Investigation -- The human, societal, and scientific legacy of cholera 19 January 2010 8:49 UTC www.jci.org [Source type: Academic]

.When these hyperinfectious bacteria underwent transcription profiles, they were found to possess a unique physiological and behavioral state, characterized by high expression levels of genes required for nutrient acquisition and motility, and low expression levels of genes required for bacterial chemotaxis.^ In stationary phase cultures, RpoS was also required for upregulation of chemotaxis and motility genes, for production of flagella, and for movement of bacteria across low nutrient swarm plates.
  • View Pathway: Cholera - Life cycle 19 January 2010 8:49 UTC apropos.mcw.edu [Source type: Academic]

^ Cumulatively, these results support a model of the V. Cholera e Life cycle in which c-di-GMP must be down-regulated early after entering the small intestine and maintained at a low level to allow virulence gene expression, colonization, and motility at appropriate stages of infection.
  • View Pathway: Cholera - Life cycle 19 January 2010 8:49 UTC apropos.mcw.edu [Source type: Academic]

^ Quantitative in vivo localization assays corroborated the rpoS phenotype and showed that it also requires HapR. Expression profiling of bacteria isolated from ileal loop fluid and mucus demonstrated a significant RpoS-dependent upregulation of many chemotaxis and motility genes coincident with the emigration of bacteria from the epithelial surface.
  • View Pathway: Cholera - Life cycle 19 January 2010 8:49 UTC apropos.mcw.edu [Source type: Academic]

.Thus, the spread of cholera can be expedited by host physiology.^ Certain environmental and host factors appear to play a role in the spread of V cholerae .
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

Research

.The Russian-born bacteriologist Waldemar Haffkine developed the first cholera vaccine around 1900. The bacterium had been originally isolated thirty years earlier (1855) by Italian anatomist Filippo Pacini, but its exact nature and his results were not widely known around the world.^ A cholera outbreak occurred in the area the following year, resulting in cholera attack rates of 1 percent in the nonrefugee Ugandan villages, less than 1 percent in the 29 nonvaccinated refugee camps, and 0 percent in the six vaccinated refugee camps.
  • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

^ The ecological relationship of cholera and planktonic copepods was first established in 1983 when Anwar Huq and I showed that V. cholerae attach to live copepods in the Chesapeake Bay and around Bangladesh.
  • NSF - OLPA - Dr. Rita R. Colwell - "Cholera and the Environment: A Classic Modelfor Human Pathogens in the Environment", Symposium: From Outside to Inside: Environmental Microorganisms as Human Pathogens, American Association for the Advancement of Science Annual Meeting, Seattle, Washington, February 14, 2004 19 January 2010 8:49 UTC www.nsf.gov [Source type: FILTERED WITH BAYES]

^ Field trial of oral cholera vaccines in Bangladesh: results from three-year follow-up.
  • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

.One of the major contributions to fighting cholera was made by the physician and pioneer medical scientist John Snow (1813–1858), who found a link between cholera and contaminated drinking water in 1854.[24] Dr Snow proposed a microbial origin for epidemic cholera in 1849. In his major "state of the art" review of 1855, he proposed a substantially complete and correct model for the aetiology of the disease.^ Cholera is a bacterial disease usually spread through contaminated water.
  • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

^ Contaminated drinking water is the most common source of cholera infection.
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  • Cholera 19 January 2010 8:49 UTC www.cnnstudentnews.cnn.com [Source type: FILTERED WITH BAYES]

^ Cholera epidemic of 1873 in the United States .
  • Cholera Online: A Modern Pandemic in Texts and Images - View the Images 19 January 2010 8:49 UTC www.nlm.nih.gov [Source type: Reference]

.In two pioneering epidemiological field-studies, he was able to demonstrate that human sewage contamination was the most probable disease vector in two major epidemics in London in 1854.[25] His model was not immediately accepted, but it was seen to be the more plausible as medical microbiology developed over the next thirty years or so.^ John Snow's earlier epidemiological study in London had proved only to some that contaminated water caused the disease.
  • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

^ Two study periods were chosen because they had different dominant biotypes of the disease .

^ For further analysis of CT-binding structures, the possible interaction of CT with two major schistosome gut antigens, circulating cathodic antigen (CCA) and circulating anodic antigen (CAA), was studied.
  • View Pathway: Cholera - Life cycle 19 January 2010 8:49 UTC apropos.mcw.edu [Source type: Academic]

.Cities in developed nations made massive investment in clean water supply and well-separated sewage treatment infractures was made between the mid-1850s and the 1900s.^ Modern sewage and water treatment have virtually eliminated cholera in industrialized countries.
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^ In the United States, cholera was prevalent in the 1800s but has been virtually eliminated by modern sewage and water treatment systems.

^ There is still a large number of cases of cholera under treatment in this city; some that will prove fatal, others that will soon be well.

.This eliminated the threat of cholera epidemics from the major developed cities in the world.^ Med Sci (Paris), 2004 Jan, 20(1), 109 - 14 {The cholera epidemics and the development of public health in Meiji Japan .

^ The rate of cholera infection was observed to decline with distance from the city of Ibadan, while the duration of the epidemic obeyed the rank-size principles.

^ Med Sci (Paris), 2004 Feb, 20(2), 236 - 40 {The cholera epidemics and the development of public health in Meiji Japan .

Robert Koch, 30 years later, identified V. cholerae with a microscope as the bacillus causing the disease in 1885.
.Cholera has been a laboratory for the study of evolution of virulence.^ The findings of this and other studies performed in this laboratory lead to the proposal that the choleraic secretion is, at least in part, secondary to the activation of intramural nervous reflexes in the gut.

.The province of Bengal in British India was partitioned into West Bengal and East Pakistan in 1947. Prior to partition, both regions had cholera pathogens with similar characteristics.^ There are several characteristics of pathogenic V. cholerae that are important determinants of the colonization process.

^ Cholera is endemic in the East over a wide area, ranging from Bombay to southern China , but its chief home is British India.

^ This was followed by its rapid spread over a large portion of British India, where it caused immense destruction of life both among natives and Europeans.

.After 1947, India made more progress on public health than East Pakistan (now Bangladesh).^ Then on succeeding July fourths of 1825, 1827, 1829, and 1832, took four more separate census returns and made public his findings.

^ Other than cholera, important public health problems in Beira are malaria, tuberculosis, HIV infection, and the acquired immunodeficiency syndrome.
  • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

^ The disease now began to spread over a wider extent than hitherto, invading China on the east and Persia on the west.

As a consequence, the strains of the pathogen that succeeded in India had a greater incentive in the longevity of the host. .They have become less virulent than the strains prevailing in Bangladesh.^ With the replacement of classic cholera with El Tor, a less virulent strain, case fatality rates reduced dramatically during the 1960s.
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

^ In nonendemic areas, incidence of infection is similar in all age groups, although adults are less likely to become asymptomatic than children.
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

^ In the field, they're somewhat less than optimal.
  • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

.These uninhibitedly draw upon the resources of the host population, thus rapidly killing many victims.^ These are the conditions which spawned the infamous Black Plague, killing an estimated one third of the European population.
  • Plagues & Epidemics 19 January 2010 8:49 UTC www.theplumber.com [Source type: FILTERED WITH BAYES]

More recently, in 2002, Alam et al. studied stool samples from patients at the .International Centre for Diarrhoeal Disease (ICDDR) in Dhaka, Bangladesh.^ Possible evolutionary significance ; Glass RI et al.; At the Matlab Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh, the authors examined the blood groups of patients hospitalized between January and September 1979 for diarrheal disease due to a variety of bacterial and viral agents .

^ As a WHO collaborative centre for research & training in diarrhoeal diseases, NICED impart training to visiting WHO Fellows from different S.E. Asian countries on different aspects of diarrhoeal diseases.
  • http://www.icmr.nic.in/niced.htm 19 January 2010 8:49 UTC www.icmr.nic.in [Source type: Academic]

^ On this, the 25th anniversary of the founding of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), this article seeks to recount the Centre’s demonstration of how high-quality research on important global health issues, including cholera, can be accomplished in conditions that may be considered by many as unsuitable for scientific research.
  • Journal of Clinical Investigation -- The human, societal, and scientific legacy of cholera 19 January 2010 8:49 UTC www.jci.org [Source type: Academic]

.From the various experiments they conducted, the researchers found a correlation between the passage of V. cholerae through the human digestive system and an increased infectivity state.^ Because of this, far less research is conducted on cholera compared to other health problems afflicting larger populations, like breast cancer or heart disease.

^ Cholera bacteria in people When humans ingest cholera bacteria, they may not become sick themselves, but they still excrete the bacteria in their stool and can pass cholera disease to others through the fecal-oral route.
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^ The good news is that it was through cholera epidemics that epidemiologists finally discovered the link between sanitation and public health, which provided the impetus for modem water and sewage systems.
  • Plagues & Epidemics 19 January 2010 8:49 UTC www.theplumber.com [Source type: FILTERED WITH BAYES]

.Furthermore, the researchers found that the bacterium creates a hyper-infected state where genes that control biosynthesis of amino acids, iron uptake systems, and formation of periplasmic nitrate reductase complexes were induced just before defecation.^ Bile depletion was found to inhibit both the secretion induced by CT, the degradation of CT, and the binding of CT to epithelial cells--all of which could be restored to normal by the application, before CT challenge, of bile acids in the loops of CD-ligated mice .

^ Furthermore, cholera toxin was found to be less effective at inducing the synthesis of microsomal cytochrome P-450C21 than ACTH, and no more effective than the prostaglandins .

^ DNA fragment of Four HCV E2 gene were sequenced and 381 residues amino acid sequence of E2 glycoprotein were deduced .

.These induced characteristics allow the cholera vibrios to survive in the "rice water" stools, an environment of limited oxygen and iron, of patients with a cholera infection.^ Asiatic Cholera; Cholera gravis; Epidemic Cholera; Rice water diarrhea; V. cholera; Vibrio .

