#cholera

La province du Sud-Kivu a enregistré six décès liés au choléra et 182 cas suspects au cours de la 24e semaine épidémiologique, selon les données publiées par la Division provinciale de la santé (DPS). D’après le rapport, le nombre de cas a connu une hausse par rapport à la semaine précédente, qui avait enregistré 130 cas suspects. Cette évolution représente une augmentation de 28,5 % entre les…

Bayangkan seseorang yang tampak sehat di pagi hari, lalu sore harinya sudah terkulai lemah, dehidrasi parah, dengan tekanan darah yang anjlok dan nyawa yang terancam—semua itu hanya karena segelas air yang terkontaminasi. Inilah kolera: penyakit yang sudah merenggut jutaan nyawa selama berabad-abad, namun hingga hari ini belum juga pergi dari muka bumi. Kolera bukan sekadar penyakit diare biasa.…

Nouvel article publié sur https://2tout2rien.fr/fort-alexander-ile-artificielle-peste/

Fort Alexander, le fort de la peste sur une île artificielle près de Saint-Pétersbourg

From The Medical Detective: John Snow, Cholera, and the Mystery of the Broad Street Pump by Sandra Hempel

There were three distinct ‘Cholera Years’ in America: 1832, 1849, and 1866, with three distinctive outbreaks. What began as a ‘scourge of the sinful’ in 1832, was regarded to be the result of poor sanitation in 1866. Cholera follows the evolution of the public health system very closely, almost ushering it into existence. Cholera challenged the American ideal of decentralized government. While it may have worked in the small, rural towns of the past, it was not feasible when trying to keep a quarter of a million people clean and safe. 

In 1832, most Americans regarded the United States as a land of health, virtue, and simplicity, her cities a stain upon the vast, green landscape of America that must be ignored.  But by 1866, America’s cities had grown to a size that could not be ignored, America had to accept her cities and make the steps necessary to keep them safe and healthy: a pure water supply, adequate sanitation, and a reliable police force were necessary.  

Much of the information in this post comes from Charles Rosenberg’s 1962 book The Cholera Years. 

The First Outbreak: 

Cholera was a known sickness by 1832, widely assumed to be spread via ‘Miasma’ or infected air. It had reached Europe, and it was only a matter of time before it crossed the Atlantic Ocean. Cholera’s presence in Europe proved that the disease had no preference for warm climates, unlike yellow fever. Americans believed themselves to be clean, pure, and pious as compared to their Old-World counterparts, but there was one glaring exception.  

There were approximately 250,000 citizens residing in New York during the outbreak of 1832. Those with the means (which were not many) had water supplies that came from the countryside, their water clean and pure. The masses, however, had no choice but to use the city’s central water supply, filled with dirt and grime. The poorest of New York lived in tiny, windowless apartments, often with more than one family. If they couldn’t afford even that, they could take shelter in stables, or room with the dogs and pigs that roamed the streets. The New York Board of Health was established in 1805 but held a very passive role in the City. The board was made up of 3 members and only met in the summer.  

As the threat of Cholera got closer, the city of New York didn’t budge. The committee made no attempts to prepare the city, and the only advice citizens of New York heard was from local physicians. They were urged to avoid hard-to-digest foods, clean the roads, and boil their water when possible. While New Yorkers tried their best to heed the advice of the doctors of the city, it was nearly impossible without any kind of city-led movement towards sanitation. 

The first recorded case of Cholera in New York was in an Irish immigrant named Fitzgerald. All who could afford it fled the city, leaving behind only the doctors, and the very poorest of New York. Doctors around the world agreed that it was the filthy who suffered most from this disease, and America took that to mean that it was purely sinners who suffered. Of “fourteen hundred lewd women” in one street in Paris, newspapers reported, thirteen hundred died of Cholera. When Cholera reached the United States, such convictions were affirmed repeatedly. Alexander H. Stevens, president of New York’s Special Medical Council, reported that “the disease had been confined to the intemperate and the dissolute with few exceptions.” This meant that any person of substance who died of Cholera, was immediately investigated. To die of Cholera was to die of suspicious circumstances. It was regarded as many to be divine impositions, especially since it did not behave like diseases of the past and had not yet been proven to be contagious. 

The truth, however, seems obvious to those of modern dispositions. Cholera targeted those seen as ‘unclean’, because it did. Cholera disproportionately targeted Irish immigrants and slaves around America, to an extreme degree. The predisposition of the poor to disease was staggering. In New York, the vast majority of the dead were buried at Potter’s Field, where the city’s poor and unclaimed lie to rest.  

It was only after cholera arrived in the city did the Board of Health spring into action. Cholera hospitals were erected in the city, as other; private hospitals refused to take patients infected with cholera. The board did what they could with the limited resources, only working with around 100,000 dollars, much of which was funded by the board themselves. Some of the dirtiest streets were cleaned, and temporary housing for the poor was erected. While the efforts of the board were better than ignoring the epidemic, their incredibly late start and limited resources did very, very little to slow down the fatality of cholera. 

Doctors around the world agreed that Cholera could be treated very, very early, but once the disease had progressed, opinions on how to proceed differed. The truth was, Cholera could very, very rarely be treated once it progressed past its initial mild symptoms into something more life threatening. Not many people were willing to go to the doctor, even less willing were the less fortunate, who would hide their symptoms until it was too late for them to be saved.