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Recommended: About epidemiology
Introduction
Cholera is an infectious disease that became a major threat to health during the 1800s. In the nineteenth century, there were extensive epidemics of cholera in Europe and America that killed thousands of people. In those times, the predominant theory behind disease transmission was the called Miasma theory; which suggested that diseases were spread through the bad air. In other words, particles from decomposed matter would become part of the air, and this dirty air spread the diseases. It was an elegant, but incorrect theory and its debunking took place when it was discovered that cholera was spread through a bacterium (Vibrio cholerae) in water. There is where John Snow play his essential roll in the history of epidemiology (Boston University School of Public Health, 2015).
John Snow, one of the Fathers of Modern Epidemiology
John Snow, born in 1813 in York, England. He was an English doctor and a leader in the adoption of medical hygiene and anesthesia. He is remembered as a father of the epidemiology, in part, due to his work in tracing the origin of the cholera outbreak in Soho, London, in 1854. John Snow spent several decades systematically studying cholera disease. And his
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Snow began examining the infected people and found that their initial symptoms were always related to the gastrointestinal tract. Then, Snow reasoned that, if cholera was spread by the bad air, defended by the prevailing Miasma theory, it should be causing pulmonary symptoms, instead. Therefore, due to the signs and symptoms were gastrointestinal, possibly it was transmitted by the consumption of water or food. In fact, cholera is spread by the fecal-oral route, been caused by the bacterium, Vibrio cholera, present in water or food contaminated with sewage (Boston University School of Public Health,
As the days went by and the number of deaths began to increase, the Board of Health in London began to improve people’s living conditions by creating the indoor restroom, This, however, caused more problems for the people of London, due to the lack of a proper sewage system, “London needed a citywide sewage system that could remove waste products from houses in a reliable and sanitary fashion,...,The problem was one of jurisdiction, not execution,”(Page 117). London didn’t have a place where the sewers could lead off to which keep the disease spreading when people used the restroom. After months of battling the type of disease London was faced with, Mr. Snow convinced the Board of Health to remove the water pump that was on Board Street. By getting rid of this pump, Mr. Snow helped stop major outbreaks from recurring, “The removal of the pump handle was a historical turning point, and not because it marked the end of London’s most explosive epidemic,..., It marks a turning point in the battle between urban man and Vibrio cholera, because for the first time a public institution had made an informed intervention into a cholera outbreak based on a scientifically sound theory of the disease.”(Page 162- 163). This marked the end of the London epidemic and how the world of science
The book, The Ghost Map, tells the story of the cholera outbreak that took place in England during the medieval era. During this time, London became popular, causing it to become one of the most populous urban cities in England. However, it suffered from overcrowding, a large lower class, and little health regulations. As a result, living conditions and water supply were not the cleanest, and many died from the disease cholera. Though this epidemic led to many deaths/illnesses during it’s time, it has proven to be helpful and important to public health today. Some public health advancements that have occurred as a result include healthier, cleaner, and longer lives lived.
During the fourteenth century, bacteria and viruses were mostly unknown to doctors, which meant they were most certainly unheard of for the majority of the population. Now, it is widely believed that it was caused by bacterial strains. Back then, however, people had to produce their own reasons for the Plague. In Europe, the causes of the Black Death were said to be miasma (impure air) carried by the warm southern winds. The event of March 20, 1345, the conjunction of Saturn, Jupiter, and Mars, and excessively atrocious clothing were thought to add to the ubiquitous disease. In contrast, the people near the East believed that the said disease was supposedly caused by miasma as well, but due to wind carrying the vile odor of Mongol bodies...
This book follows an esteemed doctor and a local clergyman who, together, are the heart of an investigation to solve the mystery of the cholera epidemic. In 1854 London was ravaged by a terrible outbreak of cholera, where within the span of mere weeks over five hundred people in the Soho district died. London, at the time, was a city of around two and a half million people, all crammed into a small area with no system for sewage removal. With overflowing cesspools, improper drainage of all the human and animal waste, and no system for guaranteed clean water, the people of London were in a bad state. They were essentially dumping all of their feces into their drinking water supply, a perfect environment for cholera to thrive.
In crowded conditions, the rate of infection is even more rapid. The diseases brought over to America were mainly spread by the respiratory method. The pathogenesis of infection is through the ingestion of contaminated food and water. Throughout Europe during the 15th century, food and water were contaminated with fecal matter and by unsanitary habits ( i.e. the lack of bathing). The traumatic route of infection is through insect and animal bites.
