Talk:Cholera/Archive 1

Archive 1

Archive 2

Article

Feel free to link to or steal anything from my article at: http://www.posen-l.com/Cholera.htm Bwood 21:27, 4 Apr 2004 (UTC)

HELP!

Where was cholera first discovered? What are some characteristics of cholera?

Please help. I need this for a shcool project by monday Nov. 15 2004! If you can answer either of my questions please e-mail me at: BroadwaySmiles06aol.com

THANK YOU SO MUCH 4 YOUR TIME AND COOPERATION!

Hi, I am doing a project for school. It is do Monday, January 10, 2005. I don't really understand the part that talks about the G proteins being locked in the "on" position. I understand it a little bit b/c in my Biology class we talked about cancer and onco genes. If you could email a diagram or something that explains it a little better that would be greatly appreciated. My email is ellafunt6yahoo.com. Thank you so much.

HELP!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

HELP! I need to know when cholera was discovered; for a project due Friday Feb. 4. Email me at kcrouch64@irule.net. 3 DAYS FROM NOW!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Katrina victims

I've read that cholera is spreading in areas hit by Hurricane Katrina, especially New Orleans. Would that be worth including in this article? --Cholmes75 15:42, 9 September 2005 (UTC)

Incubation

The article fails to address incubation times from the point of infection to the manifestation of illness. This is an important detail if one wishes to understand the paranoia associated with historical epidemics.

When was the fifth pandemic?

Anybody know why there was no "fifth pandemic"? Or was there?

Comment

I think this article would be better if S.I. units were used throughout. Several gallons does not mean much to most of the world. Pete —Preceding unsigned comment added by 147.188.171.56 (talk) 17:30, 22 April 2010 (UTC)

Symptoms?

can someone add more information on the condition rather than the history on it, as i'd like to know what it ACTUALLY does? —Preceding unsigned comment added by 122.105.39.231 (talk) 18:05, 9 June 2009 (UTC)

On another note,o There's an interesting book on the subject by Charles Rosenberg, "The Cholera Years: The United States in 1832, 1849, and 1866", primarily it focuses on NYC for reasons of simplicity and symbolism (ie. well established city, so records are easier to find and compare), though it does make some reference to other cholera outbreaks in passing.

Good Article nomination has failed

The Good article nomination for Cholera/Archive 1 has failed for the following reason:

Some areas of the article should be expanded, including the lead section, Transmission, Research, and Other Historical Information. Though not required, it could also use more images, such as those of doctors treating patients, not just the bacteria alone. -- King kof ♥ ♦ ♣ ♠ 05:24, 12 April 2006 (UTC)

The mode of toxicity of cholera needs to be expanded as at this stage it's extremely misleading and thus just plain wrong.

Above posted by User:149.167.200.3 on 10:01, 8 May 2006

Spelling of Diarrhea/Diarrhoea

To editor 86.128.86.30, if you're going to change one instance of "Diarrhea" to "Diarrhoea", change them all. That way the article is internally consistent. I'll wait a while for other users' comments, and then maybe revert or change all instances. --Storkk 21:20, 16 July 2006 (UTC)

On second thoughts, I'll just revert, as I've just visited the Diarrhea page, and it looks like the wiki standard is "Diarrhea" with "Diarrhoea" being a side note, referring to spelling differences --Storkk 21:22, 16 July 2006 (UTC)

Indeed Storkk - the consensus, as I understand it, is to use either British or American spellings as set when the article was first written and remain internally consistant with that selection. So if this article already uses American spellings then any new addition to this article should keep to this. However if a British editor creates a new article on Disease X and uses 'Diarrhoea', then subsequent American-English speaking editors should respect that too. Unfortunately (as a British-English speaker) Americans generally seem to have started most of the medical articles before we got here :-( David Ruben ^Talk 00:51, 17 July 2006 (UTC)

Cholera and Blood Types

The cited article shows an epidemiologic correlation betwen ABO blood groups and cholera, and does not advance a genetic rationale. Given the absence of any biologic reason why the arrangement of sugars on the outside of your red cells (ABO group) would have something to do with your resistance to cholera (mediated through the unrelated CFTR chloride channel) its more likely an example of coincidental coassortment of genes. The statements about A, B, and AB appear unsupported and are candidates for removal. Cholera is an ongoing public health threat in parts of the world where A, B, and AB are much more common than in caucasian-majority countries, and if they really did confer relative resistance to cholera, it would be big news, so I doubt it.

I do not claim to be an expert and have not looked at any data but it doesn't seem farfetched to me, as a possibility, it cannot be assumed to be true though i agree. Viruses and bacteria often infect cells by interacting with the carbohydrates on the cell surface in order to find appropriate protein channels to insert genetic material or to gain proximity to a cell for other purposes. Not saying the theory is valid, but further research into a relationship would not automatically be a waste either. Also, just because one blood type might be more susceptible, does not mean the others are resistant to the point of protection, just that they may have infection and/or progression at lower rates. 134.243.210.14 (talk) 14:57, 11 December 2008 (UTC)

formatting changes

it looks like somebody got an html editor attached to the wiki. there were a lot of nbsp entities, including ones which were commented out. i am truly mystified. additionally, these two refs were hanging out up top with a broken comment:

please have a look at the diff. i am quite confused at what happened to get the article into the state it was in when i arrived, and i'm not actually sure i've "fixed" anything. it displays fine in my browser, but then mine's a little weird. i don't watch this article, i just stopped by for a look at the bioweapons category. ... aa:talk 04:19, 2 November 2006 (UTC)

Additional Information?

There must have been some sort of superstition involved with cholera and how people believed it used to spread and how it could be treated. Would it improve the article if this was added? 87.5.150.10 15:56, 10 December 2006 (UTC)

Certainly, if it is a widespread belief, and if the claim is well referenced.--Steven Fruitsmaak (Reply) 19:33, 10 December 2006 (UTC)

In many cases, "bad air" was blamed. Bwood 12:42, 26 April 2007 (UTC)

Other than rehydrating the patient, which I imagine cannot go on indefinitely, and prior to antibiotics, or if they don't work, how does a patient survive? The answer, which I don't know, is not clear. 69.14.181.230 19:14, 2 January 2007 (UTC)

I'd imagine the body kills it like any other bacteria, its just a matter of keeping them alive while it does it. Plugwash 20:52, 2 January 2007 (UTC)

March 2, 2007 repair to the MainPage

I just repaired the text that was deleted without justification in this edit. --Rednblu 23:30, 1 March 2007 (UTC)

Vaccine

What about vaccine? Is there one? If so, what are the risks/side effects with it?

There is a vaccine (see the CDC comment), though it is of "questionable benefit" [1]. Side effects appear to be the standard for any vaccine (see here for specifics). -- MarcoTolo 06:13, 25 May 2007 (UTC)

Contradictory/incomplete data

The article twice says that a victim of cholera can lose "up to 20L" of fluid. (This is incongruously equated with 20% of body weight; yet most people in the world weigh significantly less than 100 kg). A later explanation says "up to 16 litres of water" could be lost via the intestines. Now, obviously these details are (slightly) contradictory. Is it 16 or 20L? Or is 20% of total body mass a better value?

Furthermore, none of these figures have an associated time scale. Is the 20L lost over the whole course of the illness, in 24 hours, or what??? Finally, there doesn't seem to be cited source for this claim. It may seem that I am nit-picking, but these issues need to be squared away if this is going to become a good article. Could one of the regular contributors see to this? Many thanks -- 125.238.205.232 14:07, 20 June 2007 (UTC)

Good point. PubMed ref added for up to 36 L loss in 6 days (~6L/day); fixed inconsistency. -- MarcoTolo 18:51, 20 June 2007 (UTC)

Outstanding. Within five hours my question was answered. What a great community of contributors wikipedia has! Thank you very much, MarcoTolo. -- 125.238.205.232 09:45, 21 June 2007 (UTC)

but now it says 36L (20% body weight) which is nonsensical, implying a whopping 180KG avg body weight. maybe change the description to 36L water loss in 6 days and up to a 20% decrease in body mass (check source) —The preceding unsigned comment was added by [[User:{{{1}}}|{{{1}}}]] ([[User talk:{{{1}}}|talk]] • [[Special:Contributions/{{{1}}}|contribs]]).

Well, actually it said "up to 36 L (or 20% of body weight)" - its not an average. I've pulled the "20%" figure as the ref only quantifies volume, not percent. Additionally, I'm assuming that the trial participants were receiving IV therapy during the six day period (i.e. some of the 36 litres were "supplemental" losses). -- MarcoTolo 23:46, 28 June 2007 (UTC)

Question

how long can it last if/once a host body has died and it has not been given a suitable new environment to occupy? Can it survive indefinitely "in the wild" without some form of "animal" host? —Preceding unsigned comment added by 66.75.119.203 (talk • contribs)

I seem to recall learning that pumpkin seeds are a treatment for Cholera. Anybody able to confirm? —Preceding unsigned comment added by 220.233.66.37 (talk) 22:13, 17 September 2007 (UTC)

Also, if a victim can be significantly hypotensive within three hours--how can there be any weight loss at all, if the low blood pressure is fatal--or do the majority of victims succumb to dehydration? More detail on massive weight loss is needed. Is it from massive dehydration of all body tissues or are there other mechanisms involved? Thanks 75.37.225.244 (talk) 04:57, 4 December 2008 (UTC)

Treatment Section

Could a treatment section be added? What can people do once they have contracted this disease - it is obviously not 100% fatal. —Preceding unsigned comment added by 198.169.119.202 (talk) 02:05, 11 November 2007 (UTC)

End Poverty to end epidemics?

I always think that the best way to end this & all epidemics is to end world poverty quickly so all nations can have purified water, etc. Should that be added? Sicknesses caused by poverty also affect, & kill, the rich people too. Socialism20091011 (talk) 05:37, 22 January 2009 (UTC)

Engorged Snood

Last time I checked, the snood was a piece of skin hanging down from the beak of a TURKEY. Therefore, considering this article is on HUMAN CHOLERA, I've removed the offending remark in the Symptoms section.

If anyone can prove to me that the snood exists in humans, I'd be glad to hear it. Russthomas15 11:12, 16 November 2007 (UTC)

Examples

Hi, i know another case of this illnes wich is the epidemy of Gran Canaria in 1851. There isn't a single source in english and i know two in spanish wich are:

One from the Canarian Stadistic Institute, page 2 (of the canarian government):

http://www.gobiernodecanarias.org/istac/estadisticas/php/saltarA.php?mid=/istac/notasdeprensa/np_20061124_EvolucionHistoricaPoblacion.pdf

Another this article but only say the location not the article itself:

http://dialnet.unirioja.es/servlet/articulo?codigo=587311

Summary: In 1851 the cholera arrived to Gran Canaria in a ship with infected dress from Cuba, the first dead was a worker woman from a laundry of the capital, along the Summer the illnes spread along the capital and with the people who was fleing from the capital to the rest of the island. The total number of deads was 6000-8000 persons, a 10% of the total population; only in Las Palmas de Gran Canaria 3500, 20% of the population with more than a half of the inhabitants infected.

I don't want put it in the article because i don't know how to put citations, sorry.--Bentaguayre (talk) 19:49, 11 February 2008 (UTC)

Recovery

Article needs some information on how quickly cholera can kill. Misread. Also, if patient is properly cared for, how long does the illness last before the patient recovers? Is there permanent damage from cholera even if the patient survives? What is the survival rate with treatment? Without treatment?--Mrs Scarborough (talk) 20:45, 11 February 2008 (UTC)

Waterfowl—The Missing Link in Epidemic and Pandemic Cholera Dissemination?

