50 Fun Facts About Cholera

Cholera is an infection of the small intestine caused by what kind of organism?

Vibrio cholerae is comma-shaped, Gram-negative and has a single flagellum for swimming.

Cholera spreads mostly through what?

Humans are the only known host, and undercooked shellfish is a common source because the bacteria accumulate in plankton.

Cholera was nicknamed the 'blue death' because of what effect on patients?

Untreated, a patient can lose 10 to 20 litres of 'rice-water' diarrhoea a day.

What is the primary treatment for cholera?

Slightly sweet and salty solutions, ideally rice-based, replace lost fluids; zinc helps children and IV fluids are used in severe cases.

Which London physician showed in 1854 that cholera spread through contaminated water, earning the title 'Father of Epidemiology'?

He had proposed a microbial origin for cholera in 1849, decades before germ theory was accepted.

The doctor investigating the 1854 Soho outbreak persuaded the local council to do what to the Broad Street water pump?

Officials quietly put the handle back once the epidemic subsided; the street is now Broadwick Street.

How many people died in the 1854 Broad Street outbreak?

Snow's dot map of the cases clustered around the pump became one of the founding documents of epidemiology.

Why did none of the workers at the Broad Street brewery catch cholera during the 1854 outbreak?

Brewing involves boiling the water, which killed the bacteria; the workhouse next door had its own well and was also spared.

The Broad Street well was contaminated by an old cesspit into which water from washing what had drained?

The Reverend Henry Whitehead's door-to-door interviews helped Snow trace the index case.

Which clergyman helped Snow by interviewing Soho residents, initially hoping to disprove his theory?

Steven Johnson's book The Ghost Map centres on the unlikely partnership of the doctor and the curate.

Snow's 'grand experiment' compared households served by two water companies. Customers of the polluted one had a cholera rate how many times higher?

Southwark and Vauxhall drew from sewage-polluted stretches of the Thames; Lambeth Waterworks took cleaner water upriver at Seething Wells.

Apart from cholera, the Broad Street investigator is famous for giving which monarch chloroform during childbirth?

He administered it with a cloth over her face for the birth of Prince Leopold, helping make anaesthesia respectable.

The theory Snow argued against held that cholera was caused by 'miasma'. What was miasma supposed to be?

Belief in miasma led to remedies like flannel 'cholera belts' to keep the abdomen warm.

Which Italian anatomist isolated the cholera microbe in 1854, though his work went largely unnoticed?

In 1965 the international nomenclature committee formally named the organism Vibrio cholerae Pacini 1854 in his honour.

Which German scientist identified Vibrio cholerae under the microscope in 1883 as the cause of the disease?

He was sent first to Alexandria in Egypt and then to Calcutta, where the outbreak was worse.

Vibrio cholerae has what distinctive shape?

Koch described the 'comma bacilli' he found in patients' intestines.

Cholera toxin causes massive fluid loss by locking an enzyme in the active state and raising levels of which molecule in gut cells?

It does this by ADP-ribosylating a G protein subunit, so the cells pump out chloride and water without stopping.

How many cholera pandemics have been recorded since the early 19th century?

The first spread from Bengal in 1817; the seventh began in Indonesia in 1961 and has never really ended.

The seventh cholera pandemic began in 1961 in which country?

It brought a new strain nicknamed El Tor, which has persisted in developing countries for decades.

The first cholera pandemic began in 1817 in which region of India?

British Army and Navy ships helped carry it around the Indian Ocean rim, from Africa to Indonesia and on to China and Japan.

The third pandemic reached North America via Irish immigrants fleeing the Great Famine, arriving first at which city?

The fourth pandemic entered the United States through New Orleans in 1873 and spread up the Mississippi.

An 1892 outbreak in which German port city killed more than 8,600 people?

It was one of the last great cholera epidemics in Western Europe.

Between 1847 and 1851, roughly how many people died of cholera in Russia alone?

Cholera riots had already broken out in Russia in 1830–31, when mobs accused doctors of poisoning the poor.

The word 'cholera' derives from the Greek 'kholē', meaning what?

European doctors long used 'cholera' for any yellow diarrhoea, so the Indian disease was called 'Asiatic cholera' to distinguish it.

Ships with cholera aboard traditionally flew a quarantine flag of which colour?

Nobody aboard could go ashore for 30 to 40 days.

Which Bengali scientist first demonstrated in a 1953 Lancet paper that a drink of salt and glucose in water could treat cholera?