^ The characteristic cholera stool is an opaque white liquid that is not malodorous and often is described as having a rice water appearance (ie, in color and consistency, it resembles water that has been used to wash or cook rice).
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

^ Rice Water - In case of diarrhea, which is the most common thing to happen during cholera, drinking one bowl of rice water is very good.
  • Home Remedies for Cholera - Cholera Natural Treatment - Herbal Cure for Cholera 19 January 2010 8:49 UTC www.herbalcureindia.com [Source type: FILTERED WITH BAYES]

[23]

Biochemistry

TEM image of Vibrio cholerae
.Most of the V. cholerae bacteria in the contaminated water consumed by the host do not survive the highly acidic conditions of the human stomach.^ Contaminated drinking water is the most common source of cholera infection.

^ Because more than a million cholera bacteria - approximately the amount you'd find in a glass of contaminated water - are needed to cause illness, cholera usually isn't transmitted through casual person-to-person contact.

^ If your area water is contaminated, you have control to do something about it in most instances and that would be the first home remedy for cholera .
  • Cholera Home Remedies - Cholera Treatment - Natural Remedies & Cure for Cholera 19 January 2010 8:49 UTC www.natural-homeremedies.org [Source type: FILTERED WITH BAYES]

[26] .The few bacteria that do survive conserve their energy and stored nutrients during the passage through the stomach by shutting down much protein production.^ Cholera bacteria can't survive in an acidic environment, and ordinary stomach acid often serves as a first-line defense against infection.
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.When the surviving bacteria exit the stomach and reach the small intestine, they need to propel themselves through the thick mucus that lines the small intestine to get to the intestinal wall where they can thrive.^ Cholera bacteria in people When humans ingest cholera bacteria, they may not become sick themselves, but they still excrete the bacteria in their stool and can pass cholera disease to others through the fecal-oral route.

^ To reach the small intestine, however, the organism has to negotiate the normal defense mechanisms of the GI tract.
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

^ After the vibrios negotiate these 2 barriers, they adhere to the intestinal wall mediated by toxin-coregulated pilus (TCP).
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

.V. cholerae bacteria start up production of the hollow cylindrical protein flagellin to make flagella, the curly whip-like tails that they rotate to propel themselves through the mucus that lines the small intestine.^ Cholera bacteria in people When humans ingest cholera bacteria, they may not become sick themselves, but they still excrete the bacteria in their stool and can pass cholera disease to others through the fecal-oral route.
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^ Cholera toxin (1 microg/mL) was injected into lumen of rat small intestinal segments and incubated for 18 h before the initiation of the perfusion .

^ Halfway through the episode, they consider the possibility it could be a kind of cancer, so Wilson can get a few lines.
  • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

.Once the cholera bacteria reach the intestinal wall, they do not need the flagella propellers to move any longer.^ After the vibrios negotiate these 2 barriers, they adhere to the intestinal wall mediated by toxin-coregulated pilus (TCP).
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

^ Yet because they shed cholera bacteria in their stool for seven to 14 days, they can still infect others.

^ Cholera bacteria in the environment Cholera bacteria occur naturally in coastal waters, where they attach to tiny crustaceans called copepods.

The bacteria stop producing the protein flagellin, thus again conserving energy and nutrients by changing the mix of proteins which they manufacture 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.^ Diarrhea Profuse watery diarrhea is a hallmark of cholera.
  • Cholera: eMedicine Pediatrics: General Medicine 19 January 2010 8:49 UTC emedicine.medscape.com [Source type: Academic]

^ Signs and symptoms of cholera (from the Mayo Clinic website): Severe, watery diarrhea.
  • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

^ In May 1911 cholera reappeared in Samsun and spread within the Ottoman Empire and 18876 persons were infected with cholera and 12143 of them died .

.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.^ Cholera bacteria can lie dormant in water for long periods, and contaminated public wells are frequent sources of large-scale cholera outbreaks.

^ Often the victims are those in underdeveloped countries who do not have pure drinking water or proper nutrition.
  • Cholera Home Remedies - Cholera Treatment - Natural Remedies & Cure for Cholera 19 January 2010 8:49 UTC www.natural-homeremedies.org [Source type: FILTERED WITH BAYES]

^ They are the ones putting it into plastic bottles and re-selling it, while propagandizing that the water out of your tap isn't as healthy -- and certainly not stylish.
  • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

.The cholera toxin (CTX or CT) is an oligomeric complex made up of six protein subunits: a single copy of the A subunit (part A), and five copies of the B subunit (part B), connected by a disulfide bond.^ Cholera toxin catalyzes incorporation of 32P into three proteins of 40 kDA, 45 kDa and 47 kDa located in the brush-border membrane .

^ The mere binding of cholera toxin to GM1 is not sufficient to allow the insertion of the enzymatically active alpha subunit in the membrane .

^ In contrast, basal lateral membranes do not contain any protein which becomes labeled in a toxin-dependent manner when incubated with cholera toxin and {32P}NAD .

.The five B subunits form a five-membered ring that binds to GM1 gangliosides on the surface of the intestinal epithelium cells.^ A-subunit and five B-subunits that bind with high affinity to GM1-ganglioside receptors found on the surface of mammalian cells .

^ CTB binds with high affinity to GM1 ganglioside cell surface receptors .

^ Mol Cell Biochem, 1984 Aug, 63(1), 83 - 91 Effects of ganglioside GM1 on the thermotropic behavior of cholera toxin B subunit ; Dalziel AW et al.; The B, or binding, subunit of cholera enterotoxin forms a pentameric ring structure in the intact toxin, and also when the subunit is isolated from the A subunit .

.The A1 portion of the A subunit is an enzyme that ADP-ribosylates G proteins, while the A2 chain fits into the central pore of the B subunit ring.^ The site of self ADP-ribosylation in the A1 subunit {C .

^ In ADP-ribosylation toxins and G proteins.
  • Journal of Clinical Investigation -- The human, societal, and scientific legacy of cholera 19 January 2010 8:49 UTC www.jci.org [Source type: Academic]

^ In the absence of acceptor self ADP-ribosylation of A1 subunit was observed .

.Upon binding, the complex is taken into the cell via receptor-mediated endocytosis.^ Immunofluorescence microscopy revealed that neither the binding nor the penetration of CT into the intestinal epithelial cells is affected by the toxin pretreatment .

^ When choleragen-receptor complexes were isolated from N18 cells labeled with {3H} galactose by immunoadsorption, only labeled GM1 was specifically recovered .

^ A mutant cholera toxin B subunit that binds GM1- ganglioside but lacks immunomodulatory or toxic activity ; Aman AT et al.; GM1-ganglioside receptor binding by the B subunit of cholera toxin (CtxB) is widely accepted to initiate toxin action by triggering uptake and delivery of the toxin A subunit into cells .

.Once inside the cell, the disulfide bond is reduced and the A1 subunit is freed to bind with a human partner protein called ADP-ribosylation factor 6 (Arf6).^ The site of self ADP-ribosylation in the A1 subunit {C .

^ In ADP-ribosylation toxins and G proteins.
  • Journal of Clinical Investigation -- The human, societal, and scientific legacy of cholera 19 January 2010 8:49 UTC www.jci.org [Source type: Academic]

^ In ADP ribosylation toxins and G proteins.
  • Journal of Clinical Investigation -- The human, societal, and scientific legacy of cholera 19 January 2010 8:49 UTC www.jci.org [Source type: Academic]

[27] .Binding exposes its active site, allowing it to permanently ribosylate the Gs alpha subunit of the heterotrimeric G protein.^ The catalytic A1 polypeptide of CT (CTA1) then crosses the ER membrane, enters the cytosol, ADP-ribosylates the stimulatory alpha subunit of the heterotrimeric G protein (Gsalpha) at the cytoplasmic face of the plasma membrane, and activates adenylate cyclase .

^ The mere binding of cholera toxin to GM1 is not sufficient to allow the insertion of the enzymatically active alpha subunit in the membrane .

^ We report here that the toxin also catalyzes ADP-ribosylation of the alpha-subunit of transducin in ROS membranes .

.This results in constitutive cAMP production, which in turn leads to secretion of H2O, Na+, K+, Cl-, and HCO3- into the lumen of the small intestine and rapid dehydration.^ Cholera toxin (1 microg/mL) was injected into lumen of rat small intestinal segments and incubated for 18 h before the initiation of the perfusion .

^ Furthermore, the intestinal secretion produced by placing a 2-mM 5-HT solution in the intestinal lumen of rats was inhibited by hexamethonium, a ganglionic receptor-blocking agent .

^ A secretion of sodium, potassium, and chloride was also seen in all experiments but the secretion rate of electrolytes was independent of the osmolality in the intestinal lumen .

.The gene encoding the cholera toxin is introduced into V. cholerae by horizontal gene transfer.^ Cholera toxin catalyzes incorporation of 32P into three proteins of 40 kDA, 45 kDa and 47 kDa located in the brush-border membrane .

^ The cultures were pulse labeled with 3H-thyrmidine at 12 and 24 hr after the addition of 10-10 M cholera toxin, and its uptake into DNA was determined .

^ In the present study, cholera toxin subunit-B (CTB) was injected into cat cochleas, and the brain tissue was examined after a survival period of 5-7 days .

.Virulent strains of V. cholerae carry a variant of lysogenic bacteriophage called CTXf or CTXφ.^ It was suggested that the ability of the hog cholera viral strains to replicate in porcine macrophages might be correlated with their virulence.

Cholera Toxin. .The delivery region (blue) binds membrane carbohydrates to get into cells.^ Immunofluorescence microscopy revealed that neither the binding nor the penetration of CT into the intestinal epithelial cells is affected by the toxin pretreatment .

^ In vitro studies indicated that isolated intestinal epithelial cells or brush-border membranes could bind about 10-fold more of E .

^ The RSVEs are made of membranous vesicles, capable of binding and fusing with host cell membrane .