This[2] article in PLoS provides some insight into the spread of cholera, as well as some further sources in its reflist. I'm not sure where such information should be included in the cholera article -- perhaps in the epidemiology section? I think this is an important part of understanding the disease and should be included. TeamZissou (talk) 21:24, 1 November 2008 (UTC)

Image

I think that the image Image:Cholera 395.1.jpg deserves a caption, and otherwise should be removed. Jimjamjak (talk) 11:49, 25 November 2008 (UTC)

Okay, I found the origin of the image and added a caption.Jimjamjak (talk) 08:40, 4 December 2008 (UTC)

Removed section on metal band and Polish "vulgarism"

The entry on the metal band going under the name "Cholera" was limited, unreferenced and unlinked. The Polish "vulgarism" is not particularly noteworthy: several other Slavic languages (and maybe others, I don't know) use this word as an expletive. I don't think that this information adds any value to the article.Jimjamjak (talk) 15:38, 4 December 2008 (UTC)

Citations

I'm new at wikipedia, so I'm coming here before I delete citation number 27. It uses wikipedia as a source. I think that means we're not allowed to use it, but I'm not sure. Here's the source, just in case you want to check more quickly. http://nursinggazette.blogspot.com/2007/11/cholera.html 71.49.57.228 (talk) 03:40, 6 December 2008 (UTC) new volunteer

I've removed the reference. There's no need to be so reticent about making such changes yourself. Wikipedia is the encyclopedia that anyone can edit, and that includes you! Phil Bridger (talk) 19:34, 14 January 2009 (UTC)

Inconsistent dates

Under the RESEARCH section:

"The scientists with major contributions to fighting cholera were John Snow, who found the link between cholera and drinking water in 1854, and Robert Koch, who identified V. cholerae as the bacillus causing the disease. The bacterium was originally isolated thirty years earlier by Italian anatomist Filippo Pacini ..."

This clearly implies that Pacini isolated the bacterium 30 years earlier that 1854 -- IE 1824.

However, in the Pacini article, http://en.wikipedia.org/wiki/Filippo_Pacini, it states:

"Pacini ... an Italian anatomist ... famous for isolating the cholera bacillus Vibrio cholerae in 1854, well before Robert Koch's more widely accepted discoveries thirty years later."

So which is it -- 1824 or 1854?

Looking up the Koch article, it looks like 1854 is correct for Pacini, and Koch made his discoveries about cholera in 1883.

Someone may want to do some fact-checking.

Fix the pagee

Someone revert the page.

Cholera in Central Africa

I think something about this should be written in section Cholera#Epidemiology or maybe an own article. --Kslotte (talk) 12:58, 23 October 2010 (UTC)

Missing: What happens after reaching intestinal wall?

There is something missing in Cause: What is Vibrio cholerae doing after reaching intestinal wall (apart from producing the toxin)? Do they adher to the wall? How? -- Tomdo08 (talk) 13:44, 23 October 2010 (UTC)

Also a rewrite reordering the material would be useful. -- Tomdo08 (talk) 14:00, 23 October 2010 (UTC)

Adding information on other outbreaks

I was grateful for the work that had gone into this page as I was reading about a cholera outbreak in a town in early 20th-century China. I was disappointed in what appears to be the U.S. and European focus of this article. I was wondering if anyone out there was able to add more information about outbreaks that happened in other places around the globe. For instance, the "sixth cholera pandemic," says that it "had little effect on Europe" except for Russia. Where else did it have an affect since Europe wasn't involved? I would be grateful to see more detailed information on that history if possible.Idlywiki (talk) 05:04, 15 September 2008 (UTC)

I notice that it has been updated to include the outbreak of cholera in Haiti that has occurred recently. What I do not see anywhere in the article about an endemic cholera episodes in Nepal which news articles about Haiti are saying that is how Haiti got it. —Preceding unsigned comment added by 71.154.232.44 (talk) 00:00, 30 October 2010 (UTC)

Death toll for Haiti continues to increase: "It has killed more than 580 people and hospitalized more than 9,500, with confirmed cases across the entire northern two-thirds of the country. Dozens of cases are rumored throughout the south." From http://www.google.com/hostednews/ap/article/ALeqM5gzUFGxzIpHaQjBOAVEs-xV7h5Wlg?docId=577d9b6d37cf4f978e0456e7aa5a0293 Jakibbe (talk) 13:10, 10 November 2010 (UTC)

host /cholera relationship

statement attributed to reference 13 is plainly incorrect, for at least badly worded, please consider correction 167.171.195.39 (talk) 17:08, 27 October 2010 (UTC)

Need refs

=== Literary works ===

• The Ghost Map: The Story of London's Most Terrifying Epidemic - and How it Changed Science, Cities and the Modern World - which tells the story of how John Snow found the transmission vector of a cholera epidemic, work that was the start of modern epidemiology.
• The Painted Veil, starring Naomi Watts and Edward Norton, in which cholera in early 20th-century China is a prominent element, based on the novel of the same name by W. Somerset Maugham.
• The Horseman on the Roof (1995 film), starring Juliette Binoche and Olivier Martinez, in which the 1832 cholera outbreak in southern France is a major influence to the story line.
• The Dress Lodger by Sheri Holman - A historical novel set in Sunderland, England during the cholera epidemic of 1831.
• Death in Venice by Thomas Mann (also a 1971 film by Lucino Visconti starring Dirk Bogard) features a main character who dies of cholera in Venice; the epidemic is a recurring sub-plot of the story.
• Love in the Time of Cholera, a novel by Nobel Prize-winning Colombian author Gabriel García Márquez, and its English-language film adaptation.
• Mary Shelley's Frankenstein suggests a cholera outbreak in Ingolstadt, while Victor is preparing his creation.
• In The Secret Garden, the main character is orphaned by her parents' deaths from cholera.

Doc James (talk · contribs · email) 11:58, 15 December 2010 (UTC)

Reviews

• Sack DA, Sack RB, Nair GB, Siddique AK (2004). "Cholera". Lancet. 363 (9404): 223–33. PMID 14738797. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Bhattacharya SK (2003). "An evaluation of current cholera treatment". Expert Opin Pharmacother. 4 (2): 141–6. doi:10.1517/14656566.4.2.141. PMID 12562304. {{cite journal}}: Unknown parameter |month= ignored (help)
• Sack DA, Sack RB, Chaignat CL (2006). "Getting serious about cholera". N. Engl. J. Med. 355 (7): 649–51. doi:10.1056/NEJMp068144. PMID 16914700. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• "Cholera, 2007". Wkly. Epidemiol. Rec. 83 (31): 269–83. 2008. PMID 18668979. {{cite journal}}: Unknown parameter |month= ignored (help)
• Preston NW (2004). "Prevention of cholera". Lancet. 363 (9412): 898. doi:10.1016/S0140-6736(04)15749-8. PMID 15031046. {{cite journal}}: Unknown parameter |month= ignored (help)

Doc James (talk · contribs · email) 09:08, 8 November 2010 (UTC)

Vaccine

There is a section mentioning the use of a Vaccine as a preventative method against Cholera. Since Cholera is a bacterium is that the proper term to use? 204.95.120.7 (talk) 16:45, 16 November 2010 (UTC) Collin 16-Nov-2010

Yes good point. However the term vaccine is used for bacteria as well as per TB [3] --Doc James (talk · contribs · email) 02:23, 17 November 2010 (UTC)

phago therapy ?!

It's possible against the cholera in Haiti to introduce the phago therapy (see Felix d'Herelle),insted of the antibyotic or it is'nt more possible ? silvano.bernasconi@mail.com —Preceding unsigned comment added by 92.105.31.147 (talk) 11:04, 19 November 2010 (UTC)

Pandemics

Have moved the stuff on pandemics to the page Cholera outbreaks and pandemics as we do not need this much detail here.Doc James (talk · contribs · email) 17:12, 6 January 2011 (UTC)

To add to our "Treatment" section . . . patient should continue to eat.

Community Health Worker Training Materials for Cholera Prevention and Control, CDC, slides at back are dated 11/17/2010. Page 7 states " . . . Continue to breastfeed your baby if the baby has watery diarrhea, even when traveling to get treatment. Adults and older children should continue to eat frequently."

Let's get a couple of sources and then include this as part of the Treatment section. Cool Nerd (talk) 19:31, 13 September 2011 (UTC)

---

THE TREATMENT OF DIARRHOEA, A manual for physicians and other senior health workers, World Health Organization, 2005.

1. INTRODUCTION, page 3 (7 in PDF):

" . . . Essential elements in management of the child with diarrhoea are the provision of oral rehydration therapy and continued feeding to all . . . "

4.2.3 Rule 3: Continue to feed the child, to prevent malnutrition, page 10 (14 in PDF):

" . . . Most children with watery diarrhoea regain their appetite after dehydration is corrected . . . Continued feeding also speeds the recovery of normal intestinal function, including the ability to digest and absorb various nutrients. . . "

I went ahead and added this. Now, I wish to state that I am not a doctor. My background is in sales and retail management. All I do is take authoritative sources and excerpt or summarize in straightforward fashion. Cool Nerd (talk) 15:36, 15 September 2011 (UTC)

Fluids, and fluid by IV for severe dehydration

THE TREATMENT OF DIARRHOEA, A manual for physicians and other senior health workers, World Health Organization, 2005.

5. MANAGEMENT OF SUSPECTED CHOLERA, pages 16-17 (20-21 in PDF):

5.2 Treatment of dehydration

" . . . For patients with severe dehydration and shock, the initial intravenous infusion should be given very rapidly to restore an adequate blood volume, as evidenced by normal blood pressure and a strong radial pulse. Typically, an adult weighing 50 kg and with severe dehydration would have an estimated fluid deficit of five litres. Of this, two litres should be given within 30 minutes, and the remainder within three hours.

"With cholera, unusually large amounts of ORS solution may be required to replace large continuing losses of watery stool after dehydration is corrected. The amount of stool lost is greatest in the first 24 hours of illness, being largest in patients who present with severe dehydration. During this period, the average fluid requirement of such patients is 200 ml/kg of body weight, but some need 350 ml/kg or more. Patients whose ongoing stool losses are in this range, or higher, usually require intravenous maintenance therapy using Ringer's Lactate Solution with added potassium chloride. Additional potassium can also be provided by ORS solution as soon as the patient can drink. . . "

posted by Cool Nerd (talk) 17:35, 14 September 2011 (UTC)

Malnourished persons as more vulnerable?

Well, it makes sense. Malnourished persons are probably more vulnerable to a number of things. And this is a WHO source from ten years ago specifically saying malnourished persons are more vulnerable to cholera. All the same, I'd like to find a more recent source if possible. Cool Nerd (talk) 19:17, 24 September 2011 (UTC)

Water Sanitation and Health (WSH), Water-related Diseases, Cholera, World Health Organization. Prepared for World Water Day 2001: “ . . . Most people who become infected have very mild diarrhoea or symptom-free infection. Malnourished people in particular experience more severe symptoms. . . ”

---

and a more recent source . .

Prevention and control of cholera outbreaks: WHO policy and recommendations, World Health Organization, Regional Office for the Eastern Mediterranean, undated but citing sources from ’07, ’04, ’03, ’04, and ’05: “ . . . Individuals with lower immunity, such as malnourished children or people living with HIV, are at greater risk of death if infected by cholera. . . ”

I added this to our Susceptibility section. Cool Nerd (talk) 00:41, 25 September 2011 (UTC)

CDC: “when feces (poop) from infected person gets into” water or food . . .

Community Health Worker Training Materials for Cholera Prevention and Control, CDC, slides at back are dated 11/17/2010. Page 3, and other places: “Cholera is spread when feces (poop) from an infected person gets into the water people drink or the food people eat.”

This is pretty good. As I view it, our goal is to be both technically correct and to communicate in a way people can actually understand. Now, we could be a little more direct, perhaps even vulgar, “feces (shit).” I mean, that’s speaking frankly. But, I tend to think the word “poop” is probably a happy medium.

And I can see how it's not a requirement to include references in the introduction if we talk about them and reference them later on, but it still might be advantageous.

