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HLTA01 Lecture 09 Notes.docx

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Health Studies
Caroline Barakat

1 HLTA01 Lecture 09 (Cholera)  Course evaluation will be coming out son  Two more lectures left  History (Until the 19 century) o The miasmatists (Pettenkofer 1818-1901)  He refused to believe in the germ theory  Drank a vial of bacteria contaminated water (he asked it from Robert Koch)  Disease caused by ‘bad vapours’ (= Miasmas)  Factor in the air and a factor in the soil; and there’s some reaction when these two factors mix and this is what causes the disease  These people were seen as social and happier and better basically o Contagionists  Believed in the “germ theory”  This theory was announced by Pasteur in 1862 for the first time  Main people = Koch and Hansen (the discoverer of the pathogen of leprosy)  Disease spread from person by an infectious agent  People viewed this people as anti-social and irresponsible since their perspective could change the social structure  Epidemiology o History of cholera is described as the history of pandemics o 7 pandemics since 1816, and we are currently experience the 7 pandemic currently (1961 ongoing) o First pandemic: 1816-1821; originated in India in the Ganges River and was spread by the British troops, headquarters in Bengal o Second pandemic: 1829-1851; more widespread, reaching Europe, Canada, and the US; a lot of episodes in the northern hemisphere; mortality reached its peak in 1831 in Cairo, Egypt; there was a high death rate in England (1832-3) and was known as the “King Cholera”; in 1849 called the “America’s greatest scourge” o Third pandemic: 1852-1859; scientific advances in understanding cholera, better public health measures o Fourth pandemic: 1863 – 73; o Fifth pandemic: 1881-96; hygienic measures stopped its spread to north America; no more spread to northern hemisphere due to better sewer, etc.; during this time Koch isolated the cholera o Sixth pandemic: 1899-1923; missed the western hemisphere for the same reasons as above o Seventh pandemic: 1961 - ongoing o Series of epidemics:  1961: Celebs Islands, Asia, Middle East  1992: aboard a flight from South America to the US  1990s: 200,000 in SE Asia  1994: Zaire, killed 50,000 Rwandan refugees in 21 days  2000: Africa  Etiology th o During the 5 epidemic (1883) when found the agent of the cholera o Koch dispatched to Egypt to isolate the microbe o Able to see the bacteria in feces of 12 patients o This microbe was named: Vibrio Cholerae due to its vibrating and wiggling nature o Incubation period – few hours to 5 days and has 139 different serogroups o V. cholerae must itself be infected with two viruses: 2 HLTA01 Lecture 09 (Cholera)  One has a gene that codes for the cholera toxin  Other must have a gene that codes for the receptor that allows the toxin-coding virus to enter the bacterium  Infection with Cholera o Trillion V. cholerae excreted each day o Indirect transmission: fecal-oral route of transmission;
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