tag:blogger.com,1999:blog-3492197469143963742.post7196122715762990798..comments2023-06-13T04:45:22.434-04:00Comments on Infection Landscapes: CholeraMichael Walshhttp://www.blogger.com/profile/05038031388622939797noreply@blogger.comBlogger56125tag:blogger.com,1999:blog-3492197469143963742.post-25611404104769250132016-03-18T10:11:26.587-04:002016-03-18T10:11:26.587-04:00The conditions that Cholera thrive in are interest...The conditions that Cholera thrive in are interesting to me as it is free-living in water plus makes an extraordinary adaptation in the gut as it increasing infectivity. It’s advancement relies on the two preservations in which it can thrive in counties and/or areas with high population density, poor sanitation infrastructures and insufficient access to clean water. This screams to me refugee health. We still see Cholera epidemics explode after natural disasters such as the earthquake in Haiti than many people have mentioned. We also see it strike during political disasters, for example the cholera epidemic in a village of Tanzanian holding Burundian refugees. As overcrowding environment, crippled infrastructure and lack of access to aid make for a cholera breeding ground it is imperative to surveillance the conditions at refugees centers during the current crisis that we see in order for cholera to be less of a threat. Of course in a more perfect world every place would have an economy to develop healthy sanitation infrastructure. <br />Are there currently vaccines against cholera than can be administered at refugee centers? Carolyn Marie Kochhttps://www.blogger.com/profile/00433281016560472480noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-55959689331822302352016-03-04T15:49:56.235-05:002016-03-04T15:49:56.235-05:00Infrastructure is essential to maintaining a clean...Infrastructure is essential to maintaining a clean water supply and getting rid of sewage safely. The other point about infrastructure is that getting hospital attention saves lives. It is very simple to deal with the effects of cholera--hydration. However, if you are a long way from safe water and people who know what to do, cholera becomes a killer disease. <br />I think cholera will be hard to eradicate because it is free-living in water so its spatial reservoir is huge. It is interesting to think about what effect global warming is having on V. cholera. It seems to prefer warm water and certainly with increased flooding there will be more chance of sewage contaminating water supplies.<br />Anonymoushttps://www.blogger.com/profile/07792996651771706535noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-66322498271251009302016-03-04T14:48:32.250-05:002016-03-04T14:48:32.250-05:00Good point Kesha, the rising temperatures of the s...Good point Kesha, the rising temperatures of the sea is a risk factor that we must be concerned about. The water temperature will be a breeding ground for multiple diseases, Cholera among them. I know Iodine can remove most risks of Cholera from the water. I'm wondering if other elements can too. Perhaps the rising temperatures of the water will dissolve salts deposits on land and thereby cure the water. Wishful thinking?<br /><br />While on the topic, global warming can bring diseases to parts of the world that have never been able to breed such diseases. For example, certain vectors, such as mosquitos, are now able to tolerate the climate of more northern regions that were too cold in the past. This can lead to drastic concerns in epidemiology. Shmuelhttps://www.blogger.com/profile/16321894818345397249noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-46302261038810851432016-02-19T14:21:34.692-05:002016-02-19T14:21:34.692-05:00Cholera is a disease of poverty. Although there a...Cholera is a disease of poverty. Although there are two-dose vaccinations, the most effective method of prevention is to improve infrastructure. However, with the limited resources, most interventions are focused on treatment first, and then prevention. Therefore, it seems like progress is slow. Developing countries should invest and distribute oral rehydration salts in high-risk populations as a preemptive strategy. Long term interventions require large investments. This is an urgent issue because the environment is changing; rising sea levels and increases in water temperatures can potentially lead to an increase in cholera outbreaks. Anonymoushttps://www.blogger.com/profile/12743446903164670735noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-40145840688320125822016-02-01T11:39:54.555-05:002016-02-01T11:39:54.555-05:00Shmuel, people do not have stronger immune systems...Shmuel, people do not have stronger immune systems in locations where water is unclean. In fact, the persistent diarrhea that is common in childhood in many areas with poor water infrastructure typically leads to malnutrition and immune compromise. Michael Walshhttps://www.blogger.com/profile/05038031388622939797noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-91049647123100296642016-01-31T18:31:24.171-05:002016-01-31T18:31:24.171-05:00Yes, because Cholera is such a debilitating and mo...Yes, because Cholera