And, I also like the idea of starting a technical paper, say, at the 10th grade level (the general nontechnical reader) and then letting it develop a narrative arc as it were, where in the middle it's college level (biology major), and toward the end it might be grad school or medical school. And, I like to assume my reader is slightly smarter than I am, just he or she doesn't happen to know this particular technical area. And I feel this has helped my own writing immensely. Cool Nerd (talk) 20:19, 24 September 2011 (UTC)

This was changed by a fellow wikipedian citing that the word "poop" doesn't fit with the tone of an encyclopedia. Okay. Let's perhaps go with the following for a while: "Transmission occurs primarily when drinking water or food is contaminated by the diarrhea from an infected person or by the feces of an infected but asymptomatic person." Cool Nerd (talk) 17:50, 26 September 2011 (UTC)

Lack of toilets and waste treatment in many parts of developing world

Everyone Poops: Kick Cholera & Create Renewable Energy in Congo, Huffington Post, Rebecca Snavely (Former web producer and staff writer for the L.A. Times entertainment site), Sept. 28, 2011:

“ . . . more than 2.6 billion people, approximately 40% of the world's population, don't have access to the most basic toilet. This isn't just a problem for tourist boards trying to turn travelers' gaze from locals pooping in ponds, streams and rivers, this is life and death. "As a result (of open defecation), more than 2 million people -- including 1.5 million children -- die from complications of chronic diarrhea." (World's Toilet Crisis, Vanguard) . . . ”

http://current.com/shows/vanguard/episodes/season-four/worlds-toilet-crisis/ " . . . Warning: This is a documentary on feces, choose when to watch wisely. . . "

posted by Cool Nerd (talk) 16:18, 25 October 2011 (UTC)

that's some heavy shit dude...

Oral vaccine efficacy

The article currently asserts that "Dukoral, an orally administered, inactivated whole cell vaccine, has an efficacy of 85%, with minimal side effects". This is sourced to an article from 2008 in Expert Reviews of Vaccines (doi:10.1586/14760584.7.5.561). I don't have access to the entire article, but its abstract indeed says that "[p]rotective efficacy against cholera is 85%". A somewhat more recent review (doi:10.1002/14651858.CD008603.pub2) in the Cochrane Collaboration, which I do have access to, claims that the protective efficacy is substantially lower.

Could anyone with access to the 2008 review please explicate on its methodology, and how many trials they based their findings on? Gabbe (talk) 08:06, 3 November 2011 (UTC)

Reading up on the Cochrane Review, it takes note of "[o]ne smaller trial in military recruits in Peru [PMID 7967990]" that "demonstrated 86% protective efficacy (95% CI 37% to 97%) in a small epidemic occurring within 4 weeks of the two-dose schedule of WC-rBS [Dukoral]". However, it also notes that "extrapolation of this result beyond short term follow-up may be unreliable." Could this perchance be the source of the 86% figure cited in the 2008 review? Gabbe (talk) 10:37, 3 November 2011 (UTC)

Hey (read your request at WP:REX). From that paper: "Dukoral® is an inactivated oral vaccine... Efficacy in protecting against cholera has been shown in clinical studies in Bangladesh, Peru and Mozambique, with a reduction in dis-ease episodes of 85% in the first 6 months [26][27][28]". The "expert commentary" section concludes: "Dukoral is a well-established and effective vaccine against cholera. Numerous field studies have shown clear evidence that this vaccine can suppress up to 85% of cholera episodes." Citations here are:

26	Clemens JD, Sack DA, Harris JR et al. Field trial of oral cholera vaccines in Bangladesh: results from a three-year follow-up. Lancet14,162–166 (1986).
27	Sanchez JL, Vasquez B, Begue RE et al. Protective efficacy of oral whole-cell/recombinant–B-subunit cholera vaccine in Peruvian military recruits.Lancet344,1273–1276 (1994). [CrossRef] [Medline]
28	Lucas ME, Deen JL, von Seidlein L et al. Effectiveness of mass oral vaccination in Beira, Mozambique. N. Engl. J. Med.352,757–767 (2005)

Hope that helps, - Jarry1250 ^{[Weasel? Discuss.]} 17:02, 5 November 2011 (UTC)

Thanks, that's exactly what I was looking for! Gabbe (talk) 09:13, 7 November 2011 (UTC)

Trolls

Hi all, I'm not a regular Wiki contributor so please excuse my faux pas if this is the wrong place to raise these concerns.

There is a troll at work on this page, evinced by poor spelling, punctuation and absurd content. Please read the very first paragraph to see what I mean.

