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Lecture 9

Lecture 9 Notes

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University of Toronto Scarborough
Health Studies
Caroline Barakat

HLTA01 – Lecture 9 Notes Thursday, November 15 , 2012 Cholera th Until the 19 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 HLTA01 – Lecture 9 Notes Thursday, November 15 , 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: th HLTA01 – Lecture 9 Notes Thursday, November 15 , 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? th HLTA01 – Lecture 9 Notes Thursday, November 15 , 2012 Cholera o Died down in Europe o Note the distance between the cases in Africa Cholera, areas reporting outbreaks, 2007-2009 (WHO 2009)  Figure 4: o Demonstrates the belief that the pandemic is dying down Number of Reported Cases in Canada, 1995 to 2004  Figure 5: o There is really no difference between males and females o Not many cases in Canada Etiology  Was discovered during the 5 epidemic (1883) HLTA01 – Lecture 9 Notes Thursday, November 15 , 2012 Cholera  Koch dispatched to Egypt to isolate the microbe  Able to see the bacteria in feces of 12 patients  Vibrio cholerae (due to its vi
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