His mix was 4 g of salt and 25 g of glucose in a litre of water; De separately discovered the cholera toxin.

Oral rehydration therapy proved itself on a mass scale in 1971 among refugees from which conflict?

Millions were displaced and cholera swept the camps; ORS cut death rates dramatically.

In 1892 Waldemar Haffkine developed an improved cholera vaccine and first tested it on whom?

He then tested it on more than 40,000 people around Calcutta between 1893 and 1896.

The 2010 cholera outbreak in Haiti, ten months after the earthquake, was traced to a base of UN peacekeepers from which country?

Around 820,000 Haitians were infected and nearly 10,000 died; the UN's Ban Ki-moon finally apologised in December 2016.

The suspected source of the Haiti outbreak was which river, from which most early victims had drunk?

It flows past the peacekeepers' base at Mirebalais.

Which UN Secretary-General said in December 2016 he was 'profoundly sorry' for the organisation's role in Haiti's outbreak?

He acted after a leaked report by Special Rapporteur Philip Alston.

In 2019, 93% of the world's reported cholera cases came from which war-torn country?

The WHO called the outbreak that began there in October 2016 'the worst cholera outbreak in the world'.

A 2008 outbreak blamed partly on government failures happened in which southern African country?

A James Baker Institute report tied it to the collapse of water and health services under Robert Mugabe.

Cholera reappeared in the Americas at the end of the 20th century with a severe outbreak in which country?

The disease had been absent from the continent for most of the century.

Which Russian composer's death in 1893 has traditionally been attributed to cholera, though some scholars suspect suicide?

His mother had also died of cholera; the story goes that he drank a glass of unboiled water days before he died.

Which US president died of cholera in 1849, only months after leaving office?

Cholera also killed Prussian theorist Carl von Clausewitz in 1831 and Charles X of France in 1836.

Which pioneer of thermodynamics died of cholera in 1832 aged 36?

Many of his papers were burned with his belongings, as was customary for cholera victims.

Which inventor contracted cholera at 17 in 1873, was bedridden for nine months and survived to pioneer alternating current?

His father reportedly promised to let him study engineering rather than enter the priesthood if he recovered.

Gabriel García Márquez's 1985 novel Love in the Time of Cholera follows the lifelong devotion of Florentino Ariza to which woman?

Cholera is 'a looming background presence' in the book; the 2007 film was directed by Mike Newell.

In Thomas Mann's Death in Venice, the protagonist Gustav von Aschenbach dies of cholera in what unrealistically peaceful manner?

Benjamin Britten made the novella his last opera in 1973, and Visconti's 1971 film likewise hid the disease's real course.

In which children's classic do the heroine Mary Lennox's parents die of cholera in India?

Frances Hodgson Burnett's orphan is sent to a Yorkshire manor as a result.

W. Somerset Maugham's 1925 novel The Painted Veil sends an unfaithful wife into a cholera epidemic in which country?

Her bacteriologist husband takes her there as revenge, and the book describes the disease's ravages frankly.

Cholera holds what distinction in US public health history?

Three big 19th-century outbreaks spread along the Erie Canal, the Mississippi and the Eastern Seaboard ports.

The single-dose oral cholera vaccine approved by the US FDA in 2017 for adult travellers is called what?

Oral vaccines give reasonable protection for about six months and also guard against a form of E. coli diarrhoea.

The watery diarrhoea of cholera is classically described as resembling what?

It may carry a fishy odour, and an untreated patient can lose 10 to 20 litres of fluid a day.

People with which blood group are the most susceptible to cholera?

Children aged two to four have the highest infection rates, and malnutrition or lowered immunity also raises the risk.

Carriers of the delta-F508 mutation for which disease are thought to resist cholera better?

The idea is a heterozygous advantage: one faulty copy of the CFTR gene may have limited the fluid loss the cholera toxin triggers.

Around 2010, roughly how many people did cholera affect worldwide each year?

WHO's 2010 estimate put cases at 3 to 5 million a year, causing 28,800 to 130,000 deaths annually, mostly in places lacking safe water and sanitation.

Which very basic filtering method has cut cholera in Bangladeshi villages using untreated water?

Chlorination and boiling remain the cheapest, most effective ways of halting transmission where they are available.

Untreated, severe cholera kills roughly what share of those affected?

With rehydration therapy the outlook transforms, which is why oral rehydration salts rank among medicine's most cost-effective tools.