HLTB21H3 Lecture Notes - Soho, Cholera Toxin, Abo Blood Group System

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Published on 13 Apr 2013
School
UTSC
Department
Health Studies
Course
HLTB21H3
Professor
HLTA01 Cholera 12/03/2013 6:13:00 AM
Social effects
Poor blame the wealthy
Cholera is a good example of how society is divided
Cholera Epidemics
1817 China/Japan/SE Asia/E African coast
1826-1837 Europe/N Africa/N America
1841-1859 Europe/N Africa/all Americas
1863-1875 pandemic
1881-1896 Europe/N Africa/Asia/Americas
1899-1923 Asia
these are areas where there are already social tension
Victorian era
It is a time where there’s complete disguising of the body
o Fully cover for wealthy
Huge population density
Industrial revolution- much more crowded
Causes?
Poisoning of the poor by the rich
o They believe it’s a way for the rich to get rid of the poor
Murder for the procurement of bodies for medical examination
o People believe that hospital were going to kill their love ones
for experiment
Public health containment measures ineffective and meant as
merely:
o control of the poor or revolutionary
o to cut off trade and starve the poor
o to acquire the bodies of the dead for medicine
religious way of burial needs to remove
o use old method to prevent cholera
o they were ineffective but harsh
John Snow and the Broad St. Pump
Believed a “poison acting on the alimentary canal”
o 2 believes, one comes from the air (miasmas) and contagion
theory
Introduced how?
1854 London epidemic
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o 500 fatalities in 10 days
o Within 250m of Broad Street pump
o In a very small contain area
John Snow- Epidemiology
Examined drinking habits of:
o 83 who died of cholera
o 535 workhouse inmates
o 70 brewery workers
0% cholera because they drink filtered liqueur
he examined individuals in the area and then compare it to other
73 people live near the Broad St pump
10 of them near other pump
o but they like the taste of the Broad St pump
Southwark, Vauxhall and Lambeth
Snow also look at other water companies
These companies get water from the same source
They have higher cholera rate
Vibrio Cholerae
Have a flagella that allow them to move around water
Many serotypes of variable pathogenicity
Can survive in water ~25 days
o Heat can bloom cholerae
Can survive on fomites ~7 days
Produces cholera toxin resulting in rapid fluid loss
o Drawing salt from the cell of bodies
Found in: contaminated water or food, shellfish
Host Risk Factors
Genetic
o Cystic fibrosis protect against cholera
Mostly European society
Inability of chloride channel
o Type O blood
Twice as likely to get it
Low gastric acidity
Consuming raw shellfish
Casual contact is NOT likely to transmit disease
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o Caring for someone will not get it
Environmental Risk Factors
Toilet that goes into water sources will lead to higher chance for
cholera
Tropical and temperate seasonal
Inadequate infrastructure, sanitation, clean water
Displacement, war, natural disasters
o E.g refuge camp with dense population
Cholera Characteristics
Incubation period of 2 hours to 5 days
o Depends on amount of cholera
Fluid loss of up to 2 litres per hour
o Watery diarrhea and vomiting
Death can occur within hours
Risk for pregnant women and their babies of premature labour and
fetal death
In endemic areas, 75% cases are asymptomatic (carriers- can still
transmit) and only 2-5% are severe forms such as cholera gravis
Symptoms
Abrupt onset of watery diarrhea (rice water stool)
Vomiting and abdominal cramps
Dehydration: thirst, sunken eyes, hypotension
o Skin turn greyish blue
Tachycardia
o Irregular heartbeat
Renal failure
Seizure, coma
Death
Untreated in non endemic areas cholera can result in mortality rates
as high as 25-50%
Treatment
Oral Rehydration Therapy (ORT)
o Prepackage mixture of sugars and salts mixed with clean
water.
Challenge for clean water
o Intravenous fluids in severe cases
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Document Summary

Cholera is a good example of how society is divided. These are areas where there are already social tension. It is a time where there"s complete disguising of the body: fully cover for wealthy. Poisoning of the poor by the rich: they believe it"s a way for the rich to get rid of the poor. Murder for the procurement of bodies for medical examination: people believe that hospital were going to kill their love ones for experiment. Public health containment measures ineffective and meant as merely: control of the poor or revolutionary, to cut off trade and starve the poor, to acquire the bodies of the dead for medicine. Religious way of burial needs to remove: use old method to prevent cholera, they were ineffective but harsh. Believed a poison acting on the alimentary canal : 2 believes, one comes from the air (miasmas) and contagion theory.

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