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Lecture 9

HLTB21H3 Lecture Notes - Lecture 9: Water Purification, Microorganism, Max Joseph Von Pettenkofer


Department
Health Studies
Course Code
HLTB21H3
Professor
Caroline Barakat
Lecture
9

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HLTA01 Lecture 9 Notes Thursday, November 15th, 2012
Cholera
Until the 19th century
Miasmatists
Max von Pettenkofer (1818 -1901)
o Steadfastly refused to believe in the germ theory
Believed that there was a factor in the air (X factor) and a factor in the dirt (Y
factor) that caused disease
Independently there is no diseases caused, but together (co-dependent) they
result in disease
o Drank a vial of bacteria contaminated water
When Koch isolated the bacteria, Pettenkofer asked for a sample
In front of a large crowd of demonstrators that supported him, he drank the vial
and told Koch that he did not get sick from it and that nothing happened
What he didn’t report were the symptoms he got such as diarrhea, etc
Believed that he had experienced Cholera before, so this episode wasn’t
as serious
Disease caused by ‘bad vapors’
o Seen as the socialists
Soon took his life after more people believed in contagionists’ theory
Contagionists
Believed in the ‘germ theory’ announced by Pasteur (1862)
Koch and Hansen
Diseases spread from person to person by an infectious agent
o Anti-social, irresponsible view
o Changes to social structure
Epidemiology
History of cholera is described as the history of pandemics
7 Pandemics:
1. 1816 1821: Originated in India (River Ganges) and was spread by mainly by British troops,
headquarters in Bengal
2. 1829 1851: More widespread, reaching Europe, Canada, and the US
1831: Mortality of 13% in Cario, Egypt
1832 - 1833: 60,000 deaths in England disease known as ‘King Cholera’
1849: Called ‘America’s greatest scourge’
Even though there wasn’t much scientific proof or reasoning, many people believed that
something was causing this disease to be passed around
o Affected public health, sanitation, hygiene

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HLTA01 Lecture 9 Notes Thursday, November 15th, 2012
Cholera
Realized that Cholera was due to lack of sanitation
3. 1852 1859: Scientific advances in understanding underlying causes of Cholera
Started to understand the risks of it in public health, sanitation, and hygiene
Went into a dormant phase
4. 1863 1873: Became active yet again, and lasted for about 10 years
5. 1881 - 1896: Bacteria in causing Cholera is identified and hygienic measures stopped its spread
to North America
Robert Koch isolated the bacteria
6. 1899 1923: For the most part missed the western hemisphere
7. 1961 Present: Believed that it’s towards the end of the pandemic
1961: Celebes Islands, Asia, Middle East
1992: Aboard a flight from South America to the US
1990’s: 200,000 cases in South East Asia
1994: Zaire, killed 50,000 Rwandan refugees in 21 days
2000: Africa
o Ie. After the earthquake in Haiti
Cases of Cholera worldwide, 2002-2003
Figure 1:

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HLTA01 Lecture 9 Notes Thursday, November 15th, 2012
Cholera
Countries/areas reporting cholera and cases reported, by year, 1993
2003 (WHO, 2004)
Figure 2:
o Demonstrates that the number of Cholera cases worldwide is decreasing with each
passing year
Note that there is a peak in 1998-1999 and 2001
There is a bit of a cyclical cycle
Example of a susceptible population
Reported Cases of Cholera, 2004 -2007 (WHO 2008)
Figure 3:
o Resurfaced cases of Cholera in North America
Is it due to important cases of travel or food?
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