Kind regards, Will

```` — Preceding unsigned comment added by 101.116.120.161 (talk) 10:52, 15 April 2012 (UTC)

2012 Lancet review

[4] Doc James (talk · contribs · email) (please reply on my talk page) 01:31, 7 July 2012 (UTC)

Epidemiology

I have suggested a minor trim in the epidemiology section as there was a reference to a 1993 report which apparently concluded that cholera was expected to remain for the remainder of the twentieth century. As this is now in the past it seemed to me that it made sense to remove that part of the sentence. However, I have not seen the paper which was referenced, so there is a risk that I may be in error. If others can advise please do. John Snow II (talk) 14:16, 27 December 2012 (UTC)

Fiction depictions

The Painted Veil, 2006 Film, A British medical doctor fights a cholera outbreak in a small Chinese village, while also being trapped at home in a loveless marriage to an unfaithful wife. 76.231.20.232 (talk) 07:01, 8 January 2013 (UTC)

Peer Review Directed Towards Predominantly Society and Culture

The expansion was substantial and well-done. However, here I offer specific advice for changes that could be made to lines of the changes made by Kimmyfromtexas to improve the neutrality and readability of the article. I am a peer in the same class. In the “Cholera” section, the phrase “of about a million bacterial cells within the body” needs to be changed. This is not academic or professional style nor scientifically accurate or an apt description. There already exists billions of colonies of microorganisms within the body, therefore, this sentence will receive severe criticism from the medical community for several reasons. Also, the next sentence about “these cells can be picked up” needs to be rephrased to a more scientific expression, as well as the example of oysters seems overly specific. Consider generalizing this second example. Changes to signs and symptoms were well-done, and represent a good movement towards appropriate expression by eliminating “painless”. “Cause” needs to be revised to a more scientific expression replacing “people used to believe that cholera occurred because of bad air”, to use phrases like “the public”, “there existed a wide-spread misconception”, “cause of cholera could be contributed to”, “pollution”, “contaminated air”, or terms such as those. In the “Transmission” section, revise “are a result of transmission by food” to be more clear/ grammatically correct. Use phrases like “In developed nations, cholera transmission occurs primarily by food contamination”. You could improve the clarity of the next sentence by making it explicit whether people contract cholera through the harvesting process or the ingestion of shellfish that have consumed infected zooplankton. In the new section, “Society and Culture”, the name could possibly use a revision to something like “Policy and politics”. The first sentence should be edited to remove the term “vital”, which takes a position or diverges from encyclopedia style. Change “not unlike” to “similar to”. The sentence that begins with “The United States” could use revision to improve clarity. The last sentence of the first paragraph definitely needs revision to improve clarity. The first sentence of the second paragraph is well-done and can be exemplary for some others. In the next sentence, the phrase “took money from” definitely needs to be revised to improve clarity and provide neutrality. Improve the neutrality of the phrase “but the poor were left” to “while impoverished individuals were not able to...”. In the last paragraph remove the term “refused international aid” in turn for a more neutral term. Lbockhorn (talk) 23:00, 6 November 2013 (UTC)

Peer Review

I am a peer reviewer from Kimmyfromtexas's class, and offer suggestions as a new yet informed Wikipedean. Your contributions to this article brought the social contexts of cholera into a previously purely biological entry on cholera. There are some sentences that lack relevance, such as your mention of "bad air" as a misconception of the causes of cholera. Consider adding information that dispels this myth, such as the deleted sentence that stated cholera can live in a variety of environments. Also clarify that cholera is a waterborne disease, and thus air quality is irrelevant to its spread. Overall, your contributions added an important new social dimension to cholera.

Samanthaplove (talk) 05:29, 7 November 2013 (UTC)

Student peer reviews do not belong on article talk pages; please place them on user talk pages. SandyGeorgia (Talk) 14:58, 27 November 2013 (UTC)

Problematic additions

I have only glanced at a large new addition here and see some problems (there are others, but for a start):

1. Kimmyfromtexas removed the appropriate for WP:MEDMOS#Sections "Society and culture" section, and
2. replaced it with a section that is actually text that belongs in numerous other sections (causes, prevention, screening, history and others), and
3. added material to the cholera article that belongs in the Zimababwe cholera article (assuming a Zimbabwe cholera article is even needed-- I haven't yet checked whether it is compliant or an essay, and curiously, it is not even linked in this article ...),
4. used a few sources that don't comply with WP:MEDRS for medical statements (not as bad as what we usually see with student editing, but some nonetheless).

Independently I haven't yet even looked at the Zimbabwe article to see if it is appropriate or an essay, but here we seem to have the creation of a new section which has some elements of being an advocacy piece rather than an encyclopedic entry.

All of the new text needs to be vetted for WP:MEDRS (which will be made more difficult than necessary because Kimmyfromtexas has provided no PMIDs, that is PubMed identifiers for her sources), and whatever portions of it are salvabeable need to be moved to the correct sections.

Again, this appears to be editing of medical articles by a class that has never been informed of MEDMOS or MEDRS, and since it is easier for the prof to grade material put into one section, the creation of one non-MEDMOS section for the addition of new content. The following may be helpful:

• Our medical guidelines
• Guidelines for organization of sections in medical articles
• Our medical sourcing guidelines
• Wikipedia:Wikipedia Signpost/2008-06-30/Dispatches explains how to search PubMed and use PMIDs.

SandyGeorgia (Talk) 15:13, 27 November 2013 (UTC)

Because Sandy and Biosthmors have both expressed negative opinions about the addition, I've opened a discussion at the Education Noticeboard incidents page. I'd like to suggest we have the discussion over there, rather than here, since it's of interest to both medical editors and editors working with the education program. Mike Christie (talk - contribs - library) 15:34, 27 November 2013 (UTC)

• Wikipedia:Education_noticeboard/Incidents#Cholera. SandyGeorgia (Talk) 15:47, 27 November 2013 (UTC)

• Agree and have reverted the changes in question. Lots of issues with language with terms like "victim".
• We already had "Water purification: All water used for drinking, washing, or cooking should be sterilized by either boiling,chlorination, ozone water treatment, ultraviolet light sterilization". So I am not sure why "The World Health Organization's Global Task Force on Cholera stresses the importance of using water that has been boiled, bottled by a reliable source, or treated with chlorine to drink, cook, and clean dishes with."
• This ref does not go anywhere [5]. Is it referring to this lecture on youtube? [6]?
• CNN is not a good source [7]
• Why was this removed " Rice-based solutions are preferred to glucose-based ones due to greater efficiency"? The source was good
• Yes this is not a great article but we do not need to duplicate content.Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:03, 27 November 2013 (UTC)

Cholera "Society and Culture" Section

I am planning on making some changes to the existing “Cholera” article for a class project, and I would appreciate any advice/suggestions you might have.

I would like to add a “society and culture” section to this article. This section will include information about the role governments play on the prevention and spread of cholera, and other socio-economic factors that influence its spread. I think it is important to make these connections because if cholera spreads, there are serious economic and social political repercussions for the country. Governments also play an important role in preventing/ helping cholera spread, an important connection that is not always made. As the current Wikipedia article on “Cholera” notes, the disease is pretty much under control in developed nations. However, it is still a huge issue in developing countries. This is a highly relevant topic, since cholera prevention in developed countries shows it can be stopped, but recent outbreaks in poorer countries show that it is still occurring, when it does not need to be. The amounts of cholera outbreaks have actually risen in some countries-like Haiti- over the past few years. This makes exploring it’s spread a highly relevant topic. Does anyone have thoughts about creating a “society and culture” section? In this section, I will summarize a lot of existing Wikipedia articles related to cholera, like “Cholera Outbreaks and Epidemics,” “Cholera Vaccine,” “Zimbabwean Cholera Outbreak,” and “2010-13 Haiti Cholera Outbreak.” What other topics do you think should be covered in a “society and culture” section on Wikipedia?

Is it ok if I delete the existing subsections called “Enrichment Media” and “Planting Media” (under Diagnosis)? There are no references, and I am not sure if the information is accurate. Are there any other sections of this article you think need serious revision?

Do you feel that the existing cholera article has any unnecessary information that should be taken out? Any really important information/sections I should work on adding?

Kimmyfromtexas (talk) 11:49, 8 October 2013 (UTC)

Hi Kimmy, I hope you are not feeling too discouraged. Editing new information into an existing article can be very difficult--I think that it is sometimes easier to write a brand new article than to try to edit an existing one. Plus, if the student has not first spent a (perhaps) great deal of time learning the basics of the article rather than just spend time on the section that they plan to write about, it is really obvious in their edits and something I see again and again...like an essay tacked on at the end of the article. That said, I believe that the idea for your addition is excellent and something that is important to me in our medical articles. Just coming here from the appendicitis article, I have to wonder if we are writing our medical articles for med students who are, hopefully, using their text books for information rather than Wikipedia, or for the general public. Gandydancer (talk) 00:31, 28 November 2013 (UTC)

As an afterthought, when I do my edits I have found that after I think I'm about done I go through and delete everything that is not absolutely needed, and I've found that I often end up with about half of what I started out with. Gandydancer (talk) 00:49, 28 November 2013 (UTC)

Sari cloth

I've removed the following text because a) it uses a primary source (please see WP:MEDRS), but more importantly, it is too closely paraphrased. Please find a secondary review, and paraphrase in our own words. SandyGeorgia (Talk) 01:14, 1 December 2013 (UTC)

Laboratory tests have shown that using 1 to 4 layers of sari cloth to filter pond and river water containing V. cholerae attached to small crustacean zooplanktonic copepods and particulate matter reduces the number of V. cholerae bacteria in the water by 90%. Four layers of sari cloth were considered optimal for water filtration, since it consistently removed >99% of the bacteria, but 2 or 3 layers were approximately equally effective. In 2005 a field trial using cotton sari cloth was performed; village women were taught how to use folded cotton sari cloth or nylon mesh to filter their daily water. A third group of villagers, receiving no instruction with respect to filtration of their water, served as the control group. Results of the field trial showed that the number of cholera cases was reduced approximately 50% in the group using cotton sari cloth to filter water, with nylon filtration slightly less effective and also very expensive compared to sari cloth. http://mbio.asm.org/content/1/1/e00034-10.full http://www.nytimes.com/2003/01/14/world/old-sari-cloth-filters-cholera-study-finds.html

It seems just common sense to me that one need not be so concerned about wording too close when one is taking information from a study as compared to other published sources, but it seems that I am wrong on that. As for using this large primary study, IMO it is going beyond the meaning of our med article guidelines to say that it is not appropriate. I will leave this article to those who better understand the guidelines and are more experienced than I. Gandydancer (talk) 01:39, 1 December 2013 (UTC)

There was one textbook there that is sort of WPMEDRS. Not great but okay. I have restored some of the previous wording and will try to improve it tonight.Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:25, 1 December 2013 (UTC)

Yes these edits do contain extensive copy and pasting [8] with text in bold being exactly the same.

Ref says [9] "When this method was tested in the laboratory, using 1 to 4 layers of sari cloth to filter pond and river water containingV. cholerae attached to small crustacean zooplanktonic copepods and particulate matter, this simple procedure successfully reduced the number of V. choleraebacteria by 2 log units (10–12). Whether 1, 2, 3, or 4 layers of sari cloth was used as a filter, the number of V. cholerae bacteria in the water was reduced by ca. 90%. Four layers of sari cloth were considered optimal for water filtration, since it consistently removed >99% of the bacteria, but 2 or 3 layers were approximately equally effective (10). After the laboratory-based tests were completed, a field trial using cotton sari cloth was performed, and as a reference, a commercially available nylon material that was used to eradicate dracunculiasis in Africa was included. Both were field tested for efficacy in reducing cholera in Matlab, Bangladesh. That is, village women responsible for collecting water, in a population of 30,000 (15,000 in each group, one group using sari filters and the other using nylon filters), were taught how to use folded cotton sari cloth or nylon mesh to filter their daily water. A third group of 15,000 villagers, receiving no instruction with respect to filtration of their water, served as the control group. Results of the field trial showed that the number of cholera cases was reduced approximately 50% in the group using cotton sari cloth to filter water at the time of collection, with nylon filtration slightly less effective and also very expensive compared to sari cloth "

Content added "Laboratory tests have shown that using 1 to 4 layers of sari cloth to filter pond and river water containing V. cholerae attached to small crustacean zooplanktonic copepods and particulate matter reduces the number of V. cholerae bacteria in the water by 90%. Four layers of sari cloth were considered optimal for water filtration, since it consistently removed >99% of the bacteria, but 2 or 3 layers were approximately equally effective. In 2005 a field trial using cotton sari cloth was performed; village women were taught how to use folded cotton sari cloth or nylon mesh to filter their daily water. A third group of villagers, receiving no instruction with respect to filtration of their water, served as the control group. Results of the field trial showed that the number of cholera cases was reduced approximately 50% in the group using cotton sari cloth to filter water, with nylon filtration slightly less effective and also very expensive compared to sari cloth"

