Mortality and Morbidity in Human History: Cholera

Cholera probably originated in South Asia and made a home in the Ganges and the Yangtze Rivers. In Bengal, there’s actually a goddess of cholera. It didn’t make it into the west until 1817, most likely through armies first and then pilgrims filled in the gaps.

The first couple great pandemics were spread by British armies traveling between India, Persia and England and killed hundreds of thousands. Soldiers reportedly died as they marched, having only caught the disease that morning.

19thcenturynurses

19th century cholera ward

Cholera was brought to America in 1831. It went from Canada to New York State with the first documented case cited in June 26, 1832. American business being what is has always been, proved to be a vocal opposition to closing down public places because of the effect it would have on commerce. This tactic had been used to good effect elsewhere.

It was an Italian scientist, Filippo Pacini, that discovered the bug first sometime between 1854-63. Robert Koch rediscovered it in 1883 and got credit for it for decades. Not until the 1960’s was Pacini honored as the first to make the discovery when the bacteria that causes the disease was officially named Vibrio cholera Pacini.

Signs/symptoms

Cholera victims present with profuse diarrhea which has a characteristic “rice water” appearance. This quickly leads to dehydration. If not properly supported, the victim then experiences a drop in blood pressure as the body’s fluid levels decrease. This can cause collapse and renal failure as the kidneys fail to receive adequate perfusion.

Cholera is spread via contaminated water so it tends to not be a danger in developed nations. There are currently two cholera vaccines though neither are available in the U.S.. Sanitation and water treatment facilities are by far, the best way to prevent cholera outbreaks. In areas of the world where large numbers of people are living together without these things, outbreaks still occur. Last year, Yemen experienced an outbreak and currently, Kenya is experiencing one in the Daadab complex, which houses around 350,000 displaced people.

 

source: Plagues & Poxes: the Impact of Human History on epidemic disease

CDC

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STD portraits: Syphilis

It was only within the last century that syphilis moved from dreaded life-long companion to minor nuisance and the villain in lifetime movies.

The first great outbreak in Europe happened during the 15th century. Charles VIII of France besieged the kingdom of Naples, claiming it was rightfully his through his Angevin line. It’s unknown whether the disease showed up within the walled city first or the attacking army and for that reason each side blamed the other for their sudden misfortune. The French believed the city had released its prostitutes for the explicit reason of weakening their number and the city believed the French had brought it with them.

peter the great

Peter the Great of Russia

Whoever was responsible, Charles’ army was so weakened by the outbreak, he blamed the “Neapolitan disease” for their failure.

Naturally, as troops returned home, the disease came with them and spread all across Europe. It later took on other names like “the Portuguese sore,”The Spanish disease” and “La Grosse Verole,” or the Great Pox.

Great Pox, it was, as it affected even heads of state. Peter the Great was among them along with Henry VIII, Louis XIV of France and Ivan the Terrible.

Most surprisingly, before the stuffy Victorians came and ruined everything, syphilis was known in the 16th century as the “gallant disease.”

source: Plagues and Poxes: The Impact of Human History of Epidemic Disease by Alfred Jay Bollet

Mortality and Morbidity in human history: Urinary Schistosomiasis

There is a parasitic worm that can be spread by contact with water contaminated with infected urine or feces or via snails. The worms develop and reproduce in snails and then can live in freshwater on their own for about two days.

If they are able to penetrate someone’s skin, they set up camp in the blood vessels and make lots of eggs. Some of the eggs migrate to the bladder and bowels where they can then pass back to the outside world but not before causing inflammation to the affected areas. Upon first contact, it can cause a rash. In a month or two, fever, chills, coughing and aches can develop. If left untreated, the worm can cause liver damage and in rare cases eggs can migrate to the brain and spinal cord and cause seizures or paralysis and the body tries to rid itself of the attacker.

ancient Egyptian fishermen

Ancient Egyptian fishermen

The Schistosoma haematobium worm can affect other parts of they body but my particular interest here is when it affects the urinary system. In ancient Egypt, it appears to have been a common affliction among fishermen. Initially, it causes hematuria, or blood in the urine. There is reason to believe that it may have been regarded as a “virile menstruation” because of the relative lack of information in medical papyri and because it disproportionately affected young men.

 

 

 

 

sources:

Medicine in the Days of the Pharaohs by Bruno Halioua and Bernard Ziskind

CDC

You know nothing Jon Snow

Actually, Ygritte said it more like, “YOU KNOW NUFFIN’ JON SNRRRR.”

But it’s not that Jon Snow anyway.

jonsnow

John Snow, the English Physician is kind of a rock star in epidemiology. He helped find the source of a cholera outbreak in London in 1854. By observation and interviews of affected people and those around them, he was able to trace the outbreak to a public water pump. The city soon shut it down by removing the handle and the epidemic subsided.

Anti-tuberculosis Propaganda

 

I watched a documentary just now called “The Forgotten Plague.” It’s about TB in America. Once public health officials caught on to its contagious nature, they launched a massive campaign to educate people on the importance minimizing transmission. According to the documentary, men were even moved to trim or shave their beards lest they bring TB home in their facial hair.

I saw this slogan on a flyer with a baby on it and suddenly this watercolor that has been sitting around for a year made sense.
germofinfectinodrybrush

Mortality and Morbidity in human history: Smallpox

U.S. Smallpox Epidemic of 1901-1903

smallpoxvibrantpaintdaubs

There were a series of outbreaks in New York, Philadelphia, Boston and in Ohio and New  Jersey. It was introduced into New York in 1900 and by 1901, there were over 900 reported cases in Manhattan while Brooklyn had over 1,500 with over 200 deaths.

By 1902, the city opened five vaccination centers and vaccinated tens of thousands a day. Over a six month period, over 800,000 people had been vaccinated which greatly helped control the spread.

In the three years of the epidemic, there were 21,000 cases of smallpox and over 3,500 deaths.

 

from Encyclopedia of Plague and Pestilence: from Ancient Times to the Present.