is such a debilitating and more importantly, an easily susceptible disease, it was imperative to restrain it. Cholera is a disease that effects the most basic life source- water and wrecks havoc to the food chain. In developing countries, this is a vital aspect of the quality of life which effects everyone in the population. <br /><br />You ask if one should eat a raw oyster... this is not a slight rhetorical question, this is a reality when a person who does not have as strong of an immune system eats food from a location where people have a stronger immune system due to the uncleanliness in the water. <br /><br />This is a challenge when traveling to developing countries. where the locals use the tap water thinking its fine and the visiter gets quick food poisoning. Shmuelhttps://www.blogger.com/profile/16321894818345397249noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-32169827576220195432015-10-15T21:59:23.548-04:002015-10-15T21:59:23.548-04:00This is the first time I have ever come across wri...This is the first time I have ever come across writing regarding Dr. John Snow and the Broad Street Pump that indicates that, "while Dr. Snow was indeed at the forefront of pushing the new, germ theory of disease, the credit should not be allocated to him alone." It was nice to read the names of others who played a role but whose names are not well known. Prior to reading this, I was not aware that neither Dr. Snow nor any of his contemporaries could identify the cholera causing pathogen. It was interesting to know that Dr. Snow did not always apply the greatest of rigor in his epidemiological analyses. <br />The reminder to readers that shellfish can be a reservoir for cholera is useful as raw shellfish is commonly eaten worldwide and cooking shellfish thoroughly before eating is a preventative measure that can be easily taken to reduce the incidence of cholera.NBhttps://www.blogger.com/profile/07062917683379409807noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-88039590429640818542015-10-09T13:02:50.102-04:002015-10-09T13:02:50.102-04:00Hi S. Wallace! There are many pathogenic types of ...Hi S. Wallace! There are many pathogenic types of E. Coli, and some types can definitely cause very similar symptoms as V. cholerae diarrhea (although not as watery as cholerae diarrhea). I think the enterotoxigenic E coli (ETEC) causes the most similar symptoms/clinical presentations (watery diarrhea, abdominal cramping) as cholera. In children, enteropathogenic E coli (EPEC) is a common culprit in pediatric diarrheal cases.<br />Here's a great link to CDC's info on ETEC:<br />http://www.cdc.gov/ncidod/dbmd/diseaseinfo/etec_g.htmAnonymoushttps://www.blogger.com/profile/00094818324874815633noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-70488481996722780062015-10-08T17:14:32.631-04:002015-10-08T17:14:32.631-04:00I completely agree with you in that it is mind blo...I completely agree with you in that it is mind blowing to think that even after all the technological and medical advances of the 21st century, there are still places, such as Haiti, where cases of cholera continue to rise. It is sad to know that a disease, which is preventable and treatable, is still a main issue in certain countries. In fact, according to the CDC cholera cases have “increased steadily since 2005 and the disease still occurs in many places including Africa, Southeast Asia, and Haiti” (CDC 2014). Access to safe water, adequate sanitation and proper hygiene education should be something that everyone has access to. Even though I know this is not the case, it makes me mad to think that most illnesses and death from diseases such as cholera to this day can be prevented if these basic necessities are provided. The article says: “With proper rehydration, no one should die from cholera” and I have the same question you did: Why are people still dying in Haiti from cholera? What are the people who run these countries and that have the power to change these water, sanitation and hygiene problems doing? I know it may sound dramatic, but it’s reality and being a person with a passion for public health, I just don’t understand how such terrible public health problems still occur in places like Haiti. How did something as basic as having clean water become a luxury?<br /><br /> Works Cited<br />Centers for Disease Control and Prevention. 2014. Retrieved from: <br /> http://www.cdc.gov/healthywater/global/index.htmlAnonymoushttps://www.blogger.com/profile/10812728419197385223noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-63194109187030034062015-10-01T22:45:28.514-04:002015-10-01T22:45:28.514-04:00Regardless of technology and medical advances, it ...Regardless of technology and medical advances, it is amazing to note that we are in the “seventh pandemic”; this is something that is very humbling. It also makes me rethink the ceviche that I had in San Salvador. The dynamic V. cholerae life cycle is so insidious yet becomes such a powerful bacterium when infecting humans- exhibiting an increase in infectivity of up to 700 fold! Thinking of Haiti in particular, in which cases of cholera have continued to go up