Now it is an open access publication but not one compatible with Wikipedia. At the bottom it says "Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported License, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original author and source are credited." Always best to rephrase and simplify to stay out of trouble. Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:50, 1 December 2013 (UTC)

Zinc supplementation

This edit is cut-and-pasted from this source. Even if public domain, this is still plagiarism (see WP:PLAGIARISM). Gandydancer, please be more careful to include cut-and-paste text in quotes or to rephrase in your own words (I am aware that you have done this on other articles). Jmh649 has already corrected this instance. I do not have a copy of the Lancet article; will someone pls review. SandyGeorgia (Talk) 01:45, 1 December 2013 (UTC)

My understanding of public domain material is that anyone can copy and paste it without necessarily using quotes. It is always a good idea to paraphrase as that wording was not really encyclopedic in style. With CC BY SA material you need to state where you got it from in the edit summary but do not necessarily need to quote it. That is why we can move around material from one article to another. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:39, 1 December 2013 (UTC)

Review WP:PLAGIARISM on how we must attribute public domain text. SandyGeorgia (Talk) 15:25, 1 December 2013 (UTC)

Ah thanks. Good to know. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:42, 1 December 2013 (UTC)

Possible copyright problem

This article has been revised as part of a large-scale clean-up project of multiple article copyright infringement. (See the investigation subpage) Earlier text must not be restored, unless it can be verified to be free of infringement. For legal reasons, Wikipedia cannot accept copyrighted text or images borrowed from other web sites or printed material; such additions must be deleted. Contributors may use sources as a source of information, but not as a source of sentences or phrases. Accordingly, the material may be rewritten, but only if it does not infringe on the copyright of the original or plagiarize from that source. Please see our guideline on non-free text for how to properly implement limited quotations of copyrighted text. Wikipedia takes copyright violations very seriously. Diannaa (talk) 22:58, 29 June 2014 (UTC)

Requested edit - mortality rate

Under "signs and symptoms", a line currently reads "Severe cholera kills about half of affected individuals." This should be changed to reflect that this is without treatment, as the referenced source claims. While the preceding statement (An untreated person with cholera may produce 10 to 20 litres (3 to 5 US gal) of diarrhea a day) could imply this, it should be more explicit. 72.200.151.13 (talk) 06:08, 20 January 2015 (UTC)

Sure Doc James (talk · contribs · email) 01:09, 21 January 2015 (UTC)

Thank you, good doctor! 72.200.151.13 (talk) 06:51, 21 January 2015 (UTC)

Semi-protected edit request on 6 March 2015

You should delete that a sign/symptom is vomiting because it's not, it's only in wikipedia that it says so, i have even read that the symptom is "Diarrhea but not vomiting". It should just say that it's diarrhea not vomiting.

The primary symptoms of cholera are profuse diarrhea and vomiting of clear fluid.[2] These symptoms usually start suddenly, half a day to five days after ingestion of the bacteria.[3] The diarrhea is frequently described as "rice water" in nature and may have a fishy odor.[2] An untreated person with cholera may produce 10 to 20 litres (3 to 5 US gal) of diarrhea a day.[2] Severe cholera, without treatment, kills about half of affected individuals.[2] If the severe diarrhea is not treated, it can result in life-threatening dehydration and electrolyte imbalances.[2] Estimates of the ratio of asymptomatic to symptomatic infections have ranged from 3 to 100.[4] Cholera has been nicknamed the "blue death" because a person's skin may turn bluish-gray from extreme loss of fluids.[1] Zakazaza (talk) 09:50, 6 March 2015 (UTC)

Not done: please provide reliable sources that support the change you want to be made. Do you have a reliable source that counters the source cited for that? Sack DA, Sack RB, Nair GB, Siddique AK (January 2004). "Cholera". Lancet 363 (9404): 223–33. doi:10.1016/S0140-6736(03)15328-7. PMID 14738797 — {{U|Technical 13}} (e • t • c) 15:55, 6 March 2015 (UTC)

"cholera morbus"

http://www.merriam-webster.com/dictionary/cholera%20morbus  : "first known use in 1673. Not used technically", but well known and long used expression which therefore should be mentioned. Everyone I talked to about it, and I along, wondered what it was exactly : the classic form of cholera, or another form of it? Cholera morbus redirects to gastroenteritis, but the word (and the link to) cholera does not even appear in the introduction of "gastroenteritis"; mentionned 3 times in the article, it first comes in towards the middle of the article. For someone who is looking for what cholera morbus is, it takes a while to get to the information (expression mentionned once, at the begining of the third third of the article) and understand why there is a redirection from it to 'gastroenteritis'. Here the expression is not even mentionned (there could at least be a redirection at the top: "for cholra mrbs, see gstroentrts"). And I am not sure I understand the differences between cholera, cholera morbus and/or gastroenteritis (ok, the last two are sort of synonyms, but then what has it got to do with 'cholera'? intense diarrhea, likely so, and anything else? The question remains). Thanks for doing something sensible about it. 88.219.191.2 (talk) 10:01, 26 April 2015 (UTC)

Discussed in the history section. CM is an old term for gastroenteritis. Doc James (talk · contribs · email) 14:14, 27 April 2015 (UTC)

Semi-protected edit request on 10 August 2015

Hi,

In the first paragraph of the section "Mechanism" there are three small mistakes: 1) The first reference, which is used to describe the survival of V. cholerae through the intestine (#21), is not accurate. Reference 22 would be correct here 2) The author list in reference #22 is incorrect as James Bliska is not an author on that publication. I just checked the paper and he is the editor of the journal thus his name should be removed 3) This sentence "V. cholerae bacteria start up production of the hollow cylindrical protein flagellin to make flagella, the cork-screw helical fibers they rotate to propel themselves through the mucus of the small intestine.[medical citation needed]" is incorrect as the bacteria possess a flagellum prior to intestinal colonization, thus they do not produce it upon arrival in the intestine. It could be removed as it does not add much to the text and is not accurate

That's it! Thanks

Glahdecai (talk) 14:51, 10 August 2015 (UTC)

Thanks User:Glahdecai and done. Doc James (talk · contribs · email) 15:31, 10 August 2015 (UTC)

Semi-protected edit request on 2 March 2016

ACTIVE VANDALISM

First paragraph, disambiguation, "butt" between paragraphs 2 and 3, etc.

User "Nosesarebeastmode" is revising the page as I read/refresh it.

I will not send any more alerts on this thread, but this needs to be stopped.

130.64.177.125 (talk) 17:54, 2 March 2016 (UTC)

Thanks person who made those changes blocked. Doc James (talk · contribs · email) 18:10, 2 March 2016 (UTC)

Semi-protected edit request on 2 March 2016

Vandalism: The word "butt" is printed between the first and second paragraphs without reason. 130.64.177.125 (talk) 17:48, 2 March 2016 (UTC)

 Done - as below - Arjayay (talk) 18:23, 2 March 2016 (UTC)

Edits for class to the Cholera page

Hello, we are doing a project for our 501 class at the University of Kansas and would like to contribute to this page.

Our edits include the following:

Extended content

== Cause == === Transmission === Cholera is an infectious disease that threatens Africa, Latin America and Asia.<ref name=":0">{{Cite journal|last=Muniru|first=Alam|date=2007|title=Viable but Nonculturable Vibrio Cholerae in Biofilms in the Aquatic Environment and Their Role in Cholera Transmissions|jstor=25450323|journal=Proceedings of the National Academy of Science of the United States|doi=|pmid=|access-date=}}</ref> Specifically fresh and saltwater environments Cholera, has been found in two animal populations: shellfish and plankton.[12] Transmission is usually through the fecal-oral route of contaminated food or water caused by environmental conditions, whether it be due to poor sanitation or natural environmental factors.<ref name=":0" /> Zooplankton has been found to a natural host for the disease, but a study done in Bangladesh have shown that Vibroe Cholerae can live in water as noncultured and can be cultured by transmission through animals.<ref name=":0" /> With in this study they found that certain environments can harbor the infection through biofilm, which creates seasonal endemics in the Bangladesh area.<ref name=":0" /> ==== Food Stigma ==== The transmission of cholera can happen when the virus is ingested. In the 2007-2009 outbreaks in Vietnam food had a bad stigma that it was contaminated with the virus. Where food was “safe” was in the home, outside food was dangerous, meaning food from restaurants and street vendors.<ref name=":1">{{Cite journal|last=Lincoln|first=Martha|date=2014|title=Tainted Commons, Public Health: The Politico-Moral Significance of Cholera in Vietnam|url=|journal=Medical Anthropology Qauterly|doi=|pmid=|access-date=}}</ref> This led to food stigma which did not help people in the developing world.The Ministry of Health in Vietnam claimed certain foods were risky for the population to eat. These foods were common for indigenous people to eat like, dog meat, shrimp paste and raw vegetables. This in cause made street vendors and restaurants that used this food stigmatized and lost business.<ref name=":1" /> In an outbreak of Cholera in Venezuela in 1992-93 public health officials deems that crabs was the source of the outbreak, not the terrible water system they had in place. The people that ate the crabs were the indigenous who were living in the rain forest. Raw crab was to be avoided and was an “attempt to link cholera in the delta to the ‘customs’ and ‘culture’ of the indigenous”<ref name=":2">{{Cite journal|last=Briggs|first=Charles|date=2004|title=Theorizing Modernity Conspiratorially: Science, Scale, and the Political Economy of Public Discourse in Explanations of a Cholera Epidemic|url=|journal=American Ethnologists|doi=|pmid=|access-date=}}</ref> With in stigmatization of the crab it then led to the idea that cholera came from the indigenous and those people were to be avoided. === Susceptibility === About 100 million bacteria must typically be ingested to cause cholera in a normal healthy adult.[12] Children are also more susceptible, with two- to four-year-olds having the highest rates of infection.[12] Individuals' susceptibility to cholera is also affected by their blood type, with those with type O blood being the most susceptible.[12] Persons with lowered immunity, such as persons with AIDS or children who are malnourished, are more likely to experience a severe case if they become infected.[19] Susceptiblity goes beyond just the persons age or health there is also a stigma that comes with the disease Cholera. ==== Social Susceptibility ==== Social status also becomes a reason in society for who is more susceptible. With in the outbreak in Vietnam between 2007-2009 merchants and prostitutes were being accused of being contaminated with Cholera. This is because they are at the bottom of the hierarchy in Vietnam culture and can be seen as dirty because of their profession. With this in mind the Vietnam government stigmatized certain labor rules, liked being civilized. Being civilized made someone less susceptible to the disease, if you stick to the rules then you will be okay. This was during the Post reconstruction after WWII where Vietnam was just beginning to really recover from the war.<ref name=":1" /> In the Orinoco Delta, Venezuela the indigenous people were constantly being stigmatized that they had cholera. The Warao indigenous ethnic group in the Delta was blamed for the Cholera outbreak in Venezuela in 1992-93. Over 500 people were killed during this outbreak most being indigenous people. Stigmatization of the indigenous people not believing in modern medicine also became a problem and the ‘root’ for how cholera spread. The public health officials fed on the scare that indigenous dont believe in physicians and only used shamans, to wade off the evil spirit affecting the person. This led to blame on the indigenous for spreading Cholera. However this theory can be debunks by the huge migration of indigenous people moving closer to health facilities and urban areas.<ref name=":2" /> ==== Environment Susceptibility ==== When people live in a certain environments they become more susceptible to the disease because of access to information, healthy facilities and proper sanitation. [[Orinoco Delta|Orinoco Delta, Venezuela]] is a coastline that stretches 42,000 kilometers and has a population of 40,000 people. This delta is a very susceptible environment because of its lack of modern society. Medical building sparse so treatment was not easy to obtain when Cholera infected the [[Warao people|Warao indigenous people]] of Delta Amacuro, Venezuela. These indigenous peoples lived in a fluvial region, with palm leaf thatches and houses built on stilts, for transportation they use dug out canoes. (Briggs) Since this environment was very rural there were issues for the people of delta to receive information and help about the virus once it started infecting. This led the indigenous people of the delta to become more susceptible to Cholera because they were not getting the information they needed to help prevent transmissions.<ref name=":2" /> The outbreak in Vietnam between 2007-2009, there were reports of acute cholera concentrated in an urban environment. The environment of an urban area is easy for something like cholera to be transmitted. Specifically in Vietnam where their socioeconomic culture was expanding and urban areas were growing to fast for the government to properly install a water system. Without proper sanitation the virus was able to spread quickly.<ref name=":1" /> [[File:Haitian graph of weekly cases of Cholera.jpg|thumb]] In October 2010 Haiti discovered its first case, since 1996, of acute diarrhea which came back positive as Vibrio Cholerae O1.