The toxic part (red) is activated inside the cell (PDB code: 1xtc).
.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.^ Cholera is among one of the serious infections of intestine.
  • Home Remedies for Cholera - Cholera Natural Treatment - Herbal Cure for Cholera 19 January 2010 8:49 UTC www.herbalcureindia.com [Source type: FILTERED WITH BAYES]

^ Cholera bacteria in people When humans ingest cholera bacteria, they may not become sick themselves, but they still excrete the bacteria in their stool and can pass cholera disease to others through the fecal-oral route.
  • Cholera 19 January 2010 8:49 UTC www.cnn.com [Source type: FILTERED WITH BAYES]
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  • Cholera 19 January 2010 8:49 UTC www.cnnstudentnews.cnn.com [Source type: FILTERED WITH BAYES]

^ Finally, the mucosal response to a protein toxin may be under some genetic control .

[28] .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 toxins can also be used as vectors to carry other proteins into the cells .

^ We have investigated the mechanism by which cholera toxin activates intestinal adenylate cyclase .

^ When a relatively larger number (8 X 10(5)) of cells were inoculated in a dish, cholera toxin moderately accelerated cell division, and increased DNA and protein levels of the culture during early days of cultivation .

.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.^ High osmolarity solutions in the gut lumen drain salts and water from the blood stream into the lumen and aggravate diarrhea and dehydration ( 16 ).
  • Journal of Clinical Investigation -- The human, societal, and scientific legacy of cholera 19 January 2010 8:49 UTC www.jci.org [Source type: Academic]

^ A secretion of sodium, potassium, and chloride was also seen in all experiments but the secretion rate of electrolytes was independent of the osmolality in the intestinal lumen .

^ In the colon, stimulation of mucus production by the goblet cells was much more pronounced than in the small intestine .

.The host can become rapidly dehydrated if an appropriate mixture of dilute salt water and sugar is not taken to replace the blood's water and salts lost in the diarrhea.^ The combination of vomiting and diarrhea is more rapidly lethal, as you lose not just water but also electrolytes.
  • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

^ Prompt and complete replacement of water and electrolytes lost through diarrhea must be the aim of all treatment .

^ The goal is to replace fluids and electrolytes lost through diarrhea using a simple rehydration solution, Oral Rehydration Salts (ORS), that contains specific proportions of water, salts and sugar.
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.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.^ The toxins can also be used as vectors to carry other proteins into the cells .

^ We have investigated the mechanism by which cholera toxin activates intestinal adenylate cyclase .

^ When a relatively larger number (8 X 10(5)) of cells were inoculated in a dish, cholera toxin moderately accelerated cell division, and increased DNA and protein levels of the culture during early days of cultivation .

.Researchers have discovered that there is a complex cascade of regulatory proteins that control expression of V. cholerae virulence determinants.^ As there are some clear links between the organism, cholera incidence and the sea, it is appropriate that cholera research should examine the nature of coastal population vulnerability to the disease .

^ COX-1 and COX-2 mRNA expression were determined by reverse transcription-polymerase chain reaction (RT-PCR) and COX-2 protein by Western blot analysis in mucosal scrapings .

^ The site of the 'lesion' has to be localized to the guanine nucleotide regulatory protein-adenylate cyclase complex rather than to its uncoupling from the hormone receptor.

.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.^ Tumorigenicity was markedly stimulated by pretreatment of the cells with cholera toxin, which raises cyclic AMP levels and activates cyclic AMP-dependent protein kinase .

^ In crude plasma membranes cholera toxin activated 5-fold at 10 micrograms/ml; vasoactive intestinal peptide (VIP) activated at concentration from 10(-8) to 10(-7) M, the maximal stimulation being 6-fold .

^ The results suggest that the activation by cholera toxin of adenylate cyclase located at the basal lateral membrane requires ADPribosylation of proteins in the brush border membrane.

.ToxT then directly activates expression of virulence genes that produce the toxins that cause diarrhea in the infected person and that permit the bacteria to colonize the intestine.^ Once ingested and if it can reach the human intestines, the bacteria will there produce a toxin which inhibits the absorption of water and salts.
  • The 1832 Cholera Epidemic in New York State 19 January 2010 8:49 UTC www.earlyamerica.com [Source type: FILTERED WITH BAYES]

^ Rudimentary modern concepts such as bacteria, toxins, personal cleanliness, and public sanitation were either unknown and largely absent from the social database.
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^ Infect Immun, 1984 Nov, 46(2), 612 - 4 Does enteropathogenic Escherichia coli produce heat-labile enterotoxin, heat-stable enterotoxins a or b, or cholera toxin A subunits?

[28] .Current 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."^ AIMS: To establish evidence for cholinergic innervation to human ileal epithelial cells and to investigate whether CT potentiates the action of acetylcholine on human intestinal epithelial cells .

^ Intestinal segments exposed to cholera toxin showed a statistically significant decrease in 5-HT levels of enterochromaffin cells compared with segments exposed to heat-inactivated cholera toxin .

^ In the colon, stimulation of mucus production by the goblet cells was much more pronounced than in the small intestine .

[28]

History

Cholera was found in Dundee in 1832.
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 actual causative factors.

Origin and spread

.Cholera likely has its origins in and is endemic to the Indian subcontinent.^ This form of cholera belongs originally to Asia , more particularly to India , where, as well as in the Indian archipelago , epidemics are known to have occurred at various times for several centuries.

^ Cholera: an analysis of its epidemic, endemic, and contagious character; with original and peculiar views of its mode of propagation and the means of counteracting it.
  • Cholera Online: A Modern Pandemic in Texts and Images - By Location 19 January 2010 8:49 UTC www.nlm.nih.gov [Source type: Academic]

^ It is generally acknowledged that cholera had long been endemic to the Indian subcontinent and particularly to its northeast regions, the Ganges Delta.
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.The disease spread by trade routes (land and sea) to Russia, then to Western Europe, and from Europe to North America.^ The earlier ones followed the land route by way of Afghanistan and Persia, and took several years to reach Europe.

^ The disease subsequently extended into France , Spain and Italy , and crossing the Atlantic spread through North and Central America .

^ From North-East England the disease quickly spread to Southern Scotland causing three thousand one hundred and sixty-six deaths in Glasgow.
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.Cholera is now no longer considered a pressing health threat in Europe and North America due to filtering and chlorination of water supplies, but still heavily affects populations in developing countries.^ Only 51 (44%) were citizens of countries in Europe or North America .

^ Despite control strategies, including improved case management, water-chlorination campaigns, and dissemination of health-education messages, the burden of cholera has remained high.
  • NEJM -- Effectiveness of Mass Oral Cholera Vaccination in Beira, Mozambique 19 January 2010 8:49 UTC content.nejm.org [Source type: Academic]

^ The adaptation of the agricultural sciences model to basic health science practice in developing countries has been partially realized.
  • Journal of Clinical Investigation -- The human, societal, and scientific legacy of cholera 19 January 2010 8:49 UTC www.jci.org [Source type: Academic]

.
  • 1816-1826 - First cholera pandemic: Previously restricted, the pandemic began in Bengal, and then spread across India by 1820. 10,000 British troops and countless Indians died during this pandemic.^ The death toll was astonishing; reportedly 20,000 of the 50,000 pilgrims died, and the imperial British army experienced 10,000 fatalities among its troops.

    ^ Note: Travel and trade restrictions between countries or different areas of one country, cannot prevent the spread of cholera.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    ^ For the third consecutive week, this was the heaviest week for new cholera cases since the beginning of the outbreak, with approximately 10,000 newly affected people.

    [29] .The cholera outbreak extended as far as China, Indonesia (where more than 100,000 people succumbed on the island of Java alone) and the Caspian Sea before receding.^ In the last 24 hours, more than 360 people got infected and eight died.

    ^ And not just contemptible bourgeous "progress": I think it's a pretty fundamental measure of the success of a society if it regards people as more valuable than things.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ Reduced osmolarity formulations are safe and more effective than standard ORS for treating non- cholera diarrhea .

    Deaths in India between 1817 and 1860 are estimated to have exceeded 15 million persons. .Another 23 million died between 1865 and 1917. Russian deaths during a similar time period exceeded 2 million.^ During periods of spontaneous flashing, onset of toxin-induced glowing was abrupt and step-like in character, due to a markedly prolonged off-time of individual flashes .

    [30]
  • .
  • 1829-1851 - Second cholera pandemic reached Russia (see Cholera Riots), Hungary (about 100,000 deaths) and Germany in 1831, London (more than 55,000 people died in the United Kingdom)[31] and Paris in 1832. In London, the disease claimed 6,536 victims and came to be known as "King Cholera"; in Paris, 20,000 succumbed (out of a population of 650,000) with about 100,000 deaths in all of France.^ By April of 1832, cholera reached Paris.
    • The 1832 Cholera Epidemic in New York State 19 January 2010 8:49 UTC www.earlyamerica.com [Source type: FILTERED WITH BAYES]

    ^ Among this class the cholera still claims victims.

    ^ More terrifying than the Black Death?
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    [24] .The epidemic reached Quebec, Ontario and New York in the same year and the Pacific coast of North America by 1834.[32] The 1831 cholera epidemic killed 150,000 people in Egypt.^ The cholera breeders in New York and vicinity.
    • Cholera Online: A Modern Pandemic in Texts and Images - View the Images 19 January 2010 8:49 UTC www.nlm.nih.gov [Source type: Reference]

    ^ In 1832, the epidemic reached New York City.

    ^ New Manchester; aged 32 years.

    [33] .In 1846, cholera struck Mecca, killing over 15,000 people.^ For the third consecutive week, this was the heaviest week for new cholera cases since the beginning of the outbreak, with approximately 10,000 newly affected people.

    ^ More than 10.000 people have been affected by a cholera outbreak that has devastated Guinea Bissau since May.

    ^ Zimbabwe's cholera outbreak has killed nearly 500 people, according to the World Health Organization.
    • Cholera: News & Videos about Cholera - CNN.com 19 January 2010 8:49 UTC topics.cnn.com [Source type: News]

    [34] .A two-year outbreak began in England and Wales in 1848 and claimed 52,000 lives.^ Resolution of these peptides by two-dimensional gel electrophoresis allowed identification of two peptides of Mr = 42,000 and 52,000 as peptide subunits of a regulatory component of adenylate cyclase .