since 2010, now 706,089 cases have been reported with 8,592 deaths; a consistent case fatality rate of 1.2%, as reported by the UN in September 2014. <br />(http://www.un.org/News/dh/infocus/haiti/Cholera_UN_Factsheet_September_2014.pdf) <br />The disappointing part about this is that Haiti’s cholera epidemic has been identified as a top priority by the UN, including rapid response teams equipped with rapid cholera tests. Given what this Infection Landscape blog reports, “that with proper rehydration, no one should die from cholera”, then why is anyone still dying in Haiti from cholera? It seems as though, not enough effort, has been put into rapid aggressive rehydration therapy once infection has occurred. <br />Anonymoushttps://www.blogger.com/profile/06851929241182903843noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-27826230304035547102015-09-05T15:26:33.183-04:002015-09-05T15:26:33.183-04:00A very interesting read! I was intrigued to read t...A very interesting read! I was intrigued to read this post after visiting Haiti for a few weeks last month to visit family. This post really touched on many issues that I personally reflected on during my trip. While traveling through the country it was very clear that despite the small advances that Haiti has made post the devastating earthquake of 2010, there is still a multitude of rehabilitation that needs to occur. Inadequate water systems and poor sanitation resources still serve as the breeding grounds for this disease. In many areas of the country there is still little separation between water, sanitation, and bathroom usage. This factor aids in creating a catalyst for the cholera when infectivity increases substantially after being released in feces. It is somewhat disheartening to see a place that is in such high need of proper and effective intervention methods while considering that deaths caused by dehydration from this disease are 100% preventable with rehydration therapy. As a disease that can result in death in healthy people, it is important for public health officials to collaborate with local aid organizations for the use of vaccines and other preventive measures to control cholera. <br /><br />The animation was also a great resource for preventive methods presented in a clear simplistic manner.Anonymoushttps://www.blogger.com/profile/14532091147791908279noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-73741217511984323092015-07-16T21:09:34.975-04:002015-07-16T21:09:34.975-04:00S. Wallace- I wonder if E. Coli would be most simi...S. Wallace- I wonder if E. Coli would be most similar to the V. cholerae pathogen. They have similar vehicles- food and water, and some symptoms are similar as well between the two. In the E Coli section of this website, there is mention of similar clinical presentation of diarrhea.Anonymoushttps://www.blogger.com/profile/09001868693815415856noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-51909461493537062402015-06-30T22:55:11.144-04:002015-06-30T22:55:11.144-04:00It is interesting to note that filter feeding shel...It is interesting to note that filter feeding shellfish such as oysters and clams are important reservoirs for V. cholerae. I wonder what makes the bacteria colonize in these types of organisms. Additionally, which other pathogens cause similar symptoms (dehydration), are similar in mode of transmission and are free living in water?Anonymoushttps://www.blogger.com/profile/16624706820510231248noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-89159465282483278452015-06-30T19:49:29.586-04:002015-06-30T19:49:29.586-04:00The animated video was simple yet easily understoo...The animated video was simple yet easily understood for any layperson. The treatment process seems easy enough but I can imagine obtaining these resources (fuel, water, and bleach/chlorine) can be challenging for people in certain countries especially when devastating events happen such as earthquakes and tsunami. Recovery alone is a lengthy process; I can only imagine the other challenge that is faced with battling this disease as well as trying to then establish a sufficient filtration system. Even currently, advanced filtering systems are still making their way to remote villages 5 years after the cholera outbreak in Haiti.Anonymoushttps://www.blogger.com/profile/09001868693815415856noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-59746200994684767202015-06-26T11:38:43.024-04:002015-06-26T11:38:43.024-04:00To some extent, I disagree with your statement. Ye...To some extent, I disagree with your statement. Yes, the threat is not obvious, but that could for two reasons, and it depends on the location you're referring to. For example, the US as a developed country already has effective means of water sanitation. The Gulf of Mexico is home to cholera, but because it of our system, its not a threat. To that end, the threat isn't obvious because there is minimal threat in the US. However, things are still done by way of prevention. <br /><br />It also sounds as though you also blame the lack of awareness on the victim. What programs are in place in developing countries to bring to light the