History of cholera

Seven cholera pandemics have occurred in the past 200 years, with the first pandemic originating in India in 1817. The seventh cholera pandemic is officially a current pandemic and has been ongoing since 1961, according to a World Health Organization factsheet in March 2022.^[1] Additionally, there have been many documented major local cholera outbreaks, such as a 1991–1994 outbreak in South America and, more recently, the 2016–2021 Yemen cholera outbreak.^[2]

Although much is known about the mechanisms behind the spread of cholera, this has not led to a full understanding of what makes cholera outbreaks happen in some places and not others. Lack of treatment of human feces and lack of treatment of drinking water greatly facilitate its spread. Bodies of water have been found to serve as a reservoir, and seafood shipped long distances can spread the disease.

Between 1816 and 1923, the first six cholera pandemics occurred consecutively and continuously over time. Increased commerce, migration, and pilgrimage are credited for its transmission.^[3] Late in this period (particularly 1879–1883), major scientific breakthroughs toward the treatment of cholera develop: the first immunization by Pasteur, the development of the first cholera vaccine, and identification of the bacterium Vibrio cholerae by Filippo Pacini and Robert Koch. After a long hiatus, a seventh cholera pandemic spread in 1961. The pandemic subsided in the 1970s, but continued on a smaller scale. Outbreaks occur across the developing world to the current day. Epidemics occurred after wars, civil unrest, or natural disasters, when water and food supplies had become contaminated with Vibrio cholerae, and also due to crowded living conditions and poor sanitation.^[4]

Deaths in India between 1817 and 1860 in the first three pandemics of the nineteenth century, are estimated to have exceeded 15 million people. Another 23 million died between 1865 and 1917, during the next three pandemics. Cholera deaths in the Russian Empire during a similar time period exceeded 2 million.^[5]

January 1991 – September 1994: Outbreak in , apparently initiated when a Chinese ship discharged ballast water. Beginning in Peru,^[69] there were 1.04 million identified cases and almost 10,000 deaths. The causative agent was an O1, El Tor strain, with small differences from the seventh pandemic strain.

South America

The 1889 novel by Giovanni Verga presents the course of a cholera epidemic across the island of Sicily, but does not show the suffering of the victims.^[127]

Mastro-don Gesualdo

In 's novella Death in Venice, first published in 1912 as Der Tod in Venedig, Mann "presented the disease as emblematic of the final 'bestial degradation' of the sexually transgressive author Gustav von Aschenbach."^[127] Contrary to the facts of how violently cholera kills, Mann has his protagonist die peacefully on a beach in a deck chair. Luchino Visconti's 1971 film version also hid from the audience the graphic course of the disease.^[127] Mann's novella was also adapted as an opera by Benjamin Britten in 1973, his last one; and as a ballet by John Neumeier for his Hamburg Ballet company, in December 2003.*

Thomas Mann

W. Somerset Maugham's novel (1925), explores a British couple's marriage against the work of the husband as a doctor in China during a 20th-century cholera epidemic. It was most recently adapted as a film of the same name (2006), starring Edward Norton and Naomi Watts. It did show people suffering the physical effects of the disease. Earlier adaptations in 1934 and 1957 kept the disease out of sight.

The Painted Veil

In 's 1985 novel Love in the Time of Cholera, cholera is "a looming background presence rather than a central figure requiring vile description."^[127] The novel was adapted in 2007 for the film of the same name directed by Mike Newell.

Gabriel Garcia Márquez

The 1995 film (Le Hussard sur Le toit) by Jean-Paul Rappeneau is about a cholera epidemic in the south of France.^[128]

The Horseman on the Roof

The 1997 American television film is about people dying in Los Angeles from a cholera outbreak.

Contagious

Unlike tuberculosis ("consumption"), which in literature and the arts was often romanticized as a disease of denizens of the demimondaine or those with an artistic temperament,^[126] cholera is a disease that today almost entirely affects the lower-classes living in filth and poverty. This, and the unpleasant course of the disease – which includes voluminous "rice-water" diarrhea, the hemorrhaging of liquids from the mouth, and violent muscle contractions which continue even after death – has discouraged the disease being romanticized. It is seldom presented at all in popular culture.^[127]

List of epidemics and pandemics

, ed. (1911). "Cholera" . Encyclopædia Britannica. Vol. 6 (11th ed.). Cambridge University Press. pp. 262–267.

Chisholm H

Evans RJ (1987). Death in Hamburg: Society and Politics in the Cholera Years, 1830-1910. Oxford University Press.

Evans RJ (1988). "Epidemics and Revolutions: Cholera in Nineteenth-Century Europe". Past & Present. 120 (120): 123–146. :10.1093/past/120.1.123. JSTOR 650924. PMID 11617908.

doi

Hamlin C (2009). Cholera: The Biography. Oxford University Press.