Cholera

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Cholera
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(No Transcript)
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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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The great mass of people. dont 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
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• 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 placeThe
  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

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Early cholera epidemiology
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The death of a patient from cholera represents a
failure of healthcare.Silvere Simeant, WHO
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Whos at RiskFarmers, Fisherman and laborersThe
poor and the malnourished
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Conditions Leading to OutbreaksContaminated Water
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Human to Human Transmissione.g. Refugee Camps
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Symptoms and Treatment

• Rehydration
• Antimicrobials

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Prevention

• Improved Sanitation
• Clean water
• Access to health care

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Cholera in Zimbabwe
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Ecology of Cholera
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• 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

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Life cycle in water
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Different serotypes
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Pathogenesis
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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)

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To Us Clean Water Seems so Simple
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Who Map of Zimbabwes Outbreak
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Mugabe's Statement