treat? Those in developing countries that are more susceptible to cholera because of poor sanitation or contaminated drinking water might know that the water is not clean, but they do not have a choice but to consume it, or they do not know how to clean it. They do not have the means to acquire the technology necessary. To that end, I believe that developed countries should do their part in helping aid others to effectively bring an end to cholera.Anonymoushttps://www.blogger.com/profile/05756619009978934237noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-19275472212825589272015-06-24T15:01:17.557-04:002015-06-24T15:01:17.557-04:00Is cholera something that can be flushed out our y...Is cholera something that can be flushed out our your system completely once excreted and the person is rehydrated? Or does it also call for antibiotics to get rid of the bacteria?<br /><br />Does rehydration therapy create a cycle where the bacteria can reproduce within the gut and continue to cause the necessity for the therapy?<br /><br />It is interesting to note that it lives in tropical waters, which often is within occurs in hotter climates where it is already important to be hydrated, does this mean that it is compounded? The map from 2009 showcased an imported case in the US. To that end, once here does that mean that while cholera already causes dehydration, it wouldn’t be to the level in a warmer climate? That is, not only would the climate affect the infectivity, but it would also affect the symptoms experienced.<br />Anonymoushttps://www.blogger.com/profile/05756619009978934237noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-56889766702389979462015-06-19T10:13:46.003-04:002015-06-19T10:13:46.003-04:00Thanks for sharing! I looked into the EAWAG Blue D...Thanks for sharing! I looked into the EAWAG Blue Diversion toilet and I think it's especially notable that the design took into consideration the cultural practices of some of the countries that this project might serve i.e. a squatting toilet as opposed to a sit-down one. I've been to countries where countless NGOs have implemented latrines with what we think constitutes a "toilet," yet they sit completely unused and ineffective because these westerners were just imposing their practices on these communities and didn't even think to consider that in their culture people squat while defecating. I'm really looking forward to seeing how this project plays out on a larger scale!Chrissyhttps://www.blogger.com/profile/12762447120645225510noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-12359818409347436372015-06-19T00:35:19.948-04:002015-06-19T00:35:19.948-04:00As a technology advances there is a possibility to...As a technology advances there is a possibility to fight back a lot of diseases as well as prevent them from happening more frequently. But there is one problem which there is no guarantee that any new technological innovations would be 100% successful to eradicate any disease from the world due to the microbial resistance and technological faults.Katarzyna Sulimahttps://www.blogger.com/profile/07636683058715747638noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-45677942225049867902015-06-19T00:32:29.739-04:002015-06-19T00:32:29.739-04:00This comment has been removed by the author.Katarzyna Sulimahttps://www.blogger.com/profile/07636683058715747638noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-33832645162829733792015-06-17T16:17:02.366-04:002015-06-17T16:17:02.366-04:00Because the primary way cholera is transmitted bet...Because the primary way cholera is transmitted between humans is water contaminated with infective fecal matter, preventing epidemic spread is as simple as effective waste management right? Shoot, we've had water treatment in the U.S. for a little more than a century.<br /><br />I'm being facetious of course, the system that allows us to consistently have access to clean water and to safely dispose of sewage far from where we live without even really thinking about it, was the result of a tremendous amount of public works projects, which, in the South at least, involved so large an undertaking as to require the backing of literally the wealthiest American ever (there's a great episode of Radiolab that talks about Rockefeller, outhouses, and parasites)!<br /><br />This month, Sallie Tisdale wrote a small piece in Harper's about a project by the Swiss Federal Institute of Aquatic Science and Technology (EAWAG), to build a toilet that requires no piped water or wired-in electricity, no grid infrastructure at all. Their goal is lofty and they're funded by USAID, the World Bank, the World Health Organization, and the Bill and Melinda Gates Foundation. These major funders are all involved because, for all the miracle cures that have been created in the last century, the innovation that we should manage sewage, arguably thousands of years old, is some of the most effective public health.Anonymoushttps://www.blogger.com/profile/00446188801114332575noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-81899265898872508472014-10-31T13:49:46.827-04:002014-10-31T13:49:46.827-04:00Eradicating or Controlling cholera infection might...Eradicating or Controlling cholera infection might be a difficult task to do.