2.9 MILLION CASES WITH 95 THOUSAND DEATHS!

2.9 MILLION CASES WITH 95 THOUSAND DEATHS

Each year.  Worldwide.

I’m not saying that.  The United States Centers for Disease Control and Prevention (CDC) is doing so!  But it is under control in the United States.  Is it Covid-19?  No.  It is Cholera!

Just the name sounds sickly.  Cholera.  What is it?  A scythe-shaped rod bacterium with a flagellum for a tail.  Even more creepy sounding.  Vibrio cholerae.  Now, that’s a name!  But a better description would be diarrhea and death.  And don’t forget the stomach cramps and vomiting.  Especially among children.  And most people carrying the disease are asymptomatic, but still capable of shedding the bacteria in their feces [maybe 1 million cholera organisms in each gram of that stuff.  Yuck!]

The good news is that Cholera is treatable with antibiotics [not being a virus] and rehydration.  And vaccination.

Modern vaccines, which trigger your own body’s defenses, were developed by Englishman Edward Jenner in 1796 [using Cowpox in the vaccine] for the treatment of Smallpox.  Variolation, or deliberate infection with Smallpox to create immunity, was used for centuries as a form of treatment.  The next disease vaccine had to wait for the work of Frenchman Louis Pasteur in 1885.  And that one was for Rabies.  Smallpox and Rabies are both caused by viral agents.

And the medical sleuthing necessary to discover the cause of Cholera makes for a good story.  In the case of Cholera, it started with John Snow, in 1854, in England.  A Cholera epidemic had been set off in London by the washing of an infected baby’s diaper in a town well.  Six hundred and sixteen people died.  And many died within hours of the onset of diarrhea and vomiting.  Cholera is a shockingly virulent disease [there is that terrible word again, this time used to describe horror, even though Cholera is a bacterium!]

Cholera was then a new disease in England.  It is thought to have been originally spread from the Ganges Delta in India, where it was called “Moryxy” in 1543 A.D. [similar symptoms had been described in Sanskrit from writings much earlier in the area].

It showed up in London in 1831.  No running water and, therefore, no toilets.  Poor sanitation in honey pots, wells, and common water sources.  Cesspools were real places back then, not people.

Snow discovered that “within 250 yards of the spot where Cambridge Street joins Broad Street, there were upwards of 500 fatal attacks of Cholera in ten days.”  You can Google “Broad Street Pump” and locate that site in the Soho district of today’s London.  It is a famous place in the history of diseases.  And one of the early victories in the emerging science of epidemiology.  A science that we rely on today for our safety.

Snow thought that the disease was caused by some sort of “poison” that passed through unsanitary waters [the Cholera bacteria do, in fact, produce a toxin].  Robert Koch, a German scientist in 1883, successfully identified the agent as the Cholera organism [check out Koch’s postulates and his use of the scientific method].  That then allowed for the development of a species-specific vaccination program.

Yet, all of that knowledge was not enough to stop the spread of Cholera.  It escaped India in 1817, and then expanded to Asia.  It reached Europe and North America in the 1830s, and again after 1846 and 1865.  It erupted again in Asia and Europe in 1899, in a pandemic lasting more than 25 years.  Its spread was facilitated by colonial rule, religious pilgrimages, and modern movement on roads, rails, and ships.  After suffering Plague for 400 years, and Smallpox in the 1700s, Cholera became the epidemic to fear in Europe in the 1800s.

Cholera epidemics continued to explode into the next century.  In 1953, Calcutta; 1964, South Vietnam; 1971, Bangladesh; 1992, Burundi and Zimbabwe.  Beginning in 2016, warfare in Yemen has continued the Cholera epidemic there.  But the disease is preventable with good water and sanitation.  And the disease is treatable, if treated early.  So what happened?

There are about 7.7 billion people on our planet today, and most of them are concentrated in cities [expect that to increase to 68% by 2050].  In 1950, the year of my birth, there were 2.6 billion people on Earth.  In 1987, the population reached 5 billion.  By 2050, look for the population of Earth to increase to 9.7 billion.