    ^ Any patient above the age of two years has acute watery diarrhoea in an area where there is an outbreak of cholera.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    ^ It was not until the following summer, however, that the peak of the epidemic was reached in England and Wales, where fifty-three thousand two hundred and ninety-two deaths occurred.
    • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

    [35]
  • 1849 - Second major outbreak in Paris. In London, it was the worst outbreak in the city's history, claiming 14,137 lives, over twice as many as the 1832 outbreak. Cholera hit Ireland in 1849 and killed many of the Irish Famine survivors already weakened by starvation and fever.[36] .In 1849 cholera claimed 5,308 lives in the port city of Liverpool, England, and 1,834 in Hull, England.^ July 03, 2008, 11:46 AM : Cholera happened to strike several cities in the spring of 1849, including St. Louis.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ In England cholera obtained a footing on the Humber at Grimsby , and to a lesser extent at Hull , and isolated attacks occurred in some 50 different localities.

    ^ We describe a series of street riots that took place in the city of Liverpool in north-west England in 1832 during a cholera epidemic .

    [24] An outbreak in North America took the life of former U.S. President James K. Polk. Cholera, believed spread from ship(s) from England, spread throughout the Mississippi river system killing over 4,500 in St. Louis[24] and over 3,000 in New Orleans[24] as well as thousands in New York.[24] Mexico was similarly attacked.[34] .In 1849 cholera was spread along the California, Mormon and Oregon Trails as 6,000 to 12,000[37] are believed to have died on their way to the California Gold Rush, Utah and Oregon in the cholera years of 1849-1855.[24] It is believed that over 150,000 Americans died during the two pandemics between 1832 and 1849.[38][39]
  • 1852-1860 - Third cholera pandemic mainly affected Russia, with over a million deaths.^ As a result, several of the wagon-trains heading westward over the Plains -- and thanks to the California gold rush there were massive numbers that year -- carried cholera with them, and buried people one by one along the trails.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ In Russia over 30,000 persons died of it, in Germany about 500, but the most violent outbreak was in Galicia, where upwards of 8000 deaths were registered.

    ^ During the two succeeding years it prevailed extensively throughout the continent, and fell with severity on the armies engaged in the Crimean War .

    .In 1852, cholera spread east to Indonesia and later invaded China and Japan in 1854. The Philippines were infected in 1858 and Korea in 1859. In 1859, an outbreak in Bengal once again led to the transmission of the disease to Iran, Iraq, Arabia and Russia.^ The disease now began to spread over a wider extent than hitherto, invading China on the east and Persia on the west.

    ^ The Bush administration: Winning hearts and minds by helping spread cholera democracy in the Middle East.
    • Think Progress » Chlorine Restrictions Due To Security Concerns Help Fuel Spread Of Cholera In Iraq 19 January 2010 8:49 UTC thinkprogress.org [Source type: News]

    ^ Although the number of new cholera cases nationwide continues to slowly decrease, the outbreak in Angola has spread to provinces further from the capital, Luanda.

    [34] .There were at least seven major outbreaks of cholera in Japan between 1858 and 1902. The Ansei outbreak of 1858-60, for example, is believed to have killed between 100,000 and 200,000 people in Tokyo alone.^ There was an outbreak of cholera last April.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ Americans knew that cholera was raging throughout Europe, but many believed that they would be spared because the Atlantic stood between them and the "Old World."

    ^ There are more than 60 cholera bacteria, however, current outbreaks in Africa are caused by El Tor biotype of Vibrio cholera serogroup 01.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    [40]
  • .
  • 1854 - Outbreak of cholera in Chicago took the lives of 5.5% of the population (about 3,500 people).^ When you enter an area with many people sick from cholera or a clinic completely overloaded with cholera patients, you know lives will soon be lost.

    ^ In Russia over 30,000 persons died of it, in Germany about 500, but the most violent outbreak was in Galicia, where upwards of 8000 deaths were registered.

    ^ Since December 2007, cholera outbreaks have affected thousands of people in the cities of Lubumbashi and Likasi in southern Katanga province, Democratic Republic of Congo.

    [24] .In 1853-4, London's epidemic claimed 10,738 lives.^ It was not, however, until September 1853 that it was officially announced by the British authorities that a cholera epidemic was claiming victims not only in London but also in other parts of the country .

    ^ The 1832-33 cholera epidemic claimed 4,000 to 7,000 victims in London .

    .The Soho outbreak in London ended after removal of the handle of the Broad Street pump by a committee instigated to action by John Snow.^ Famously, this is the case where the board of governors removed the handle from the Broad Street Pump.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ The site of the Broad Street Pump is now a pub called the John Snow.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ John Snow's earlier epidemiological study in London had proved only to some that contaminated water caused the disease.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    [41] .This proved that contaminated water (although it didn't identify the contaminant) was the main agent spreading cholera.^ Cholera is a bacterial disease usually spread through contaminated water.
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    ^ Cholera bacteria can lie dormant in water for long periods, and contaminated public wells are frequent sources of large-scale cholera outbreaks.
    • Cholera 19 January 2010 8:49 UTC www.cnn.com [Source type: FILTERED WITH BAYES]
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    ^ John Snow's earlier epidemiological study in London had proved only to some that contaminated water caused the disease.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    It would take almost 50 years for this message to be believed and acted upon. .Building and maintaining a safe water system was and is not cheap—but is absolutely essential.
  • 1863-1875 - Fourth cholera pandemic spread mostly in Europe and Africa.^ Cholera is a bacterial disease usually spread through contaminated water.
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    ^ The system consists of behavior change techniques along with point-of-use treatment and safe storage of water .

    ^ Provision of safe drinking water, improving sanitation and strengthening of disease surveillance is necessary for control of cholera and other diarrhoeal diseases in slum areas.

    At least 30,000 of the 90,000 Mecca pilgrims fell victim to the disease. .Cholera claimed 90,000 lives in Russia in 1866.[42] The epidemic of cholera that spread with the Austro-Prussian War (1866) is estimated to have claimed 165,000 lives in the Austrian Empire.^ The 1832-33 cholera epidemic claimed 4,000 to 7,000 victims in London .

    ^ Cholera epidemics are public health problems and could claim up to 50% of its victims.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    ^ Cholera epidemics are most likely to occur in communities without adequate sanitation and in areas affected by natural disasters or war.
    • Cholera 19 January 2010 8:49 UTC www.cnn.com [Source type: FILTERED WITH BAYES]

    [43] .Hungary and Belgium both lost 30,000 people and in the Netherlands 20,000 perished.^ Cholera in Angola: Number of Infected People Reaches 20,000 - Response Remains Insufficient .

    In 1867, Italy lost 113,000 lives.[44]
1892 cholera outbreak in Hamburg, hospital ward
.
1892 cholera outbreak in Hamburg, disinfection team
  • 1866 - 1873 - Outbreaks in North America.^ Practical recommendations for the exclusion and prevention of Asiatic cholera in North America.
    • Cholera Online: A Modern Pandemic in Texts and Images - By Location 19 January 2010 8:49 UTC www.nlm.nih.gov [Source type: Academic]

    ^ He and his team tried to cure cholera patients by disinfecting the patients and their wastes with carbolic acid or phenol .

    ^ The outbreak of cholera in Latin America is simply the most recent stop of a worldwide cholera epidemic which began in Indonesia in 1961 .

    .It killed some 50,000 Americans.^ In 1991, some 200,000 mostly poor Latin American children died of common diarrheal diseases .

    [38] .In London, a localized epidemic in the East End claimed 5,596 lives just as London was completing its major sewage and water treatment systems—the East End was not quite complete.^ I'm not a Londoner - I just live here now.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ It was during this epidemic that John Snow, a London doctor, succeeded in tracing the epidemic to a single water pump on Broad Street in the Golden Square area .

    ^ Remarks on some account of the cholera epidemic of 1861 as it appeared at Vizagapatam, Madras Presidency, East Indies, and upon the treatment which proved successful.
    • Cholera Online: A Modern Pandemic in Texts and Images - By Location 19 January 2010 8:49 UTC www.nlm.nih.gov [Source type: Academic]

    .William Farr, using the work of John Snow et al.^ I work in Marylebone and have some time to kill after work...maybe I'll pop down to Soho and have a drink in the John Snow while I get started on The Ghost Map .
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ In the 1840s and 1850s Farr's work was considered definitive, while Snow's was regarded as ingenious but flawed .

    ^ July 16, 2008, 06:08 PM : When I was in grad school for public health, my epidemology prof used to call John Snow the Father of Epidemology.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    as to contaminated drinking water being the likely source of the disease, was able to relatively quickly identify the .East London Water Company as the source of the contaminated water.^ John Snow's earlier epidemiological study in London had proved only to some that contaminated water caused the disease.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ The leading role of the water route of transmission of this infection is shown due to the contamination of water sources with non-decontaminated sewage water .

    ^ In an outbreak situation all water sources with potential for contamination must be tested, rendered safe if contaminated or otherwise closed to usage and alternative sources provided.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    .Quick action prevented further deaths.^ To stop cholera transmission and avoid additional illness and death, further preventive measures are needed.

    [24] .Also a minor outbreak at Ystalyfera in South Wales.^ The towns of the South Wales coalfield experienced the more severe outbreaks of the disease, however, both in 1832 and in the subsequent epidemic years.
    • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

    .Caused by the local water works using contaminated canal water, it was mainly its workers and their families who suffered, 119 died.^ John Snow's earlier epidemiological study in London had proved only to some that contaminated water caused the disease.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ Even when drinking water is rendered safe, infection may still be transmitted by contaminated surface water used for bathing and for washing clothing, food or cooking utensils.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    ^ This mainly occurs when human feces contaminate food or water supplies, both of which can serve as ideal breeding grounds for the cholera bacteria.
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    .In the same year more than 21,000 people died in Amsterdam, The Netherlands.^ In the last 24 hours, more than 360 people got infected and eight died.