<ref name=":3">{{Cite journal|last=Routh|first=Janell|date=2011|title=Rapid Assessment of Cholera-related Deaths, Artibonite Deparpartment|url=|journal=Emerging Infectious Diseases|doi=|pmid=|access-date=}}</ref> This was just a few months before a huge [[2010 Haiti earthquake|earthquake devastated Haiti]], only making the country more susceptible to the virus. The source was the Artibonite River, where 19% of Haitians have had access to proper sanitation since 2006<ref>{{Cite web|url=http://www.who.int/cholera/countries/HaitiCountryProfileMay2011.pdf?ua=1|title=Cholera Country Proflie: Haiti|last=|first=|date=|website=|publisher=World Health Organization|access-date=}}</ref>. When living in a rural area, as many Haitians did, without having proper sanitation was the right mix for Cholera to thrive. In Figure 1. we can see that weekly, Cholera was affecting thousands of people leaving more and more people susceptible to mortality, because of lack of treatment and information Haitians were receiving. Lack of information and health care can be another way a community can be more susceptible, “Early in the outbreak, the population knew little about cholera”<ref name=":3" />. In a study done by Janell A. Routh in 2011 about the rapid deaths occurring during this cholera outbreak, she found that people were not receiving information about the disease and health facilities were too far for them. If people are not getting updated information or health care cholera can spread fast<ref name=":3" />. ==History== Under the history section it lists the seven pandemics but are scattered and don’t really make any sense. The seven pandemics are going to be completely taken out and the following will be added in; The first pandemic started near Calcutta, India in 1817 and spread to the rest of India then to the Southeast Asia, the Middle East, southern Europe, and Eastern Africa through trade routes (Britannica). The second pandemic spread from India in 1829 and spread to Europe, Russia, and the Americas through shipping routes (Britannica). The third pandemic spread from India in 1852 and spread to Europe (through Persia) then the Americas, then East Africa (Britannica). The fourth pandemic started in 1863 from India to Naples and Spain. The fifth pandemic started in 1881 from India to Europe, Asia, and South America (Britannica). The sixth pandemic started in 1899 and lasted until 1923 from India to the Arabian peninsula and the coast of North Africa (Britannica). The seventh pandemic began in Indonesia in 1963 then spread to Asia, the Middle East, and Africa (Britannica). The rest of paragraph 6 will go under “the seven pandemics” subheading because it talks about the spread of cholera to New York. ===Government Intervention/Prevention=== A government intervention/prevention subheading will be added under the history section. Paragraph 4 and the first sentence in paragraph 6 will go under this heading because it talks about how quarantine flags were flown on infected vessels(Briggs 2004). Also added, will be how the Venezuelan government acted during the cholera outbreak in 1992. The Venezuelan government blamed the Warao people in the delta of Orinoco(Briggs 2004). The government basically did nothing except for block off the capital Caracas and made a checkpoint and if you looked indigenous they would turn you away (Briggs 2004). They would also round up refugees and take them back using military transportation (Briggs 2004). Instead of taking patients, they sent them to Trinidad and had them try to negotiate health care since they did do a lot of trade with them (Briggs 2004). The Venezuelan government denied the Warao people their health rights and banned the consumption of shellfish (even though the Warao people boiled it before consumption) (Briggs 2004). In Brazil, they handed out information pamphlets and had newspaper coverage. The Brazilian government also put into effect sanitary measure and distributed oral re-hydration salts (<ref>Ashworth 1992</ref>). Russia during the first outbreak (1829-1831) had anti-cholera campaigns, cordon sanitaires, and would inspect all caravans (<ref>Afanasyeva 2013</ref>).. During the second outbreak (1892), Russia put into effect sanitation reforms and regulations for doctors (<ref>Afanasyeva 2013</ref>). Doctors would have to go free of charge to patients and treat them homeopathically (<ref>Afanasyeva 2013</ref>). Even though in Canada, they did not have an outbreak, the government still prepared for cholera (Jackson 2012). In order to prevent Cholera, the Canadian government put sanitary reforms into effect, secured national borders, and had immigration reforms (Jackson 2012). Unfortunately, cholera did spread to America, mostly in New York (Jackson 2012). The government of New York quarantined immigrants and would not let them ashore for at least 20 days (<ref>Jackson 2012</ref>). They also put regulations into effect, they required the ships and immigrants to be inspected and documented (<ref>Jackson 2012</ref>). They also required medical documentation for the immigrants on board (Jackson 2012). Today, there are antibiotics given to try to treat and stop the spread of cholera. Governments are in acting more sanitary reforms and sanitation infrastructure to try and prevent cholera (Routh 2011). ==Cholera in Pop-Culture: The Language of an Epidemic== Cholera in its modern conception is essentially considered a “tropical disease” or a disease that affects the poor in underdeveloped countries. However, because of its ability to spread easily from one person to another through contaminated water, it has had major outbreaks throughout the centuries that have affected almost every region of the world. Cholera, as a result, has had an effect on popular culture and has affected the language that we use to speak about those who contract and spread the disease. The stories that surround the victims and the way those victims are described are sometimes supernatural, but most often reflect the social order of the particular epidemics. It has affected affluent members of society in the past, and presently affects mostly those that live in areas that do not have an adequate sanitation infrastructure in place. Popular figures that have contracted Cholera in the past include two United States Presidents: Zachary Taylor and James K. Polk, the twelfth and eleventh presidents, respectively (Staff 2010; Dusinberre 2003). Taylor was in office and Polk was out of office when they died by the disease. Fanny Fitzwilliam, a fairly prominent English Actress in the 19th century also contracted the disease, and subsequently died by cholera in 1854 (Urban 1854). This is significant because it means that at one point in the epidemiology, cholera was not just a “tropical disease,” but rather affected members of every echelon of society. It is also important because these figures died within a culture in which contracting cholera did not make them dirty and diseased. These prominent figures were not buried ashamed or disgraced. The language used to describe these figures, or Westerners that died from Cholera in this time period were essentially romantic or tragic. For example, from the popular book, Love in the Time of Cholera: “his examination revealed that he had no fever, no, pain anywhere, and that his only concrete feeling was an urgent desire to die. All that was needed was shrewd questioning… to conclude once again that the symptoms of lover were the same as those of cholera” (Marquez 1988). While the book was written after these figures had died, the author was born in 1927 during a time when cholera was still a concern and he would have had a certain perception of cholera victims from the language used around him. The language is considerably more loving and tolerant with the sense that a death due to cholera is analogous to unrequited love. Given that this time period was the Romantic era, it makes sense that people would have held death due to excruciating disease in an almost desirable light. It is distinctly different from its current association as a disease of the poor. The language that defines the sick changes significantly between regions and throughout epidemics. People fear cholera due to the severity of the disease and the speed with which it can kill its victims, but in some regions the disease makes those that contract it equitable to diseased animals. From 1991 to 1993, cholera swept South America with over 27,000 cases and landed itself in Brazil’s impoverished communities (Nations 1996). It gained the nickname of “The Dog’s Disease” and the policies that were put in place to battle the outbreak made those that were diagnosed even more aware of their social status. It made people angry and resistant as they didn’t necessarily believe that the disease was real. This led the sick to react as if the disease was made up by government officials (Nations 1996). It made treatment efforts difficult as members of the community would not cooperate with public health officials because they felt targeted. The victims believed that the healthcare workers were making them sick by either speaking the name of the illness into their lives or by actively giving them the disease. Ultimately, the people affected in Brazil were poor and believed that cholera was a conspiracy concocted by the rich to decimate those in poverty (Briggs 2004). The language used to describe the campaign was violent and war-like with the idea that the disease is representative of “otherness.” It was perpetuated because the people’s mantra eventually became “we ARE the cholera!” resulting in internalizing the disease as a state of being (Nations 1996). They believed that they were essentially being decimated for being filthy and dirty, which is an aberration in Brazilian culture. These feelings of sub-humanity and destitution are representative and a glaring example of the structural violence present in Brazilian society, which speaks to why the disease perpetuated for so long. This is not true only in Brazil, but rather existed in the entirety of the South American outbreak of the 1990’s. Most cultures have a distinct narrative for people that are sick and one interesting explanation for cholera victims lies in the supernatural. In Poland in the 1800s, cholera was not well understood and those that died from it had incredibly violent deaths. The bodies become incredibly emaciated and weak, but sometimes people do survive to come back to life in a manner of speaking. Some scientists believe that cholera is a potential explanation for the concept of vampirism. This is due to the research of Lesley Gregoricka and her colleagues in which burial sites of what are called “deviant deaths” were found. The buried are found with stakes in the heart, rocks or boulders on their necks, and sickles below that to cut off their heads if the people try to get up (Gregoricka 2014). Bone analysis indicated that these people died of cholera and were likely the first victims in an outbreak in the region (Main 2014). At the time, vampirism didn’t necessarily mean what it does today. In Polish culture, a vampire was more of a demon that was trapped between life and death as opposed to the nocturnal creatures personified in contemporary books and movies. (Beresford 2008). It is interesting to consider why this culture believed cholera victims were vampires, which is likely due to the violent death of the victims. Refernces Ashworth, J. L., and S. A. Shields. "Cholera in Brazil." Bmj 304, no. 6841 (1992): 1569. doi:10.1136/bmj.304.6841.1569-b. Afanasyeva, A. "Quarantines and Copper Amulets: The Struggle against Cholera in the Kazakh Steppe in the Nineteenth Century." Jahrbücher Für Geschichte Osteuropas 61, no. 1 (October 1, 2013): 489-512. Accessed May 4, 2016. http://search.proquest.com.www2.lib.ku.edu/docview/1470427129/fulltextPDF/67EDF45B5D 2F4FA9PQ/1?accountid=14556. Alam, Munirul et al.. “Viable but Nonculturable Vibrio Cholerae O1 in Biofilms in the Aquatic Environment and Their Role in Cholera Transmission”. Proceedings of the National Academy of Sciences of the United States of America 104.45 (2007): 17801–17806. Web... Beresford, Matthew. From Demons to Dracula : The Creation of the Modern Vampire Myth. London: Reaktion, 2008. Briggs, Charles L.. 2004. “Theorizing Modernity Conspiratorially: Science, Scale, and the Political Economy of Public Discourse in Explanations of a Cholera Epidemic”. American Ethnologist 31 (2). [Wiley, American Anthropological Association]: 164–87. http://www.jstor.org.www2.lib.ku.edu/stable/3805421. Claeson, Mariam. "Cholera: Pathology." Encyclopedia Britannica, Inc. December 29, 2015.Accessed May 7, 2015. http://www.britannica.com/science/cholera. Dusinberre, William. Slavemaster President: The Double Career of James Polk 2003. "President Taylor Dies of Cholera." History.com. 2010. Accessed May 09, 2016. http://www.history.com/this-day-in-history/president-taylor-dies-of-cholera. García Márquez, Gabriel. Love in the Time of Cholera. 1st American ed. New York: Alfred A. Knopf, 1988. Gregoricka, Lesley A, Tracy K Betsinger, Amy B Scott, and Marek Polcyn. "Apotropaic Practices and the Undead: A Biogeochemical Assessment of Deviant Burials in Post-medieval Poland." PloS One 9, no. 11 (2014): E113564. Jackson, P. S. B. "Fearing Future Epidemics: The Cholera Crisis of 1892." Cultural Geographies 20, no. 1 (2012): 43-65. doi:10.1177/1474474012455017. Lincoln, Martha L.1. "Tainted Commons, Public Health: The Politico-Moral Significance Of Cholera In Vietnam." Medical Anthropology Quarterly 28.3 (2014): 342-361. OmniFile Full Text Select (H.W. Wilson). Web. 11 May 2016. Nations, Mk, and Cmg Monte. "''I'm Not Dog, No!'': Cries of Resistance against Cholera Control Campaigns."Social Science & Medicine 43, no. 6 (1996): 1007-024. Routh, Janell A., Anagha Loharikar, Marie-Delvrance Bernadette Fouche, Emily J. Cartwrigh, Sharon L. Roy, Elizabeth Ailes, and W. Roodly Archer. "Rapid Assessment of Cholera-related Deaths, Artibonite Department, Haiti, 2010." Emerging Infectious Diseases 17.11 (2011): 2139. Expanded Academic ASAP [Gale]. Web. 05 May 2016. Sarchet, Penny. 2014. "Polish 'vampires' were locals not persecuted outsiders." New Scientist 224, no. 2997: 1. Academic Search Complete, EBSCOhost(accessed May 10, 2016). Urban, Sylvanus, Gent. The Gentleman's Magazine and Historical Review. Vol. 196. London: John Bowyer Nichols and Sons, 1854. Accessed May 9, 2016. https://books.google.com/books?id=r6_PAAAAMAAJ&pg=PA525&dq=fannyfitzwillia mobit 1 854&hl=en&sa=X&ved=0ahUKEwi5g9-Yz87MAhWBRyYKHdCVA8EQ6AEIIjAB#v= onepage&q=fanny fitzwilliam obit 1854&f=false.

Thank you for your time and we hope to hear back! Culvesam (talk) 14:48, 13 May 2016 (UTC)

Semi-protected edit request on 13 May 2016

I would like to request one of the editors of this page to consider adding the following.

Extended content

== Cause == === Transmission === Cholera is an infectious disease that threatens Africa, Latin America and Asia.<ref name=":0">{{Cite journal|last=Muniru|first=Alam|date=2007|title=Viable but Nonculturable Vibrio Cholerae in Biofilms in the Aquatic Environment and Their Role in Cholera Transmissions|jstor=25450323|journal=Proceedings of the National Academy of Science of the United States|doi=|pmid=|access-date=}}</ref> Specifically fresh and saltwater environments Cholera, has been found in two animal populations: shellfish and plankton.[12] Transmission is usually through the fecal-oral route of contaminated food or water caused by environmental conditions, whether it be due to poor sanitation or natural environmental factors.<ref name=":0" /> Zooplankton has been found to a natural host for the disease, but a study done in Bangladesh have shown that Vibroe Cholerae can live in water as noncultured and can be cultured by transmission through animals.<ref name=":0" /> With in this study they found that certain environments can harbor the infection through biofilm, which creates seasonal endemics in the Bangladesh area.<ref name=":0" /> ==== Food Stigma ==== The transmission of cholera can happen when the virus is ingested. In the 2007-2009 outbreaks in Vietnam food had a bad stigma that it was contaminated with the virus. Where food was “safe” was in the home, outside food was dangerous, meaning food from restaurants and street vendors.<ref name=":1">{{Cite journal|last=Lincoln|first=Martha|date=2014|title=Tainted Commons, Public Health: The Politico-Moral Significance of Cholera in Vietnam|url=|journal=Medical Anthropology Qauterly|doi=|pmid=|access-date=}}</ref> This led to food stigma which did not help people in the developing world.The Ministry of Health in Vietnam claimed certain foods were risky for the population to eat. These foods were common for indigenous people to eat like, dog meat, shrimp paste and raw vegetables. This in cause made street vendors and restaurants that used this food stigmatized and lost business.