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Lecture 8

lecture 8


Department
Health Studies
Course Code
HLTB21H3
Professor
Caroline Barakat
Lecture
8

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Cholera
Æ
History
Miasmatists
- Pettenkofer (1818-1901) -- steadfastly refused to believe in the germ theory
- drank a vial of bacteria contaminated bacteria
- caused by bad vapour
- said that there was nothing wrong -- but experienced episodes of diarrhea
Contagionists
- believed in the germ theory announced by Pasteur (1862)
- Koch, Hansen
- spread from infectious agent
- conservative, antisocial
Æ
Epidemiology
- history of pandemics -- 7
1. 1816 - 1821: originated in India (River Ganges) and was spread by mainly British
troops with headquarters in Bengal
-- colonization - spread to Europe
2. 1829 - 1851: more widespread, reaching Europe, Canada, and the US
-- public health and sanitation measures were adapted
-- 1831 - morality of 13% in Cairo, Egypt
-- 1832 - 60 000 deaths related in England King Cholera
-- 1849 - made its way to America - Americas greatest scourge
3. 1852 - 1859: scientific advances in understanding Cholera
4. 1863 - 1873
5. 1881 - 1896: hygienic measures stopped its spread to North America
6. 1899 - 1923: missed most of the Western hemisphere from the advances in
science
7. 1961: ongoing, towards the end
-- 1961: Celebes Islands, Asia, Middle East
-- 1992: aboard a flight from South America to the US
-- 1990s: 200 000 in SouthEast Asia
-- 1994: Zaire, killed 50 000 Rwandan refugees in 21 days
-- 2000: Africa
- many countries have reported cholera cases & imported cases
- died down in European Northern hemisphere
- more cases in Southern/Central Africa, SouthEast Asia
- appears to be dying down
Etiology
- not much was known until the 5th pandemic (1883)
- Koch dispatched to Egypt to isolate the microbe
-- able to find/see the bacteria in feces of 12 patients
- vibrio cholerae (due to its vibrating wiggles)
- incubation period: few hours to 5 days
-- 139 different serogroups (139th not discovered until 2004)
- v cholerae must be infected with
two viruses
- a gene that codes for the cholera toxin (cause of diarrhea)
-- does not allow for rehydration, excrete fluids
- a gene that codes for the receptor that allows the toxin-coding virus to enter
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