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Cholera. History. Miasma Theory The theory that diseases were caused by miasma or bad air arising from organic decay, filth, or other conditions of the local environment. ‘All smell is disease.’ English Sanitary reformer Edwin Chadwick, 1842.
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Cholera Robin Cochran-Dirksen
History • Miasma Theory • The theory that diseases were caused by miasma or bad air arising from organic decay, filth, or other conditions of the local environment. ‘All smell is disease.’ English Sanitary reformer Edwin Chadwick, 1842 Robin Cochran-Dirksen
‘The great mass of people…. don’t know that the miasma of an impure alley is productive of cholera and disease. If they did know these things, people would take care that they inhabited better houses.’English Liberal Economist, Richard Cobden 1853 Robin Cochran-Dirksen
‘We live in muck and filth. We aint got no priviz, no dust bins, no drains, no water-splies, and no drain or suer in the hole place…The Stenche of a Gully-hole is disgustin. We all of us suffer, and numbers are ill, and if the Colera comes Lord help us.We are living like piggs, and it aint faire we shoulde be so ill treted.’ Letter to the London Times 1849, signed by 54 slum dwellers Robin Cochran-Dirksen
Early cholera epidemiology Robin Cochran-Dirksen
‘The death of a patient from cholera represents a failure of healthcare.’Silvere Simeant, WHO Robin Cochran-Dirksen
Who’s at RiskFarmers, Fisherman and laborersThe poor and the malnourished Robin Cochran-Dirksen
Conditions Leading to OutbreaksContaminated Water Robin Cochran-Dirksen
Human to Human Transmissione.g. Refugee Camps Robin Cochran-Dirksen
Symptoms and Treatment • Rehydration • Antimicrobials Robin Cochran-Dirksen
Prevention • Improved Sanitation • Clean water • Access to health care Robin Cochran-Dirksen
Cholera in Zimbabwe Robin Cochran-Dirksen
Ecology of Cholera Robin Cochran-Dirksen
Life cycle in humans • Host drinks water • Bacteria conserve energy during the passage through the stomach, most die • Surviving bacteria reach the intestine, produce flagella • Propel themselves through the mucus of the sm. intestine • Bacteria produce toxin causing diarrhea • Feces carry new bacteria back into drinking water Robin Cochran-Dirksen
Life cycle in water Robin Cochran-Dirksen
Different serotypes Robin Cochran-Dirksen
Pathogenesis Robin Cochran-Dirksen
Biochemistry • Cholera Toxin. The delivery region (blue) binds membrane carbohydrates to get into cells. The toxic part (red) is activated inside the cell (PDB code: 1xtc) Robin Cochran-Dirksen
To Us Clean Water Seems so Simple Robin Cochran-Dirksen
Who Map of Zimbabwe’s Outbreak Robin Cochran-Dirksen
Mugabe's Statement Robin Cochran-Dirksen