IN DEPTH
Health
Cholera's seven pandemics
Disease has killed millions since 19th century
Last Updated: Friday, May 9, 2008 | 4:58 PM ET
CBC News
In the past 200 hundred years, seven cholera pandemics have killed millions across the globe. The seventh is still going on, but advancements in medical science have greatly reduced the number of people who die from it.
In addition, modern-day sewage and water treatment systems have largely eliminated cholera from developed countries. But it continues to be a concern in the developing world, especially in areas ravaged by war and natural disasters such as earthquakes and hurricanes that leave people without access to clean drinking water.
These are the major cholera outbreaks:
1817-1823
The first known pandemic of cholera originated in the Ganges River delta in India. The disease broke out near Calcutta and spread through the rest of the country. By the early 1820s, colonization and trade had carried the disease to Southeast Asia, central Asia, the Middle East, eastern Africa, and the Mediterranean coast.
The death toll from this outbreak is not known, but based on the 10,000 recorded deaths among British troops, researchers estimate that hundreds of thousands across India succumbed to the disease. In 1820, 100,000 people died on the Indonesian island of Java alone. By 1823, cholera had disappeared from most of the world, except around the Bay of Bengal.
1852-1859
The third pandemic, generally considered the most deadly, originated once again in India. It devastated large swaths of Asia, Europe, North America and Africa.
In 1854, the worst year, 23,000 died in Britain alone. In that same year, British physician John Snow succeeded in identifying contaminated water as the transmitter of the disease, a breakthrough in eventually bringing it under control.
Snow carefully mapped the cases of cholera in the Soho area in London and traced the source to a water pump. After convincing officials to remove the pump handle, the number of cholera cases in the area immediately declined.
1881-1896
The fifth pandemic originated in the Bengal region of India and swept through Asia, Africa, South America and parts of France and Germany. Cholera claimed 200,000 lives in Russia between 1893 and 1894; and 90,000 in Japan between 1887 and 1889. Quarantine measures based on the findings of John Snow kept cholera out of Britain and the United States.
In 1892, Waldemar Haffkine, a Ukrainian bacteriologist who worked mostly in India, developed a human vaccine for cholera.
1961 to present
Unlike the first six, the seventh pandemic originated in Indonesia. It ravaged populations across Asia and the Middle East, eventually reaching Africa by 1971. In 1991, 100 years after being vanquished from South America, cholera appeared in Peru.
An outbreak among Rwandan refugee camps in the Democratic Republic of Congo killed tens of thousands in 1994.
The discovery of a new species of the cholera bacteria (O139) in Bangladesh in 1992, which has since been detected in 11 countries, has raised the possibility and fear of an eighth pandemic.
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