    ^ And not just contemptible bourgeous "progress": I think it's a pretty fundamental measure of the success of a society if it regards people as more valuable than things.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ Since February 13, when the first case was officially reported, close to 38,000 cases have been reported nationwide and more than 1,350 people have died.

    .In the 1870s, cholera spread in the US as epidemic from New Orleans along the Mississippi River and related ports of tributaries, with thousands dying.
  • 1881-1896 - Fifth cholera pandemic ; According to Dr A. J. Wall, the 1883-1887 epidemic cost 250,000 lives in Europe and at least 50,000 in Americas.^ Although the number of new cholera cases nationwide continues to slowly decrease, the outbreak in Angola has spread to provinces further from the capital, Luanda.

    ^ In May 1911 cholera reappeared in Samsun and spread within the Ottoman Empire and 18876 persons were infected with cholera and 12143 of them died .

    ^ The second great cholera epidemic in Britain had again spread from the East, reaching the German shores of the North Sea in 1848 and appearing in Edinburgh at the beginning of October.
    • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

    .Cholera claimed 267,890 lives in Russia (1892);[45] 120,000 in Spain;[46] 90,000 in Japan and over 60,000 in Persia.^ The 1832-33 cholera epidemic claimed 4,000 to 7,000 victims in London .

    ^ Deaths from cholera in Merthyr in 1849 were 98 per 10,000 persons living, and in 1854, 9 per 10,000.
    • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

    [45] .In Egypt cholera claimed more that 58,000 lives.^ More than 10.000 people have been affected by a cholera outbreak that has devastated Guinea Bissau since May.

    ^ The 1832-33 cholera epidemic claimed 4,000 to 7,000 victims in London .

    ^ The cholera epidemic that emerged around mid-June in Chad is still raging, with more than 2,000 people infected, including 100 deaths.

    The 1892 outbreak in Hamburg killed 8,600 people. Although generally held responsible for the virulence of the epidemic, the city government went largely unchanged. .This was the last serious European cholera outbreak.
  • 1899-1923 - Sixth cholera pandemic had little effect in Europe because of advances in public health, but major Russian cities (more than 500,000 people dying of cholera during the first quarter of the 20th century)[47] and the Ottoman Empire were particularly hard hit by cholera deaths.^ "A cholera death is a health programme failure.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    ^ Millions of poor people have had their water supply cut off because of inability to pay, forcing them to get their water from polluted rivers and lakes and leading to South Africa's worst cholera outbreak--which the government paid millions of dollars to control .

    ^ Cholera bacteria can lie dormant in water for long periods, and contaminated public wells are frequent sources of large-scale cholera outbreaks.
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    .The 1902-1904 cholera epidemic claimed 200,000 lives in the Philippines.^ The 1832-33 cholera epidemic claimed 4,000 to 7,000 victims in London .

    ^ Cholera epidemics are public health problems and could claim up to 50% of its victims.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    ^ The risk of cholera epidemic is highest when poverty, war or natural disasters force people to live in crowded conditions without adequate sanitation.
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    [48] .27 epidemics were recorded during pilgrimages to Mecca from the 19th century to 1930, and more than 20,000 pilgrims died of cholera during the 1907–08 hajj.^ During a local cholera epidemic: .
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    ^ Med Ges Gesch, 1997, 16, 125 - 44 The homoepathic management of cholera in the nineteenty century with special reference to the epidemic in London, 1854 ; Leary B; During the nineteenth century homoeopaths claimed better results than their conventional colleagues did for the treatment of epidemic cholera .

    ^ METHODS: During the ongoing cholera epidemic in 1994 in Guinea-Bissau, West Africa, a roster of all adult residents in a rural community was established .

    [47] .The sixth pandemic killed more than 800,000 in India.^ Since February 13, when the first case was officially reported, close to 38,000 cases have been reported nationwide and more than 1,350 people have died.

    ^ More than 10.000 people have been affected by a cholera outbreak that has devastated Guinea Bissau since May.

    ^ The cholera epidemic that emerged around mid-June in Chad is still raging, with more than 2,000 people infected, including 100 deaths.

    .The last outbreak in the United States was in 1910-1911 when the steamship Moltke brought infected people to New York City.^ The last major outbreak in the United States occurred in 1911.
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    ^ In the last 24 hours, more than 360 people got infected and eight died.

    ^ Letter on the cholera asphyxia, now prevailing in the city of New York; addressed to James Bond Read, M. D., chairman of the medical board, Savannah.
    • Cholera Online: A Modern Pandemic in Texts and Images - By Location 19 January 2010 8:49 UTC www.nlm.nih.gov [Source type: Academic]

    Vigilant health authorities isolated the infected on Swinburne Island. .Eleven people died, including a health care worker on Swinburne Island.^ Eight people —including a child under five— have died from cholera in Mornay, western Darfur, in the last two weeks.

    ^ Nearly 300 people have died from a cholera outbreak in Zimbabwe that is compounded by the country's collapsing health-care system, according to the World Health Organization.
    • Cholera: News & Videos about Cholera - CNN.com 19 January 2010 8:49 UTC topics.cnn.com [Source type: News]

    [13][14][49]
  • .
  • 1961-1970s - Seventh cholera pandemic began in Indonesia, called El Tor after the strain, and reached Bangladesh in 1963, India in 1964, and the USSR in 1966. From North Africa it spread into Italy by 1973. In the late 1970s, there were small outbreaks in Japan and in the South Pacific.^ South Africa: Responding to cross-border cholera outbreak .

    ^ There was an outbreak of cholera last April.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ Millions of poor people have had their water supply cut off because of inability to pay, forcing them to get their water from polluted rivers and lakes and leading to South Africa's worst cholera outbreak--which the government paid millions of dollars to control .

    .There were also many reports of a cholera outbreak near Baku in 1972, but information about it was suppressed in the USSR.
  • January 1991 to September 1994 - Outbreak in South America, apparently initiated when a ship discharged ballast water.^ There was an outbreak of cholera last April.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ Millions of poor people have had their water supply cut off because of inability to pay, forcing them to get their water from polluted rivers and lakes and leading to South Africa's worst cholera outbreak--which the government paid millions of dollars to control .

    ^ Cholera bacteria can lie dormant in water for long periods, and contaminated public wells are frequent sources of large-scale cholera outbreaks.
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    .Beginning in Peru there were 1.04 million identified cases and almost 10,000 deaths.^ The death toll was astonishing; reportedly 20,000 of the 50,000 pilgrims died, and the imperial British army experienced 10,000 fatalities among its troops.

    ^ For the third consecutive week, this was the heaviest week for new cholera cases since the beginning of the outbreak, with approximately 10,000 newly affected people.

    ^ Deaths from cholera in Merthyr in 1849 were 98 per 10,000 persons living, and in 1854, 9 per 10,000.
    • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

    .The causative agent was an O1, El Tor strain, with small differences from the seventh pandemic strain.^ There are more than 60 cholera bacteria, however, current outbreaks in Africa are caused by El Tor biotype of Vibrio cholera serogroup 01.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    ^ Epidemiological characteristics of the outbreak of cholera El tor in Vladivostok} ; Onishchenko GG et al.; The materials on the investigation of the outbreak cholera eltor in Vladivostok, caused by the import of infection from China .

    .In 1992 a new strain appeared in Asia, a non-O1, nonagglutinable vibrio (NAG) named O139 Bengal.^ By December 1992, V.cholerae non-O1 became the predominant organism (> 95%) isolated from cholera-like diarrhoea patients examined in the said hospital.
    • http://www.icmr.nic.in/niced.htm 19 January 2010 8:49 UTC www.icmr.nic.in [Source type: Academic]

    ^ The global cholera scenario experienced an unprecedented event during 1992-93, when a new toxigenic non-O1 strain, designated as Vibrio cholerae O139 Bengal, appeared in the Indian subcontinent and later reported from many other countries of the region as well as from the developed countries like U.K. and U.S.A. The scientists of NICED are credited for bringing this to the notice of global scientific community for the first time.
    • http://www.icmr.nic.in/niced.htm 19 January 2010 8:49 UTC www.icmr.nic.in [Source type: Academic]

    ^ The appearance of a new toxigenic non O1 Vibrio cholerae designated as Vibrio cholerae O139 Bengal was for the first time reported from this Institute.
    • http://www.icmr.nic.in/niced.htm 19 January 2010 8:49 UTC www.icmr.nic.in [Source type: Academic]

    It was first identified in Tamil Nadu, India and for a while displaced El Tor in southern Asia before decreasing in prevalence from 1995 to around 10% of all cases. .It is considered to be an intermediate between El Tor and the classic strain and occurs in a new serogroup.^ There are more than 60 cholera bacteria, however, current outbreaks in Africa are caused by El Tor biotype of Vibrio cholera serogroup 01.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    ^ From 1992 to 1996 El Tor cholera was dominant and from 1983 to 1987 classical cholera was dominant .

    ^ From 1983-1987 classical cholera was dominant and from 1992-1996 El Tor was dominant .

    There is evidence of the emergence of wide-spectrum resistance to drugs such as trimethoprim, sulfamethoxazole and streptomycin.

