Download Cholera

Cholera
Robin Cochran-Dirksen
Robin Cochran-Dirksen
History
• Miasma Theory
• The theory that diseases were caused by
miasma or bad air arising from organic
decay, filth, or other conditions of the local
environment.
‘All smell is disease.’
English Sanitary reformer Edwin Chadwick, 1842
Robin Cochran-Dirksen
‘The great mass of people…. don’t know that the
miasma of an impure alley is productive of cholera
and disease. If they did know these things, people
would take care that they inhabited better houses.’
English Liberal Economist, Richard Cobden 1853
Robin Cochran-Dirksen
‘We live in muck and filth. We aint got no priviz,
no dust bins, no drains, no water-splies, and no
drain or suer in the hole place…The Stenche of
a Gully-hole is disgustin. We all of us suffer, and
numbers are ill, and if the Colera comes Lord
help us.We are living like piggs, and it aint faire
we shoulde be so ill treted.’
Letter to the London Times 1849, signed by 54 slum dwellers
Robin Cochran-Dirksen
Early cholera epidemiology
Robin Cochran-Dirksen
‘The death of a patient from cholera
represents a failure of healthcare.’
Silvere Simeant, WHO
Robin Cochran-Dirksen
Who’s at Risk
Farmers, Fisherman and laborers
The poor and the malnourished
Robin Cochran-Dirksen
Conditions Leading to Outbreaks
Contaminated Water
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Human to Human Transmission
e.g. Refugee Camps
Robin Cochran-Dirksen
Symptoms and Treatment
• Rehydration
• Antimicrobials
Robin Cochran-Dirksen
Prevention
• Improved
Sanitation
• Clean water
• Access to health
care
Robin Cochran-Dirksen
Cholera in Zimbabwe
Robin Cochran-Dirksen
Ecology of Cholera
Robin Cochran-Dirksen
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Life cycle in humans
Host drinks water
Bacteria conserve energy
during the passage through
the stomach, most die
Surviving bacteria reach the
intestine, produce flagella
Propel themselves through
the mucus of the sm.
intestine
Bacteria produce toxin
causing diarrhea
Feces carry new bacteria
back into drinking water
Robin Cochran-Dirksen
Life cycle in water
Robin Cochran-Dirksen
Different serotypes
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Pathogenesis
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Biochemistry
•
Cholera Toxin. The delivery
region (blue) binds membrane
carbohydrates to get into cells.
The toxic part (red) is activated
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inside the cell (PDB code: 1xtc)
To Us Clean Water Seems so
Simple
Robin Cochran-Dirksen
Who Map of Zimbabwe’s Outbreak
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Mugabe's Statement
Robin Cochran-Dirksen