<br />That task needs to include a clean water source, and better health education that involve personal hygiene and a sanitation system supported by government/or local municipalities, and/or developing a vaccine that gives a long term immunity, since infection itself is not giving a life long immunity. All that is basically not happening in most of the countries of the world. So that in comparison Polio infection is controlled/eradicated by the polio vaccine which is comparatively easier and cheaper to initiate and maintain than the costly and almost impossible task of changing the country’s infrastructure and the population behavior especially in poor or developing countries. So I am hopeful that developing a vaccine with high effectiveness and long immunity period will be the quicker/less costly, and better way to control cholera infection of-course in addition to other methods.<br />There are 2 oral vaccines available at the moment (Dukoral and shanchol) that are about 50% effective and protection lasts for about 5 years.<br />Usama Wissanoreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-26470266838856405112014-10-10T15:33:45.415-04:002014-10-10T15:33:45.415-04:00I am puzzled by the mechanism which cholera uses t...I am puzzled by the mechanism which cholera uses to increase its infectivity. The fact that transmission of cholera can be greatly reduced by filtering of water and dilution by bleach yet the bacteria that causes this disease can survive the harsh conditions in the stomach and become more virulent. The equilibrium of this pathogen is destroyed at 100 degrees, only a few degrees different from the human body temp. The speed at which dehydration occurs in an affected individual is so serious that it could lead to death. <br />One part of the report that I found a bit humorous is the cholera cot. I have never seen this type of apparatus before, along with the bucket and calibrated dip-stick. I suppose it is practical because the infected individual is likely weakened and unable to visit the bathroom at an appropriate time. <br />Nadine Blackwoodnoreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-11758518246100932912014-09-26T16:18:05.473-04:002014-09-26T16:18:05.473-04:00Technology to clean water is available. but not ne...Technology to clean water is available. but not necessarily accessible to everyone. This is the problem with cholera and many of the other gut infections. <br /><br />While I agree with you that "proper resource allocation and preparedness on the part of the government" needs to be improved, it is extremely hard to do that. Especially when many of the countries effected are poor and developing.<br /><br />Maybe all the developed countries should pick one of the poorer afflicted countries every year and help them develop their clean water technology. This way the cost is reduced for the countries providing help and millions of deaths are prevented (from cholera and other infections). However, this then raised the issue of maintenance and who will be responsible. <br /><br />Like you said, the surveillance work is commendable, but it is not nearly enough.Richard Shttps://www.blogger.com/profile/07809743197514220377noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-75545177876433542202014-09-10T11:17:36.820-04:002014-09-10T11:17:36.820-04:00Anika,
Thanks for sharing your experience. It is ...Anika,<br /><br />Thanks for sharing your experience. It is both interesting and alarming that V. cholerae can survive and spread at such a rapid pace. Natural disasters like the earthquake in Haiti really set the stage for the emergence of infectious diseases such as cholera. As you mentioned, the earthquake practically destroyed Haiti's infrastructure. The earthquake also may have brought more people in contact with one another, allowing for easier transmission. Close interpersonal contact, along with limited access to clean water, promoted the epidemic. There also may have been limited treatment options during that time; the idea of the cholera cot is ingenious, but I wonder how practical it was in a post-earthquake setting. I'm sure providing sleeping cots for displaced people was a higher priority. Anonymoushttps://www.blogger.com/profile/10646013720531113340noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-68946865611236055492014-09-04T15:10:46.258-04:002014-09-04T15:10:46.258-04:00With increased awareness and education why is the ...With increased awareness and education why is the mortality rate still so high? What has been done in the immediate response to those who have experienced the outbreak such as persons in Haiti and most recently, the rapid onset in Ghana? What type of rehydration treatments have been administered, if any have been made available. I also, read briefly an article that in Haiti they are developing a vaccination against cholera. http://www.thebahamasweekly.com/publish/caribbean-news/Haiti_launches_cholera_vaccination_campaign36774.shtmlAnonymoushttps://www.blogger.com/profile/09151898896031061829noreply@blogger.com