Recent and ongoing outbreaks

.
  • In 2000, some 140,000 cholera cases were officially notified to WHO. Africa accounted for 87% of these cases.^ At Dowlais, where typhus had been raging some three months previously, the new visitation of cholera prompted the Dowlais Company to open a temporary hospital to deal with the cases.
    • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

    ^ More than 60,000 people have now been infected with cholera in Zimbabwe, according to the World Health Organization (WHO).
    • Cholera: News & Videos about Cholera - CNN.com 19 January 2010 8:49 UTC topics.cnn.com [Source type: News]

    ^ Some of the Swansea doctors were being accused of giving too much sedation to their cholera cases and that some of the patients died as a result.
    • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

    [50]
  • .
  • July - December 2007 - A lack of clean drinking water in Iraq has led to an outbreak of cholera.^ U.N. reports cholera outbreak in northern Iraq .
    • Cholera: News & Videos about Cholera - CNN.com 19 January 2010 8:49 UTC topics.cnn.com [Source type: News]

    ^ Iraq reports cholera outbreak .
    • Cholera: News & Videos about Cholera - CNN.com 19 January 2010 8:49 UTC topics.cnn.com [Source type: News]

    ^ Capital lacks clean water, cholera kills hundreds in Zimbabwe .
    • Cholera: News & Videos about Cholera - CNN.com 19 January 2010 8:49 UTC topics.cnn.com [Source type: News]

    [51] .As of 2 December 2007, the UN has reported 22 deaths and 4,569 laboratory-confirmed cases.^ However, the UN has reported a major spike in cases – on January 6 1,080 new cases and 19 deaths were reported while January 5 saw 675 new cases and 59 deaths.

    ^ In periods of lower incidence, all cases need to be confirmed using laboratory methods.

    ^ Laboratory confirmation should be obtained at the earliest opportunity and also reported to WHO. Weekly reporting is required where cholera is confirmed.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    [52]
  • .
  • August 2007 - The cholera epidemic started in Orissa, India.^ The first cholera epidemic was experienced in India and spread out to other countries .

    ^ The epidemic, of course, is the cholera outbreak around Golden Square in Soho, 28 August— 6 September 1854.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ Special report of the board of health upon the cholera epidemic in Honolulu, Hawaiian Islands, in August and September, 1895.
    • Cholera Online: A Modern Pandemic in Texts and Images - By Location 19 January 2010 8:49 UTC www.nlm.nih.gov [Source type: Academic]

    .The outbreak has affected Rayagada, Koraput and Kalahandi districts where more than 2,000 people have been admitted to hospitals.^ And not just contemptible bourgeous "progress": I think it's a pretty fundamental measure of the success of a society if it regards people as more valuable than things.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ The number of females affected was more than the males .

    ^ THE BACKGROUND More than a billion people lack access to drinkable water.
    • Cholera: News & Videos about Cholera - CNN.com 19 January 2010 8:49 UTC topics.cnn.com [Source type: News]

    [53]
  • .
  • August - October 2008 - As of 29 October 2008, a total of 644 laboratory-confirmed cholera cases, including eight deaths, had been verified in Iraq.^ Quicker confirmation helps to decrease death rates at the start of cholera outbreaks and leads to earlier public health interventions for outbreak control.
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    ^ In periods of lower incidence, all cases need to be confirmed using laboratory methods.

    ^ The cholera epidemic that emerged around mid-June in Chad is still raging, with more than 2,000 people infected, including 100 deaths.

    [54]
  • March - April 2008 - 2,490 people from 20 provinces throughout Vietnam have been hospitalized with acute diarrhea. .Of those hospitalized, 377 patients tested positive for cholera.^ Since 1966, the authors have analyzed hospital records of 7141 surveillance-area patients culture-positive for v .

    ^ All 11 cholera patients tested had CT/LTh ratios of greater than 0.70, whereas in only 1 of 47 LTh E .

    [55]
  • .
  • November 2008 - Doctors Without Borders reported an outbreak in a refugee camp in the Democratic Republic of the Congo's eastern provincial capital of Goma.^ Since the start of 2008, 767 people suffering from cholera have required treatment in a cholera treatment center (CTC) supported by Doctors Without Borders/Médecins Sans Frontières (MSF) the city of Lubumbashi, the capital of Katanga province and the economic center of the Democratic Republic of the Congo.

    ^ Since December 2007, cholera outbreaks have affected thousands of people in the cities of Lubumbashi and Likasi in southern Katanga province, Democratic Republic of Congo.

    ^ New York, November 29, 2006 — Following the latest outbreak of the cholera epidemic that resurfaced with the arrival of seasonal rains, the international humanitarian medical organization Doctors Without Borders/Médecins Sans Frontières (MSF) has reopened its previous intervention in Lubango in southern Angola.

    .Some 45 cases were reportedly treated between November 7 through 9th.
  • August 2008 - April 2009: In the 2008 Zimbabwean cholera outbreak, which is still continuing, an estimated 96,591 people in the country have been infected with cholera and, by 16 April 2009, 4,201 deaths had been reported.^ There was an outbreak of cholera last April.
    • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

    ^ Cholera bacteria in people When humans ingest cholera bacteria, they may not become sick themselves, but they still excrete the bacteria in their stool and can pass cholera disease to others through the fecal-oral route.
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    ^ At Dowlais, where typhus had been raging some three months previously, the new visitation of cholera prompted the Dowlais Company to open a temporary hospital to deal with the cases.
    • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

    [56] .According to the World Health Organization, during the week of 22–28 March 2009, the "Crude Case Fatality Ratio (CFR)" had dropped from 4.2% to 3.7%.^ We defined cholera cases according to the recommendations of the World Health Organization for international notification .

    ^ Cholera experts and epidemiologists from the World Health Organisation are held in greatest regards for guiding the National Department of Health, in guiding us during the compilation of these guidelines.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    ^ From a total of 129 cases notified to the World Health Organisation detailed reports were obtained on 117 patients .

    [56] .The daily updates for the period 29 March 2009 to 7 April 2009, list 1748 cases and 64 fatalities, giving a weekly CFR of 3.66% (see table above);[57] however, those for the period 8 April to 16 April list 1375 new cases and 62 deaths (and a resulting CFR of 4.5%).^ Last Updated: 2009-04-16 .
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    ^ However, the UN has reported a major spike in cases – on January 6 1,080 new cases and 19 deaths were reported while January 5 saw 675 new cases and 59 deaths.

    ^ These figures do not include the 'diarrhoea deaths' although a considerable number of those were undoubtedly the result of cholera.
    • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

    [57] The CFR had remained above 4.7% for most of January and early February 2009.[58]
.
By 12 February 2009, the number of cases of infection by cholera in sub-Saharan Africa had reached 128,548 and the number of fatalities, 4,053.
  • January 2009 - The Mpumalanga province of South Africa has confirmed over 381 new cases of Cholera, bringing the total number of cases treated since November 2008 to 2276. 19 people have died in the province since the outbreak.^ Millions of poor people have had their water supply cut off because of inability to pay, forcing them to get their water from polluted rivers and lakes and leading to South Africa's worst cholera outbreak--which the government paid millions of dollars to control .

    ^ But cholera is still present in Asia, the Middle East, Latin America, India and sub-Saharan Africa.
    • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

    ^ The experiences learnt in the 1980s provided a wealth of knowledge, which culminated into the compilations of guidelines for the control of cholera outbreaks not only in South Africa but also in other developing countries throughout the world.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    [59]

Pandemic genetic diversity

.Amplified fragment length polymorphism (AFLP) fingerprinting of the pandemic isolates of Vibrio cholerae has revealed variation in the genetic structure.^ Vibrio cholerae isolated from Moore pads should be tested to determine whether they are indeed Vibrio cholerae 01 or not, since Vibrio cholerae 01 result in diarrhoea.
  • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

^ The amplified E2 fragments of four HCV strains were all 1273 bp in length by agarose gel electrophoresis .

.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.^ Despite large losses of bicarbonate (HCO3-)-containing diarrhoeal fluid, laboratory acid-base values were remarkably close to normal .

^ Two CD11c+ DC subsets were identified both in Peyer's patches and mesenteric lymph nodes (MLN) based on the expression of CD8alpha (CD8+ and CD8- DCs, respectively) .

^ Modification of the B protomer, either directly or when it remains a component part of the holo toxin structure, results in a change in its sedimentation value and its elution from gel filtration columns .

This grouping of strains is best seen in the strains from the African Continent.[60]

False historical report

.A persistent myth states that 90,000 people died in Chicago of cholera and typhoid fever in 1885, but this story has no factual basis.^ Cholera abated, but sunk into Typhus fever & died.

^ Altona filtered the water, and its citizens escaped the disease; Hamburg did not filter the water, and there 8,606 people died of cholera.
  • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

^ Taken of Malignant Cholera, Sept 5th & died Sept 7th at 12 OClock M. No premonitory Symptoms.

[61] .In 1885, there was a torrential rainstorm that flushed the Chicago River and its attendant pollutants into Lake Michigan far enough that the city's water supply was contaminated.^ Millions of poor people have had their water supply cut off because of inability to pay, forcing them to get their water from polluted rivers and lakes and leading to South Africa's worst cholera outbreak--which the government paid millions of dollars to control .

^ The public water supply at Swansea at the time of the epidemic can therefore hardly be blamed since the spate of cholera occurred where the supply came directly from the river, from the easily contaminated pumps and from vendors' carts.
  • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

^ In 1892 cholera contaminated the water supply of Hamburg and Altona, a smaller adjacent city.
  • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

.However, because cholera was not present in the city, there were no cholera-related deaths, though the incident caused the city to become more serious about its sewage treatment.^ Cholera requires immediate treatment because the disease can cause death within hours.
  • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

^ Because travelers have a low risk of contracting cholera and because the traditional injected vaccine offers minimal protection, no cholera vaccine is currently available in the United States.
  • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

^ Modern sewage and water treatment have virtually eliminated cholera in industrialized countries.
  • Cholera - Valley Health System 19 January 2010 8:49 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

Cholera morbus

.The term cholera morbus was used in the 19th and early 20th centuries to describe both non-epidemic cholera and other gastrointestinal diseases (sometimes epidemic) that resembled cholera.^ Cholera has been prevalent worldwide since the early 19th centuries.
  • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

^ Practical observations on the prevailing epidemic called cholera, with advice to the heads of families and others, as to the precautionary and primary domestic treatment to be used in warding off a threatened attack of, and assisting those already affected by the epidemic.
  • Cholera Online: A Modern Pandemic in Texts and Images - By Location 19 January 2010 8:49 UTC www.nlm.nih.gov [Source type: Academic]

^ That's why cholera (and all the other similar diseases) have an easier time killing off children.
  • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

The term is not in current use, but is found in many older references.[62] The other diseases are now known collectively as gastroenteritis.