<ref name=":1" /> In an outbreak of Cholera in Venezuela in 1992-93 public health officials deems that crabs was the source of the outbreak, not the terrible water system they had in place. The people that ate the crabs were the indigenous who were living in the rain forest. Raw crab was to be avoided and was an “attempt to link cholera in the delta to the ‘customs’ and ‘culture’ of the indigenous”<ref name=":2">{{Cite journal|last=Briggs|first=Charles|date=2004|title=Theorizing Modernity Conspiratorially: Science, Scale, and the Political Economy of Public Discourse in Explanations of a Cholera Epidemic|url=|journal=American Ethnologists|doi=|pmid=|access-date=}}</ref> With in stigmatization of the crab it then led to the idea that cholera came from the indigenous and those people were to be avoided. === Susceptibility === About 100 million bacteria must typically be ingested to cause cholera in a normal healthy adult.[12] Children are also more susceptible, with two- to four-year-olds having the highest rates of infection.[12] Individuals' susceptibility to cholera is also affected by their blood type, with those with type O blood being the most susceptible.[12] Persons with lowered immunity, such as persons with AIDS or children who are malnourished, are more likely to experience a severe case if they become infected.[19] Susceptiblity goes beyond just the persons age or health there is also a stigma that comes with the disease Cholera. ==== Social Susceptibility ==== Social status also becomes a reason in society for who is more susceptible. With in the outbreak in Vietnam between 2007-2009 merchants and prostitutes were being accused of being contaminated with Cholera. This is because they are at the bottom of the hierarchy in Vietnam culture and can be seen as dirty because of their profession. With this in mind the Vietnam government stigmatized certain labor rules, liked being civilized. Being civilized made someone less susceptible to the disease, if you stick to the rules then you will be okay. This was during the Post reconstruction after WWII where Vietnam was just beginning to really recover from the war.<ref name=":1" /> In the Orinoco Delta, Venezuela the indigenous people were constantly being stigmatized that they had cholera. The Warao indigenous ethnic group in the Delta was blamed for the Cholera outbreak in Venezuela in 1992-93. Over 500 people were killed during this outbreak most being indigenous people. Stigmatization of the indigenous people not believing in modern medicine also became a problem and the ‘root’ for how cholera spread. The public health officials fed on the scare that indigenous dont believe in physicians and only used shamans, to wade off the evil spirit affecting the person. This led to blame on the indigenous for spreading Cholera. However this theory can be debunks by the huge migration of indigenous people moving closer to health facilities and urban areas.<ref name=":2" /> ==== Environment Susceptibility ==== When people live in a certain environments they become more susceptible to the disease because of access to information, healthy facilities and proper sanitation. [[Orinoco Delta|Orinoco Delta, Venezuela]] is a coastline that stretches 42,000 kilometers and has a population of 40,000 people. This delta is a very susceptible environment because of its lack of modern society. Medical building sparse so treatment was not easy to obtain when Cholera infected the [[Warao people|Warao indigenous people]] of Delta Amacuro, Venezuela. These indigenous peoples lived in a fluvial region, with palm leaf thatches and houses built on stilts, for transportation they use dug out canoes. (Briggs) Since this environment was very rural there were issues for the people of delta to receive information and help about the virus once it started infecting. This led the indigenous people of the delta to become more susceptible to Cholera because they were not getting the information they needed to help prevent transmissions.<ref name=":2" /> The outbreak in Vietnam between 2007-2009, there were reports of acute cholera concentrated in an urban environment. The environment of an urban area is easy for something like cholera to be transmitted. Specifically in Vietnam where their socioeconomic culture was expanding and urban areas were growing to fast for the government to properly install a water system. Without proper sanitation the virus was able to spread quickly.<ref name=":1" /> [[File:Haitian graph of weekly cases of Cholera.jpg|thumb]] In October 2010 Haiti discovered its first case, since 1996, of acute diarrhea which came back positive as Vibrio Cholerae O1.<ref name=":3">{{Cite journal|last=Routh|first=Janell|date=2011|title=Rapid Assessment of Cholera-related Deaths, Artibonite Deparpartment|url=|journal=Emerging Infectious Diseases|doi=|pmid=|access-date=}}</ref> This was just a few months before a huge [[2010 Haiti earthquake|earthquake devastated Haiti]], only making the country more susceptible to the virus. The source was the Artibonite River, where 19% of Haitians have had access to proper sanitation since 2006<ref>{{Cite web|url=http://www.who.int/cholera/countries/HaitiCountryProfileMay2011.pdf?ua=1|title=Cholera Country Proflie: Haiti|last=|first=|date=|website=|publisher=World Health Organization|access-date=}}</ref>. When living in a rural area, as many Haitians did, without having proper sanitation was the right mix for Cholera to thrive. In Figure 1. we can see that weekly, Cholera was affecting thousands of people leaving more and more people susceptible to mortality, because of lack of treatment and information Haitians were receiving. Lack of information and health care can be another way a community can be more susceptible, “Early in the outbreak, the population knew little about cholera”<ref name=":3" />. In a study done by Janell A. Routh in 2011 about the rapid deaths occurring during this cholera outbreak, she found that people were not receiving information about the disease and health facilities were too far for them. If people are not getting updated information or health care cholera can spread fast<ref name=":3" />.

Naedmondson45 (talk) 14:48, 13 May 2016 (UTC)

Edits for class to the Cholera page

Hello, we are doing a project for our 501 class at the University of Kansas and would like to contribute to this page.

Our edits include the following:

Are information and edits include:

Within the Cause section we wanted to make edits to include more information about the

We need better formatting of the content in question. I am unable to figure out what ref supports what content. Doc James (talk · contribs · email) 16:20, 13 May 2016 (UTC)

Extended content

== Cause == === Transmission === Cholera is an infectious disease that threatens Africa, Latin America and Asia.<ref name=":0">{{Cite journal|last=Muniru|first=Alam|date=2007|title=Viable but Nonculturable Vibrio Cholerae in Biofilms in the Aquatic Environment and Their Role in Cholera Transmissions|url=http://www.jstor.org/stable/pdf/25450323.pdf?_=1462999118990|journal=Proceedings of the National Academy of Science of the United States|doi=|pmid=|access-date=}}</ref> Specifically fresh and saltwater environments Cholera, has been found in two animal populations: shellfish and plankton.[12] Transmission is usually through the fecal-oral route of contaminated food or water caused by environmental conditions, whether it be due to poor sanitation or natural environmental factors.<ref name=":0" /> Zooplankton has been found to a natural host for the disease, but a study done in Bangladesh have shown that Vibroe Cholerae can live in water as noncultured and can be cultured by transmission through animals.<ref name=":0" /> With in this study they found that certain environments can harbor the infection through biofilm, which creates seasonal endemics in the Bangladesh area.<ref name=":0" /> ==== Food Stigma ==== The transmission of cholera can happen when the virus is ingested. In the 2007-2009 outbreaks in Vietnam food had a bad stigma that it was contaminated with the virus. Where food was “safe” was in the home, outside food was dangerous, meaning food from restaurants and street vendors.<ref name=":1">{{Cite journal|last=Lincoln|first=Martha|date=2014|title=Tainted Commons, Public Health: The Politico-Moral Significance of Cholera in Vietnam|url=|journal=Medical Anthropology Qauterly|doi=|pmid=|access-date=}}</ref> This led to food stigma which did not help people in the developing world.The Ministry of Health in Vietnam claimed certain foods were risky for the population to eat. These foods were common for indigenous people to eat like, dog meat, shrimp paste and raw vegetables. This in cause made street vendors and restaurants that used this food stigmatized and lost business.<ref name=":1" /> In an outbreak of Cholera in Venezuela in 1992-93 public health officials deems that crabs was the source of the outbreak, not the terrible water system they had in place. The people that ate the crabs were the indigenous who were living in the rain forest. Raw crab was to be avoided and was an “attempt to link cholera in the delta to the ‘customs’ and ‘culture’ of the indigenous”<ref name=":2">{{Cite journal|last=Briggs|first=Charles|date=2004|title=Theorizing Modernity Conspiratorially: Science, Scale, and the Political Economy of Public Discourse in Explanations of a Cholera Epidemic|url=|journal=American Ethnologists|doi=|pmid=|access-date=}}</ref> With in stigmatization of the crab it then led to the idea that cholera came from the indigenous and those people were to be avoided. === Susceptibility === About 100 million bacteria must typically be ingested to cause cholera in a normal healthy adult.[12] Children are also more susceptible, with two- to four-year-olds having the highest rates of infection.[12] Individuals' susceptibility to cholera is also affected by their blood type, with those with type O blood being the most susceptible.[12] Persons with lowered immunity, such as persons with AIDS or children who are malnourished, are more likely to experience a severe case if they become infected.[19] Susceptiblity goes beyond just the persons age or health there is also a stigma that comes with the disease Cholera. ==== Social Susceptibility ==== Social status also becomes a reason in society for who is more susceptible. With in the outbreak in Vietnam between 2007-2009 merchants and prostitutes were being accused of being contaminated with Cholera. This is because they are at the bottom of the hierarchy in Vietnam culture and can be seen as dirty because of their profession. With this in mind the Vietnam government stigmatized certain labor rules, liked being civilized. Being civilized made someone less susceptible to the disease, if you stick to the rules then you will be okay. This was during the Post reconstruction after WWII where Vietnam was just beginning to really recover from the war.<ref name=":1" /> In the Orinoco Delta, Venezuela the indigenous people were constantly being stigmatized that they had cholera. The Warao indigenous ethnic group in the Delta was blamed for the Cholera outbreak in Venezuela in 1992-93. Over 500 people were killed during this outbreak most being indigenous people. Stigmatization of the indigenous people not believing in modern medicine also became a problem and the ‘root’ for how cholera spread. The public health officials fed on the scare that indigenous dont believe in physicians and only used shamans, to wade off the evil spirit affecting the person. This led to blame on the indigenous for spreading Cholera. However this theory can be debunks by the huge migration of indigenous people moving closer to health facilities and urban areas.<ref name=":2" /> ==== Environment Susceptibility ==== When people live in a certain environments they become more susceptible to the disease because of access to information, healthy facilities and proper sanitation. [[Orinoco Delta|Orinoco Delta, Venezuela]] is a coastline that stretches 42,000 kilometers and has a population of 40,000 people. This delta is a very susceptible environment because of its lack of modern society. Medical building sparse so treatment was not easy to obtain when Cholera infected the [[Warao people|Warao indigenous people]] of Delta Amacuro, Venezuela. These indigenous peoples lived in a fluvial region, with palm leaf thatches and houses built on stilts, for transportation they use dug out canoes. (Briggs) Since this environment was very rural there were issues for the people of delta to receive information and help about the virus once it started infecting. This led the indigenous people of the delta to become more susceptible to Cholera because they were not getting the information they needed to help prevent transmissions.<ref name=":2" /> The outbreak in Vietnam between 2007-2009, there were reports of acute cholera concentrated in an urban environment. The environment of an urban area is easy for something like cholera to be transmitted. Specifically in Vietnam where their socioeconomic culture was expanding and urban areas were growing to fast for the government to properly install a water system. Without proper sanitation the virus was able to spread quickly.<ref name=":1" /> [[File:Haitian graph of weekly cases of Cholera.jpg|thumb]] In October 2010 Haiti discovered its first case, since 1996, of acute diarrhea which came back positive as Vibrio Cholerae O1.<ref name=":3">{{Cite journal|last=Routh|first=Janell|date=2011|title=Rapid Assessment of Cholera-related Deaths, Artibonite Deparpartment|url=|journal=Emerging Infectious Diseases|doi=|pmid=|access-date=}}</ref> This was just a few months before a huge [[2010 Haiti earthquake|earthquake devastated Haiti]], only making the country more susceptible to the virus. The source was the Artibonite River, where 19% of Haitians have had access to proper sanitation since 2006<ref>{{Cite web|url=http://www.who.int/cholera/countries/HaitiCountryProfileMay2011.pdf?ua=1|title=Cholera Country Proflie: Haiti|last=|first=|date=|website=|publisher=World Health Organization|access-date=}}</ref>. When living in a rural area, as many Haitians did, without having proper sanitation was the right mix for Cholera to thrive. In Figure 1. we can see that weekly, Cholera was affecting thousands of people leaving more and more people susceptible to mortality, because of lack of treatment and information Haitians were receiving. Lack of information and health care can be another way a community can be more susceptible, “Early in the outbreak, the population knew little about cholera”<ref name=":3" />. In a study done by Janell A. Routh in 2011 about the rapid deaths occurring during this cholera outbreak, she found that people were not receiving information about the disease and health facilities were too far for them. If people are not getting updated information or health care cholera can spread fast<ref name=":3" />. ==History== Under the history section it lists the seven pandemics but are scattered and don’t really make any sense. The seven pandemics are going to be completely taken out and the following will be added in; The first pandemic started near Calcutta, India in 1817 and spread to the rest of India then to the Southeast Asia, the Middle East, southern Europe, and Eastern Africa through trade routes (Britannica). The second pandemic spread from India in 1829 and spread to Europe, Russia, and the Americas through shipping routes (Britannica). The third pandemic spread from India in 1852 and spread to Europe (through Persia) then the Americas, then East Africa (Britannica). The fourth pandemic started in 1863 from India to Naples and Spain. The fifth pandemic started in 1881 from India to Europe, Asia, and South America (Britannica). The sixth pandemic started in 1899 and lasted until 1923 from India to the Arabian peninsula and the coast of North Africa (Britannica). The seventh pandemic began in Indonesia in 1963 then spread to Asia, the Middle East, and Africa (Britannica). The rest of paragraph 6 will go under “the seven pandemics” subheading because it talks about the spread of cholera to New York. ===Government Intervention/Prevention=== A government intervention/prevention subheading will be added under the history section. Paragraph 4 and the first sentence in paragraph 6 will go under this heading because it talks