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Lecture

week 10 - Cholera

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Department
Health Studies
Course
HLTB21H3
Professor
Caroline Barakat
Semester
Fall

Description
HLTA01 – week 10 Novemeber, 14 2011 Cholera Lecture Outline – Context – Epidemiology –Historical perspective – Etiology – Clinical manifestations and symptoms – Diagnosis and treatment – Underlying causative factors – Prevention – Video segment from ‘Plagued’ – Episode 2, 25 – 52 min Until the 19 Century Miasmatists – Pettenkofer (1818 – 1901) • steadfastly refused to believe in the germ theory • drunk a vial of bacteria contaminated water – Disease caused by ‘bad vapors’ Contagionists – Believed in the ‘germ theory’ announced by Pasteur (1862) – Koch and Hansen – Diseases spread from person to person by an infectious agent 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) Second pandemic: 1829 – 1851: more widespread, reaching Europe, Canada, and the US • 1831 – mortality of 13% in Cairo, Egypt • 1832 – 3: 60,000 death in England – disease known as ‘King Cholera’ • In 1849 – called ‘America’s greatest scourge’ 1) 1852 – 1859: Scientific advances in understanding Cholera 2) 1863 – 1873 3) 1881 – 1896: hygienic measures stopped its spread to N America 4) 1899 – 1923: for the most part missed the western hemisphere 5) 1961 – ongoing • 1961: Celebes Islands, Asia, Middle East • 1992: aboard a flight from S America to the US • 1990s: 200,000 in SE Asia • 1994: Zaire, killed 50,000 Rwandan refugees in 21 days • 2000: Africa Etiology th – During the 5 epidemic (1883) – Koch dispatched to Egypt to isolate the microbe – Able to 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 – V. cholerae must itself be infected with two viruses: • 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 – Trillion V. cholerae excreted each day – Indirect transmission: fecal – oral route of transmission • Bacteria can survive on food for up to 5 days at ambient temperatures, and up to 10 days at 5-10 C
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