Other historical information

.In the past, people traveling in ships would hang a yellow quarantine flag if one or more of the crew members suffered from cholera.^ As the brig displayed a yellow flag with a black ball, the quarantine signal, the custom house boat was immediately sent off to her .
  • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

^ The Department would also like to extend its gratitude to all the members of the National Cholera Task Team whose inputs made this document a reality.
  • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

^ The transmissibility of yellow fever and cholera in their realtion to quarantine.
  • Cholera Online: A Modern Pandemic in Texts and Images - By Location 19 January 2010 8:49 UTC www.nlm.nih.gov [Source type: Academic]

.Boats with a yellow flag hung would not be allowed to disembark at any harbor for an extended period, typically 30 to 40 days.^ As the brig displayed a yellow flag with a black ball, the quarantine signal, the custom house boat was immediately sent off to her .
  • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

[63]. .In modern international maritime signal flags the quarantine flag is yellow and black.^ As the brig displayed a yellow flag with a black ball, the quarantine signal, the custom house boat was immediately sent off to her .
  • GENUKI: Cholera in Wales 19 January 2010 8:49 UTC www.genuki.org.uk [Source type: FILTERED WITH BAYES]

Famous victims

The pathos in the last movement of Tchaikovsky's (c. 1840-1893) last symphony made people think that Tchaikovsky had a premonition of death. One observer noted that a week after the premiere of his Sixth Symphony, "Tchaikovsky was dead--6 November 1893. The cause of this indisposition and stomach ache was suspected to be his intentionally infecting himself with cholera by drinking contaminated water. .The day before, while having lunch with Modest (his brother and biographer), he is said to have poured tap water from a pitcher into his glass and drunk a few swallows.^ Diatryma ::: (view all by) ::: July 04, 2008, 07:04 PM : I don't drink my tap water immediately-- it goes into a filter pitcher.
  • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

^ They are the ones putting it into plastic bottles and re-selling it, while propagandizing that the water out of your tap isn't as healthy -- and certainly not stylish.
  • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

^ Now I have a nice glass bottle, fill it with water from the tap and keep it in the fridge.
  • Making Light: Eat Shit and Die 19 January 2010 8:49 UTC nielsenhayden.com [Source type: General]

Since the water was not boiled and cholera was once again rampaging St. Petersburg, such a connection was quite plausible ...."[64]
Other famous people believed to have died of cholera include:

Notes

  1. ^ a b c d Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 376–7. ISBN 0838585299. 
  2. ^ Faruque SM; Nair GB (editors) (2008). Vibrio cholerae: Genomics and molecular biology. Caister Academic Press. ISBN 978-1-904455-33-2. 
  3. ^ McLeod KS (April 2000). "Our sense of Snow: the myth of John Snow in medical geography". Soc Sci Med 50 (7-8): 923–35. doi:10.1016/S0277-9536(99)00345-7. PMID 10714917. 
  4. ^ "Cholera: prevention and control". World Health Organization (WHO). 2010. http://www.who.int/topics/cholera/control/en/index.html. Retrieved 2010-02-01. 
  5. ^ "Cholera" (pdf). World Health Organization. 2000. http://www.who.int/csr/resources/publications/surveillance/en/cholera.pdf. Retrieved 2010-02-01. 
  6. ^ "Cholera treatment". Molson Medical Informatics. 2007. http://sprojects.mmi.mcgill.ca/tropmed/disease/chol/treatment.htm. Retrieved 2008-01-03. 
  7. ^ Krishna BV, Patil AB, Chandrasekhar MR (March 2006). "Fluoroquinolone-resistant Vibrio cholerae isolated during a cholera outbreak in India". Trans. R. Soc. Trop. Med. Hyg. 100 (3): 224–6. doi:10.1016/j.trstmh.2005.07.007. PMID 16246383. http://linkinghub.elsevier.com/retrieve/pii/S0035-9203(05)00237-3. 
  8. ^ Mackay IM (editor) (2007). Real-Time PCR in microbiology: From diagnosis to characterization. Caister Academic Press. ISBN 978-1-904455-18-9. 
  9. ^ Ramamurthy T (2008). "Antibiotic resistance in Vibrio cholerae". Vibrio cholerae: Genomics and molecular biology. Caister Academic Press. ISBN 978-1-904455-33-2. 
  10. ^ http://www.netdoctor.co.uk/travel/diseases/cholera.htm
  11. ^ http://www.textbookofbacteriology.net/cholera.html
  12. ^ a b "Laboratory Methods for the Diagnosis of Epidemic Dysentery and Cholera" (pdf). Atlanta, GA: CDC. 1999. http://www.cdc.gov/ncidod/dbmd/diseaseinfo/cholera/top.pdf. Retrieved 2010-02-01. 
  13. ^ a b "Cholera Kills Boy. All Other Suspected Cases Now in Quarantine and Show No Alarming Symptoms.". New York Times. July 18, 1911. http://query.nytimes.com/mem/archive-free/pdf?res=990CEFD61431E233A2575BC1A9619C946096D6CF. Retrieved 2008-07-28. "The sixth death from cholera since the arrival in this port from Naples of the steamship Moltke, thirteen days ago, occurred yesterday at Swineburne Island. The victim was Francesco Farando, 14 years old." 
  14. ^ a b "More Cholera in Port". Washington Post. October 10, 1910. http://pqasb.pqarchiver.com/washingtonpost_historical/access/250061412.html?dids=250061412:250061412&FMT=ABS&FMTS=ABS:FT&date=OCT+10%2C+1910&author=&pub=The+Washington+Post&desc=MORE+CHOLERA+IN+PORT&pqatl=google. 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." 
  15. ^ a b "Is a vaccine available to prevent cholera?". CDC disease info: Cholera. 2008-03-27. http://www.cdc.gov/nczved/dfbmd/disease_listing/cholera_gi.html. Retrieved 2010-02-01. 
  16. ^ "Cholera vaccines". Health topics. WHO. 2008. http://www.who.int/topics/cholera/vaccines/en/index.html. Retrieved 2010-02-01. 
  17. ^ "Cholera: prevention and control". Health topics. WHO. 2008. http://www.who.int/topics/cholera/control/en/index.html. Retrieved 2008-12-08. 
  18. ^ Swerdlow DL, Mintz ED, Rodriguez M, et al. (August 1994). "Severe life-threatening cholera associated with blood group O in Peru: implications for the Latin American epidemic". J. Infect. Dis. 170 (2): 468–72. PMID 8035040. 
  19. ^ Harris JB, Khan AI, LaRocque RC, et al. (November 2005). "Blood group, immunity, and risk of infection with Vibrio cholerae in an area of endemicity". Infect. Immun. 73 (11): 7422–7. doi:10.1128/IAI.73.11.7422-7427.2005. PMID 16239542. PMC 1273892. http://iai.asm.org/cgi/pmidlookup?view=long&pmid=16239542. 
  20. ^ Bertranpetit J, Calafell F (1996). "Genetic and geographical variability in cystic fibrosis: evolutionary considerations". Ciba Found. Symp. 197: 97–114; discussion 114–8. PMID 8827370. 
  21. ^ Kirn TJ, Jude BA, Taylor RK (December 2005). "A colonization factor links Vibrio cholerae environmental survival and human infection". Nature 438 (7069): 863–6. doi:10.1038/nature04249. PMID 16341015. http://dx.doi.org/10.1038/nature04249. 
  22. ^ Archivist (1997). "Cholera phage discovery". Arch Dis Child 76: 274. doi:10.1136/adc.76.3.274. http://adc.bmj.com/cgi/content/extract/76/3/274. 
  23. ^ a b Merrell DS, Butler SM, Qadri F, et al. (June 2002). "Host-induced epidemic spread of the cholera bacterium". Nature 417 (6889): 642–5. doi:10.1038/nature00778. PMID 12050664. PMC 2776822. http://dx.doi.org/10.1038/nature00778. 
  24. ^ a b c d e f g h i Rosenberg, Charles E. (1987). The cholera years: the United States in 1832, 1849 and 1866. Chicago: University of Chicago Press. ISBN 0-226-72677-0. 
  25. ^ Dr John Snow, The mode of communication of cholera, London 1855
  26. ^ Hartwell LH, Hood L, Goldberg ML, Reynolds AE, Silver LM, and Veres RC (2004). Genetics: From genes to genomes. Boston: Mc-Graw Hill. pp. 551–552, 572–574.  (using the turning off and turning on of gene expression to make toxin proteins in cholera bacteria as a "comprehensive example" of what is known about the mechanisms by which bacteria change the mix of proteins they manufacture to respond to the changing opportunities for surviving and thriving in different chemical environments).
  27. ^ O'Neal C, Jobling M, Holmes R, Hol W (2005). "Structural basis for the activation of cholera toxin by human ARF6-GTP". Science 309 (5737): 1093–6. doi:10.1126/science.1113398. PMID 16099990. 
  28. ^ a b c DiRita VJ, Parsot C, Jander G, Mekalanos JJ (June 1991). "Regulatory cascade controls virulence in Vibrio cholerae". Proc. Natl. Acad. Sci. U.S.A. 88 (12): 5403–7. doi:10.1073/pnas.88.12.5403. PMID 2052618. 
  29. ^ Pike J (2007-10-23). "Cholera- Biological Weapons". Weapons of Mass Destruction (WMD). GlobalSecurity.com. http://www.globalsecurity.org/wmd/intro/bio_cholera.htm. Retrieved 2010-02-01. 
  30. ^ Beardsley GW (2000). "The 1832 Cholera Epidemic in New York State: 19th Century Responses to Cholerae Vibrio (part 1)". The Early America Review 3 (2). http://www.earlyamerica.com/review/2000_fall/1832_cholera_part1.html. Retrieved 2010-02-01. 
  31. ^ Asiatic Cholera Pandemic of 1826-37
  32. ^ Wilford JN (2008-04-15). "How Epidemics Helped Shape the Modern Metropolis". New York Times. http://www.nytimes.com/2008/04/15/science/15chol.html?_r=1&8dpc. Retrieved 2010-02-01. "On a Sunday in July 1832, a fearful and somber crowd of New Yorkers gathered in City Hall Park for more bad news. The epidemic of cholera, cause unknown and prognosis dire, had reached its peak." 
  33. ^ Cholera Epidemic in Egypt (1947).
  34. ^ a b c Asiatic Cholera Pandemic of 1846-63. UCLA School of Public Health.
  35. ^ Cholera's seven pandemics, cbc.ca, December 2, 2008.
  36. ^ The Irish Famine.
  37. ^ Unruh, John David (1993). The plains across: the overland emigrants and the trans-Mississippi West, 1840-60. Urbana, IL: University of Illinois Press. pp. 408–10. ISBN 0-252-06360-0. 
  38. ^ a b Beardsley GW (2000). "The 1832 Cholera Epidemic in New York State: 19th Century Responses to Cholerae Vibrio (part 2)". The Early America Review 3 (2). http://www.earlyamerica.com/review/2000_fall/1832_cholera_part2.html. Retrieved 2010-02-01. 
  39. ^ Vibrio cholerae in recreational beach waters and tributaries of Southern California.
  40. ^ "Local agrarian societies in colonial India: Japanese perspectives.". Kaoru Sugihara, Peter Robb, Haruka Yanagisawa (1996). p 313.
  41. ^ Snow, John (1855). "On the Mode of Communication of Cholera". http://eee.uci.edu/clients/bjbecker/PlaguesandPeople/week8a.html. 
  42. ^ Eastern European Plagues and Epidemics 1300-1918.
  43. ^ Impact of infectious diseases on war. Matthew R. Smallman-Raynor PhD and Andrew D. Cliff DSc [1].
  44. ^ Vibrio Cholerae and Cholera - The History and Global Impact.
  45. ^ a b Cholera (11th ed.). 1911. pp. 265. http://www.archive.org/stream/encyclopaediabrit06chisrich#page/265/mode/1up/. Retrieved 2010-01-31. 
  46. ^ "The cholera in Spain". New York Times. 1890-06-20. http://query.nytimes.com/gst/abstract.html?res=9E05EED7123BE533A25753C2A9609C94619ED7CF. Retrieved 2008-12-08. 
  47. ^ a b "Cholera (pathology): Seven pandemics". Britannica Online Encyclopedia. http://www.britannica.com/EBchecked/topic/114078/cholera/253250/Seven-pandemics. Retrieved 2010-01-31. 
  48. ^ 1900s: The Epidemic years, Society of Philippine Health History.
  49. ^ The Boston Medical and Surgical journal. Massachusetts Medical Society. 1911. http://books.google.com/books?id=0NQEAAAAYAAJ&pg=PP281&lpg=PP281&dq=cholera+1910+moltke&source=web&ots=4PaBpOhnYT&sig=fVTMduYVBGirjSVMWAeikwE-8o4&hl=en&sa=X&oi=book_result&resnum=1&ct=result. "In New York, up to July 22, there were eleven deaths from cholera, one of the victims being an employee at the hospital on Swinburne Island, who had been discharged. The tenth was a lad, seventeen years of age, who had been a steerage passenger on the steamship, Moltke. The plan has been adopted of taking cultures from the intestinal tracts of all persons held under observation at Quarantine, and in this way it was discovered that five of the 500 passengers of the Moltke and Perugia, although in excellent health at the time, were harboring cholera microbes." 
  50. ^ Disease fact sheet: Cholera. IRC International Water and Sanitation Centre.
  51. ^ "U.N. reports cholera outbreak in northern Iraq". CNN. 2007-08-30. http://www.cnn.com/2007/WORLD/meast/08/29/iraq.cholera/index.html. Retrieved 2010-02-01. 
  52. ^ Smith D (2007-12-02). "Cholera crisis hits Baghdad". The Observer. http://www.guardian.co.uk/world/2007/dec/02/iraq.davidsmith. Retrieved 2010-02-01. 
  53. ^ Jena S (2007-08-29). "Cholera death toll in India rises". BBC News. http://news.bbc.co.uk/2/hi/south_asia/6968281.stm. Retrieved 2010-02-01. 
  54. ^ "Situation report on diarrhoea and cholera in Iraq". ReliefWeb. 2008-10-29. http://www.reliefweb.int/rw/rwb.nsf/db900sid/SHIG-7KWHHY?OpenDocument. Retrieved 2010-02-01. 
  55. ^ Cholera Country Profile: Vietnam. WHO.
  56. ^ a b World Health Organization. Cholera in Zimbabwe: Epidemiological Bulletin Number 16 Week 13 (22-28 March 2009). March 31, 2009.; WHO Zimbabwe Daily Cholera Update, 16 April 2009.
  57. ^ a b World Health Organization: Zimbabwe Daily Cholera Updates.
  58. ^ Mintz & Guerrant 2009
  59. ^ 381 new cholera cases in Mpumalanga, News24, 24 January 2009.
  60. ^ Lan R, Reeves PR (Jan 2002). "Pandemic Spread of Cholera: Genetic Diversity and Relationships within the Seventh Pandemic Clone of Vibrio cholerae Determined by Amplified Fragment Length Polymorphism" (Free full text). Journal of Clinical Microbiology 40 (1): 172–181. doi:10.1128/JCM.40.1.172-181.2002. ISSN 0095-1137. PMID 11773113. http://jcm.asm.org/cgi/pmidlookup?view=long&pmid=11773113. 
  61. ^ "Did 90,000 people die of typhoid fever and cholera in Chicago in 1885?". The Straight Dope. 2004-11-12. http://www.straightdope.com/columns/041112.html. Retrieved 2010-02-01. 
  62. ^ "Archaic medical terms". Antiquus Morbus. 2007. http://www.antiquusmorbus.com/English/EnglishC.htm. Retrieved 2010-02-01. 
  63. ^ Sehdev PS (November 2002). "The origin of quarantine". Clin. Infect. Dis. 35 (9): 1071–2. doi:10.1086/344062. PMID 12398064. http://www.journals.uchicago.edu/doi/abs/10.1086/344062?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dncbi.nlm.nih.gov. 
  64. ^ Meumayr A (1997). Music and medicine: Chopin, Smetana, Tchaikovsky, Mahler: Notes on their lives, works, and medical histories. Med-Ed Press. pp. 282–3.  (summarizing various theories on what killed the composer Tchaikovsky, including his brother Modest's idea that Tchaikovksy drank cholera infested water the day before he became ill).
  65. ^ Burnshaw S (2000). "Robert Frost". American National Biography Online. Archived from the original on 2001-03-18. http://www.english.uiuc.edu/maps/poets/a_f/frost/life.htm. 