The CDC projects that 780 million people, worldwide, do not have access to improved water sources.  And that 2.5 billion people do not have access to improved sanitation [greatest in Sub-Saharan Africa, Southern and Eastern Asia].  And 70% of those people live in rural areas.  They estimated that more than 800,000 children die of diarrheal disease each year [about 2,200 each day].  These are mostly preventable and treatable diseases.

Here are some people that have had Cholera.

James K. Polk.  He was our 11th President (1845-1849).  From Columbia, Tennessee, but not from the “Rattle and Snap” branch.  Those are my people.  Remember President Polk for the war with Mexico and the annexation of Texas and California.  We are, geographically, the “Destiny” that Polk dreamed of.  He was 53 when he died, only months after leaving office in 1849.  He died of Cholera, along with others who contracted the disease on his riverboat heading home.

George Croghan (1791-1849) was a famous American soldier from Kentucky.  His home in Louisville was known as Locust Grove [it is a museum today], and was frequented by George Rogers Clark, the brother of Croghan’s mother.  Her other famous brother was William Clark of the Lewis and Clark expedition.  George Croghan served in the Battle of Tippecanoe, in 1811, fighting against the forces of Tecumseh and his brother, Tenskwatawa, the Shawnee prophet.  Croghan was 57 when he died of Cholera.

Nicolas Carnot (1796-1832).  Have you ever heard of his book published in 1824 and entitled, “Reflections on the Motive Power of Fire?”  We don’t pay enough attention to the nature of the destruction that goes on all around us.  He did.  He described it as “Chaos,” with fire as its “Brand.”  Carnot is considered the “Father of Thermodynamics.”  From his work was developed the “Second Law of Thermodynamics,” and the concept of “Entropy.”  It is everywhere, and worth you paying attention.  It will ultimately be your undoing.  Cholera killed Carnot at the young age of 36.

Prussian General Carl Von Clausewitz (1780-1831) was a famous military theorist.  His work entitled, “On War,” is still much studied and quoted.  He is the one that described the “Fog of War.”  Here is some of what he said

War is the realm of uncertainty; three quarters of the factors on which action in war is based are wrapped in a fog of greater or lesser uncertainty … Judgment is called for; a skilled intelligence to scent out the truth.

 

Clausewitz died at age 51, in 1831, during the great Cholera pandemic in Europe [that one that reached America, too].

Here is an English doctor’s partial description of Cholera’s symptoms in that pandemic.

Giddiness, sick stomach, nervous agitation, intermittent, slow, or small pulse, cramps beginning at the tops of the fingers and toes, and rapidly approaching the trunk, give the first warning.  Vomiting or purging, or both these evacuations of a liquid like rice-water or whey, or barley-water, come on; the features become sharp and contracted, the eye sinks, the look is expressive of terror and wildness…

 

George Cuvier (1769-1832) was a great French naturalist, and a scholar of animal relationships.  He was also killed by Cholera in that great European pandemic.  He is known as “The Father of Paleontology,” and he has an important connection with Kentucky.  When giant fossils from Kentucky’s Big Bone Lick were sent to his Paris laboratory, he determined that some types of life forms had become extinct.  The scientific and religious consequences of this discovery were revolutionary!

The study of disease causation, transmission, and treatment now has a scientific history.  And epidemiology has provided us with the experience and expertise to address new disease epidemics.  Science, through the “Scientific Method,” is continuously accumulating new data and self-correcting.  So the prospect of continued, improved learning in our defense, is encouraging.

But it is not for science to make the human decisions as to what risk is acceptable in any one activity.  Or how people behave when faced with that risk.  And it is not for science to determine which course of action humans will take to address that risk, once identified.  Those decisions are to be made by you and our elected officials, and adopted for our society, as a whole, consistent with our form of government.

But, in the end, regardless of the course of action taken, it will be science that describes what our nation accomplished, when facing any disease, especially one that is a “pandemic.”

In Greek, “pan” means “all,” and “demos” means “people.”

Appropriate, since we are all in this together.

 

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