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Chapter 8

Chapter 8: King Cholera


Department
Health Studies
Course Code
HLTB21H3
Professor
Caroline Barakat
Chapter
8

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Chapter 8: King Cholera
Cholera: as known as ‘King Cholerain England
Water or food borne disease, sewage disease
·History: described as the history of pandemics
-7 pandemics:
1) 1816-1821: originated in India (River Ganges) and spread mainly by British troops, headquarters in Bengal
2) 1829-1851: reaching Europe, Canada, and the US
1831: mortality of 13% in Cairo, Egypt
1832: known as ‘King Cholerain England
1849: 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: stopped for the most part of western hemisphere
7) 1961-ongoing: in its dying phase, series of outbreak below
·Etiology:
-Bacteria: Vibrio Cholerae (due to its vibrating wiggles), gram negative, comma-shaped bacillus (Koch saw the bacteria
in feces during 5th epidemic 1883)
-has two viruses within it, one that codes for cholera toxin (1929), the other codes for the receptor which allow the toxin
coding virus to enter bacterium
-bacteria can go dormant and enter spore-like cell when reproduction is not favourable, next epidemic boom may come
from phytoplankton triggered by global warming
-Incubation period: few hours to 5 days
·Transmission
-indirect transmission: fecal—oral route of transmission (water)
-bacteria can survive on food for up to 5 days at ambient temperatures, and up to 10 days at 5-10 c
-often found in the aquatic environment, can live in dirty water
-stomach gastric juice is lethal to V. cholerae
-low stomach acidity implies high susceptibility to cholera because the bacteria can survive on those environment
-people with O type blood are more susceptible
-infected individual can excrete a trillion viruses per day
-bacteria may become dormant in between epidemics, can only happen to humans
·Symptoms:
-severe diarrhea (producing ‘rice waterstools), vomiting, convulsions, muscle cramps
-but little abdominal pain, leads to loss of water and electrolytes but not protein, radical dehydration, ruptured capillaries
causing them to be black and blue.
-Death: severe dehydration in less than 10% of ill persons, sometimes within hours
·Diagnosis and Treatment:
-Dark-field or phase-contrast microscope
-1832: rehydration therapy
-Food-based ORT: using starches and proteins instead of glucose, antibiotics to reduce severity
-ORT(oral rehydration salts): glucose, NaCl, K and lactate
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