See also

References

  • Colwell RR (December 1996). ."Global climate and infectious disease: the cholera paradigm".^ For the recent cholera series and during specific time intervals corresponding to local maxima in ENSO, this climate phenomenon accounts for over 70% of disease variance .

    ^ Rodo X, Pascual M, Fuchs G, Faruque AS. We present here quantitative evidence for an increased role of interannual climate variability on the temporal dynamics of an infectious disease .

    ^ Cholera outbreaks in the early 1980s were used as training grounds for the South African Health System in so far as prevention and control of infectious diseases is concerned.
    • Guidelines for Cholera Control 19 January 2010 8:49 UTC www.doh.gov.za [Source type: Academic]

    Science 274 (5295): 2025–31. PMID 8953025. .http://www.sciencemag.org/cgi/pmidlookup?view=long&pmid=8953025. 

Further reading

External links


1911 encyclopedia

Up to date as of January 14, 2010
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From LoveToKnow 1911

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Wiktionary

Up to date as of January 15, 2010

Definition from Wiktionary, a free dictionary

See also cholera

German

Noun

Cholera f. (genitive Cholera, no plural)
  1. cholera

Simple English

File:Cholera bacteria
Cholera bacteria under an electron microscope

Cholera is an infectious disease. It is caused by a bacterium Vibrio cholerae. This bacteria usually lives in water. Vibrio cholera is more common where fresh water mixes with salt water, like where rivers enter the ocean. It is more common in water with lots of algae.

Contents

Symptoms

Cholera is an acute intestinal illness. It causes stomach aches, very watery diarrhea, and vomiting. The diarrhea and vomiting, in turn, can cause very bad dehydration, leading to death if untreated. If you have these symptoms visit your doctor as soon as possible.

How people get cholera

File:Vibrio
Single Vibrio Cholera

Cholera is contracted by eating foods and/or drinking water contaminated with the bacterium Vibrio Cholerae.

Often, people get cholera from eating fish that is not cooked enough. They can also get it if they eat food or drink that was polluted with the diarrhoea from people who have cholera. The most common symptoms of cholera are dehydration and fever.

How to treat cholera

People with cholera need medical treatment. Most of the treatment for cholera is giving people fluids (water) and electrolytes (salts). For most people with cholera, fluids and electrolytes are given by mouth. This can be done with 80-90% of people. The best way to give this by mouth is WHO-ORS: World Health Organization Oral Rehydration Solution. (Oral means by mouth. Rehydration means to give back fluids and electrolytes to someone who is dehydrated. Solution is a mixture of salts and water.)

Some people cannot take enough fluids and electrolytes by mouth. Usually this is because vomiting is so bad. These people must be given treatment intravenously. (Intravenous means into a vein. Intravenous fluids and electrolytes are given through a needle into a person's vein.) This is necessary because if people cannot drink enough fluids and electrolytes, they can die quickly.

How to prevent cholera

Cholera can be stopped by three steps:

  • Never eat raw fish (especially shellfish.)
  • Good sanitation. This means keeping things clean. It also means making sure human waste (urine and feces) does not get into food or water supply.
  • Boiling, filtering, or chlorinating water before use. (Boiling works best.)

Other websites


Citable sentences

Up to date as of December 18, 2010

Here are sentences from other pages on Cholera, which are similar to those in the above article.








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