Epidemic Cholera = Asiatic Cholera = Vibrio cholerae

Cholera is an acute, infectious disease characterized by extreme diarrhea, vomiting, and cramps. Cholera is primarily spread by feces-contaminated water and food; or as some say, it is a deadly water borne disease usually resulting from poor hygiene and untreated water. The cholera bacteria produce a toxin which keeps the human body from absorbing liquids. It is one of the most rapidly fatal illnesses known. Untreated individuals may die from severe dehydration within two to three hours. This disease has been the killer of millions worldwide. It is endemic in both Bangladesh and Peru. In 1991, a cholera epidemic swept down the west coast of South America. Africa suffered a similar cholera surge in 1991.

It seems that the bacteria prefers brackish coastal waters (moderately salty waters, i.e., coastal estuaries). Traditionally, this link to the seacoast areas has been credited with the transmission of the disease to other areas via ships.

The bacteria is controlled by chlorination of water and by waste water management. Of course, the less developed nations with their less developed water and waste systems are more at risk of outbreaks than the more developed nations. Natural disasters can greatly heighten the cholera risk by damaging the water and waste water systems.

Today . . . “Cholera can be simply and successfully treated by immediate replacement of the fluid and salts lost through diarrhea. Patients can be treated with oral rehydration solution, a prepackaged mixture of sugar and salts to be mixed with water and drunk in large amounts. This solution is used throughout the world to treat diarrhea. Severe cases also require intravenous fluid replacement. With prompt rehydration, fewer than 1% of cholera patients die.” U.S. Centers for Disease Control (CDC)

Cholera is still with us, lurking . . .

History

Asiatic Cholera appears to have started on the Indian subcontinent, ca. 1826. In India it became endemic. By 1831, it had spread to Russia. Eastern and Central Europe have suffered outbreaks and epidemics through World War I. The disease came the United States via English immigrants, ca. 1832.

Unfortunately, when the first epidemic hit our shores, there was no preventive, no good treatment, and no cure for the disease. The cause of the disease was not known, but we do see that early on, poor sanitation was suspected. During the years that King Cholera reigned in the United States (1832-1873), our cities were filthy, especially the ghetto areas. Waste management in those years was poor at best, but usually nonexistent. Waste would run down the middle of the streets, exposed. The streets were “ripe” with odors. Once cholera was introduced into the waste system, it was easy for the drinking water systems (poor as they were) to become cross contaminated; and once the water system was comprised, neither poor nor rich were spared. King Cholera was and is an “equal opportunity” killer. In London England, 1854, Dr. John Snow was able to stop a major cholera epidemic by closing the Broad Street pump, and thus he showed that cholera is a water borne disease. This was not previously known. According to Snow, prior to his finding it was believed that cholera “was communicated by effluvia given off from the patient into the surrounding air, and inhaled by others into the lungs ...”   Yes, London was filthy too!

One of the most common treatments for cholera in the United States up through the Civil War was the medicine calomel (Mercurous Chloride; Calogreen; Mercury Monochloride; Mercury Chloride). It was commonly used as a purgative (laxative) for the treatments of bowel illnesses ranging from diarrhea to cholera; unfortunately calomel’s effects were seriously harmful. It may have cleansed the bowels, but at the same time it caused teeth to loosen, hair to fall out and could destroy the patient’s gums and intestines. In other words, it could cause acute mercury poisoning. By 1870, we see remedies for diarrhea, brought on by long-continued use of calomel. We would need to ask -- if a person who had contracted cholera and taken calomel as treatment, could have survived to suffer calomel’s side effects?   There are a number of diseases which cause extreme diarrhea other than cholera.

Whenever there were major epidemics in the United States, it was common in the urban areas to send wagons to collect the dead. As the wagons passed the homes, the drivers would cry out, “Bring out your dead.” The deaths and burials often went without being recorded. Some families were so devastated that no one remained to put up headstones in the cemeteries -- assuming that a private burial was even possible.

The Cholera Epidemic Years in the United States

Major epidemics struck the United States in the years 1832, 1849, and 1866. There were smaller epidemics between the major ones.

1832:
   Major Epidemic
   New York City: over 3,000 people killed.
   New Orleans: 4,340 people killed.

1833:
   Columbus, Ohio.

1834:
   New York City.

1848:
   New York City: more than 5,000 killed.

1848-9:
   Major nationwide epidemic.
   See: 1849 Cholera Letter, Memphis Tennessee

1849:
   New York

1851:
   Coles Co., Illinois, The Great Plains, and Missouri

1865-73:
   Major nationwide epidemics.
   Baltimore, Memphis, Washington DC - Cholera.
   Baltimore, Memphis, New York City, Philadelphia, and Washington DC: recurring epidemics of cholera, scarlet fever, smallpox, typhus, typhoid, and yellow fever.