The Cholera Epidemic of 1873 in the United States. 43d Cong. , 2d Sess. House. The.
Again, at the time of Dr. Snow’s practice, germ theory wasn’t even in its infancy. It might be more appropriate to say the theory was still in utero. It was understood that there was some causative agent behind illness, but with limited ability to detect and identify the actual agents of disease – in the case of cholera the cause was a bacteria – it was nearly impossible to definitively place blame. Proponents of the miasma theory believed that impure air could cause disease, and in some ways they were correct. For example, inhaling smoke, a form of impure air, can cause a range of pulmonary diseases in addition to an immediate cough. Dr. Snow, on the other hand, was hesitant to blame air on everything. If bad air alone was to blame, why did it not affect all who breathed it equally? With such questions in mind, he set out to scientifically gather evidence towards his theory surrounding water
The most intriguing article within the stimulating documents was William Stearns Davis’ “The Life of a Peasant” (Davis, 1922). Which offers an unaltered view of the lives of peasants in the middle ages. In his article, Davis introduces the idea of deadly bacteria through a description of the Black Plague, a disease caused by the bacterium named Yersinia Pestis. The Black Plague devastated the kingdoms of the middle ages. Yersinia Pestis was able to do this as at the time of its major outbreak, poor hygiene was commonplace, and antibiotics were non-existent. The question that stood out from the article was “To what extent, would it be possible for superbugs to create an environment today absent of effective antibiotics?”
By the 1840’s high rates of disease were ascribed to the housing many of New York’s poverty-stricken immigrants lived in. Fear spread that while disease was rooted in the polluted living conditions of New York’s poorer communities, disease could easily spread to the more well off citizens too. Public health officials realized that the city’s soiled streets and polluted sewers were a health risk to all New Yorkers. In the mid-nineteenth century, New York possessed a primitive sewage system. Poorly planned sewers spanned the city, but most citizens’ homes did not connect to these pipes. Instead, most New Yorkers relied on outdoor outhouses and privies. Because of the high levels of unmanaged waste, epidemics of infectious diseases were commonplace in New York. The city battled outbreaks of smallpox, typhoid, malaria, yellow fever, cholera, and tuberculosis. In 1849, a rash of cholera struck the city, killing more than five thousand people. A wave of typhoid in the mid-1860’s resulted in a similar amount of deaths. Port cities and transportation hubs, like New York, were especially prone to outbursts of infectious diseases because of the high volume of travelers that passed through the city. Americans realized that they were contracting and dying from infectious diseases at an alarming rate, but weren’t entirely sure of why or how. (Web, par. 17,
Unlike the first cholera pandemic in 1817, the second one also affected countries in Europe and North America in addition to Asia. Of the seven total cholera pandemics, many consider this one the greatest of the 19th century. Cholera caused more deaths, more quickly than any other epidemic disease of the 1800s. It is an infectious disease that causes severe diarrhea that can lead to dehydration and death if untreated. Eating food or drinking water contaminated with a bacterium called Vibrio cholerae causes cholera. After the first pandemic had diminished throughout Asia by1824, the disease began spreading again from Bengal in 1826. It began with outbreaks in the Ganges River of Bengal and quickly spread throughout most of India. It had moved into Afghanistan and Persia by 1829 and surfaced in Russia in August of that year. From Russia, the disease travelled to Poland and eventually Hungary, Germany, Berlin, England, Scotland, and Wales. While the disease was penetrating most of Europe, it had also reached areas in Mesopotamia and the Arabian Peninsula by 1831. Thousands of Muslim pilgrims from Mecca died from the disease and carried it into Palestine, Syria, and Egypt that year. Mecca continued to be infected by cholera until about 1912. The disease also reached Portugal in 1833, from an English ship that docked in Portugal. Cholera’s path east of India remains
The first notable case of epidemiologic investigation occurred in London in 1854. A British physician named John Snow surveyed townspeople and analysed data to determine that cholera was the result of polluted drinking water. (Schneider, 2014 p. 48). This technique is a common practice for epidemiologists. When an epidemic erupts, they will survey the infected to determine similarities and narrow down the search, and then collect samples in the field to pinpoint the
This theory superseded other theories and it fundamentally changed the practice of medicine and it is still a guiding theory that inspires contemporary biomedicine today. (Science Museum, 2008) This theory helped us understand that germs could be spread from person to person and treatment was still years away. The article states that the large decline in mortality associated with the end of the 19th century is not even associated with the impact of germ theory instead with the improvement of sanitation and nutrition. (Harvard University Library, n.d.)