about how quarantine flags were flown on infected vessels(Briggs 2004). Also added, will be how the Venezuelan government acted during the cholera outbreak in 1992. The Venezuelan government blamed the Warao people in the delta of Orinoco(Briggs 2004). The government basically did nothing except for block off the capital Caracas and made a checkpoint and if you looked indigenous they would turn you away (Briggs 2004). They would also round up refugees and take them back using military transportation (Briggs 2004). Instead of taking patients, they sent them to Trinidad and had them try to negotiate health care since they did do a lot of trade with them (Briggs 2004). The Venezuelan government denied the Warao people their health rights and banned the consumption of shellfish (even though the Warao people boiled it before consumption) (Briggs 2004). In Brazil, they handed out information pamphlets and had newspaper coverage. The Brazilian government also put into effect sanitary measure and distributed oral re-hydration salts (<ref>Ashworth 1992</ref>). Russia during the first outbreak (1829-1831) had anti-cholera campaigns, cordon sanitaires, and would inspect all caravans (<ref>Afanasyeva 2013</ref>).. During the second outbreak (1892), Russia put into effect sanitation reforms and regulations for doctors (<ref>Afanasyeva 2013</ref>). Doctors would have to go free of charge to patients and treat them homeopathically (<ref>Afanasyeva 2013</ref>). Even though in Canada, they did not have an outbreak, the government still prepared for cholera (Jackson 2012). In order to prevent Cholera, the Canadian government put sanitary reforms into effect, secured national borders, and had immigration reforms (Jackson 2012). Unfortunately, cholera did spread to America, mostly in New York (Jackson 2012). The government of New York quarantined immigrants and would not let them ashore for at least 20 days (<ref>Jackson 2012</ref>). They also put regulations into effect, they required the ships and immigrants to be inspected and documented (<ref>Jackson 2012</ref>). They also required medical documentation for the immigrants on board (Jackson 2012). Today, there are antibiotics given to try to treat and stop the spread of cholera. Governments are in acting more sanitary reforms and sanitation infrastructure to try and prevent cholera (Routh 2011). ==Cholera in Pop-Culture: The Language of an Epidemic== Cholera in its modern conception is essentially considered a “tropical disease” or a disease that affects the poor in underdeveloped countries. However, because of its ability to spread easily from one person to another through contaminated water, it has had major outbreaks throughout the centuries that have affected almost every region of the world. Cholera, as a result, has had an effect on popular culture and has affected the language that we use to speak about those who contract and spread the disease. The stories that surround the victims and the way those victims are described are sometimes supernatural, but most often reflect the social order of the particular epidemics. It has affected affluent members of society in the past, and presently affects mostly those that live in areas that do not have an adequate sanitation infrastructure in place. Popular figures that have contracted Cholera in the past include two United States Presidents: Zachary Taylor and James K. Polk, the twelfth and eleventh presidents, respectively (Staff 2010; Dusinberre 2003). Taylor was in office and Polk was out of office when they died by the disease. Fanny Fitzwilliam, a fairly prominent English Actress in the 19th century also contracted the disease, and subsequently died by cholera in 1854 (Urban 1854). This is significant because it means that at one point in the epidemiology, cholera was not just a “tropical disease,” but rather affected members of every echelon of society. It is also important because these figures died within a culture in which contracting cholera did not make them dirty and diseased. These prominent figures were not buried ashamed or disgraced. The language used to describe these figures, or Westerners that died from Cholera in this time period were essentially romantic or tragic. For example, from the popular book, Love in the Time of Cholera: “his examination revealed that he had no fever, no, pain anywhere, and that his only concrete feeling was an urgent desire to die. All that was needed was shrewd questioning… to conclude once again that the symptoms of lover were the same as those of cholera” (Marquez 1988). While the book was written after these figures had died, the author was born in 1927 during a time when cholera was still a concern and he would have had a certain perception of cholera victims from the language used around him. The language is considerably more loving and tolerant with the sense that a death due to cholera is analogous to unrequited love. Given that this time period was the Romantic era, it makes sense that people would have held death due to excruciating disease in an almost desirable light. It is distinctly different from its current association as a disease of the poor. The language that defines the sick changes significantly between regions and throughout epidemics. People fear cholera due to the severity of the disease and the speed with which it can kill its victims, but in some regions the disease makes those that contract it equitable to diseased animals. From 1991 to 1993, cholera swept South America with over 27,000 cases and landed itself in Brazil’s impoverished communities (Nations 1996). It gained the nickname of “The Dog’s Disease” and the policies that were put in place to battle the outbreak made those that were diagnosed even more aware of their social status. It made people angry and resistant as they didn’t necessarily believe that the disease was real. This led the sick to react as if the disease was made up by government officials (Nations 1996). It made treatment efforts difficult as members of the community would not cooperate with public health officials because they felt targeted. The victims believed that the healthcare workers were making them sick by either speaking the name of the illness into their lives or by actively giving them the disease. Ultimately, the people affected in Brazil were poor and believed that cholera was a conspiracy concocted by the rich to decimate those in poverty (Briggs 2004). The language used to describe the campaign was violent and war-like with the idea that the disease is representative of “otherness.” It was perpetuated because the people’s mantra eventually became “we ARE the cholera!” resulting in internalizing the disease as a state of being (Nations 1996). They believed that they were essentially being decimated for being filthy and dirty, which is an aberration in Brazilian culture. These feelings of sub-humanity and destitution are representative and a glaring example of the structural violence present in Brazilian society, which speaks to why the disease perpetuated for so long. This is not true only in Brazil, but rather existed in the entirety of the South American outbreak of the 1990’s. Most cultures have a distinct narrative for people that are sick and one interesting explanation for cholera victims lies in the supernatural. In Poland in the 1800s, cholera was not well understood and those that died from it had incredibly violent deaths. The bodies become incredibly emaciated and weak, but sometimes people do survive to come back to life in a manner of speaking. Some scientists believe that cholera is a potential explanation for the concept of vampirism. This is due to the research of Lesley Gregoricka and her colleagues in which burial sites of what are called “deviant deaths” were found. The buried are found with stakes in the heart, rocks or boulders on their necks, and sickles below that to cut off their heads if the people try to get up (Gregoricka 2014). Bone analysis indicated that these people died of cholera and were likely the first victims in an outbreak in the region (Main 2014). At the time, vampirism didn’t necessarily mean what it does today. In Polish culture, a vampire was more of a demon that was trapped between life and death as opposed to the nocturnal creatures personified in contemporary books and movies. (Beresford 2008). It is interesting to consider why this culture believed cholera victims were vampires, which is likely due to the violent death of the victims. Refernces Ashworth, J. L., and S. A. Shields. "Cholera in Brazil." Bmj 304, no. 6841 (1992): 1569. doi:10.1136/bmj.304.6841.1569-b. Afanasyeva, A. "Quarantines and Copper Amulets: The Struggle against Cholera in the Kazakh Steppe in the Nineteenth Century." Jahrbücher Für Geschichte Osteuropas 61, no. 1 (October 1, 2013): 489-512. Accessed May 4, 2016. http://search.proquest.com.www2.lib.ku.edu/docview/1470427129/fulltextPDF/67EDF45B5D 2F4FA9PQ/1?accountid=14556. Alam, Munirul et al.. “Viable but Nonculturable Vibrio Cholerae O1 in Biofilms in the Aquatic Environment and Their Role in Cholera Transmission”. Proceedings of the National Academy of Sciences of the United States of America 104.45 (2007): 17801–17806. Web... Beresford, Matthew. From Demons to Dracula : The Creation of the Modern Vampire Myth. London: Reaktion, 2008. Briggs, Charles L.. 2004. “Theorizing Modernity Conspiratorially: Science, Scale, and the Political Economy of Public Discourse in Explanations of a Cholera Epidemic”. American Ethnologist 31 (2). [Wiley, American Anthropological Association]: 164–87. http://www.jstor.org.www2.lib.ku.edu/stable/3805421. Claeson, Mariam. "Cholera: Pathology." Encyclopedia Britannica, Inc. December 29, 2015.Accessed May 7, 2015. http://www.britannica.com/science/cholera. Dusinberre, William. Slavemaster President: The Double Career of James Polk 2003. "President Taylor Dies of Cholera." History.com. 2010. Accessed May 09, 2016. http://www.history.com/this-day-in-history/president-taylor-dies-of-cholera. García Márquez, Gabriel. Love in the Time of Cholera. 1st American ed. New York: Alfred A. Knopf, 1988. Gregoricka, Lesley A, Tracy K Betsinger, Amy B Scott, and Marek Polcyn. "Apotropaic Practices and the Undead: A Biogeochemical Assessment of Deviant Burials in Post-medieval Poland." PloS One 9, no. 11 (2014): E113564. Jackson, P. S. B. "Fearing Future Epidemics: The Cholera Crisis of 1892." Cultural Geographies 20, no. 1 (2012): 43-65. doi:10.1177/1474474012455017. Lincoln, Martha L.1. "Tainted Commons, Public Health: The Politico-Moral Significance Of Cholera In Vietnam." Medical Anthropology Quarterly 28.3 (2014): 342-361. OmniFile Full Text Select (H.W. Wilson). Web. 11 May 2016. Nations, Mk, and Cmg Monte. "''I'm Not Dog, No!'': Cries of Resistance against Cholera Control Campaigns."Social Science & Medicine 43, no. 6 (1996): 1007-024. Routh, Janell A., Anagha Loharikar, Marie-Delvrance Bernadette Fouche, Emily J. Cartwrigh, Sharon L. Roy, Elizabeth Ailes, and W. Roodly Archer. "Rapid Assessment of Cholera-related Deaths, Artibonite Department, Haiti, 2010." Emerging Infectious Diseases 17.11 (2011): 2139. Expanded Academic ASAP [Gale]. Web. 05 May 2016. Sarchet, Penny. 2014. "Polish 'vampires' were locals not persecuted outsiders." New Scientist 224, no. 2997: 1. Academic Search Complete, EBSCOhost(accessed May 10, 2016). Urban, Sylvanus, Gent. The Gentleman's Magazine and Historical Review. Vol. 196. London: John Bowyer Nichols and Sons, 1854. Accessed May 9, 2016. https://books.google.com/books?id=r6_PAAAAMAAJ&pg=PA525&dq=fannyfitzwillia mobit 1 854&hl=en&sa=X&ved=0ahUKEwi5g9-Yz87MAhWBRyYKHdCVA8EQ6AEIIjAB#v= onepage&q=fanny fitzwilliam obit 1854&f=false.

Thank you for your time and we hope to hear back! Culvesam (talk) 14:53, 13 May 2016 (UTC)

We need better formating of the references. Please see WP:MEDHOW Doc James (talk · contribs · email) 16:17, 13 May 2016 (UTC)

Hi all! Thank you for posting to the talk page before making large changes to the article! I'm a little unclear as to the goal here. Some questions:

Cause

1. Is the cause section you present here supposed to replace the current cause section? Or is this all additional information you hope to add (I did notice that some of your proposal is copied from the current section so I assume you mean for this to be the replacement section)?
2. The source you use throughout much of your Cause>Transmission section (Alam, et al. 2007) is a primary source which (as you know) is about V. cholera biofilm persistence. Wikipedia is a tertiary source and as such we try to rely almost exclusively on secondary sources as references. For a statement such as "Cholera is an infectious disease that threatens Africa, Latin America, and Asia" a primary source on biofilm formation is not appropriate (even if that source does mention this fact in the intro). Instead, a secondary source on the geographical range of cholera, or on cholera generally would be best (the current reference to the lancet review on cholera is a good choice. If you don't have access to that source, let me know and I can either find you a copy or let you know what statements it covers).
3. The short paragraph you have in the Transmission section concerning the conclusions of the primary source mentioned above is probably not appropriate for the article. I'm sure it's a fine paper, and their conclusions are interesting, however we try to avoid specifically mentioning primary papers. If we devote two sentences to this paper, then should we devote two sentences to every primary study in this field? (The answer, of course, is no we can't do that. Encyclopedias can't cover every piece of primary literature; that's what secondary sources are for. We trust the experts who write secondary sources to view the primary literature and make conclusions which we report here in our encyclopedia).
4. The cause section is probably not the right place for a discussion on food stigma. Perhaps in a "Society and Culture" section this would be more appropriate. But food stigma doesn't deal with the cause of cholera per se, it deals with the societal effects of investigations into cholera outbreaks.
5. Social Susceptibility - Hm. I'm undecided here. Obviously this has to do with susceptibility to cholera, but again it's maybe more a "Society and Culture" issue. I think discussions of victims of cholera being stigmatized (because they are more susceptible) would be more appropriate in discussions of the societal effects of cholera (in a "Society and Culture" section) rather than in the discussion of what causes cholera.
6. Environment Susceptibility - You seem to have picked up a lot of information on cholera in Venezuela and Vietnam. My concern here is that giving so much information on Venezuela and Vietnam leaves the article unbalanced. If we devote so much space to a discussion of these two countries, why not devote that much space to each other effected country? And if we devote that much to each country, the article would be HUGE. So maybe you might like to start a Cholera in Venezuela or Cholera in Vietnam article, where you could put together a really excellent discussion of the causes, stats, and effects of the disease in those countries!

History

1. I'm not clear on what you're proposing here. Are you proposing removing the entire section and replacing it with the text you proposed? The current section is a bit scattered, but burning it down and building a new section in its place seems a bit harsh. If you want to talk about ways to improve that section, we could try to clarify the pandemics bit (as it seems you are keen to do), and then maybe re-organize the rest to make the section flow better. The current organization appears to be: Intro → Pandemics → Historical Deaths → a random fun fact about maritime quarantine (which could be fit in elsewhere or removed) → Historical remedies → Historical prevention → an etymological clarification. I'm no literary mastermind, but I'm sure we could somehow improve that.
2. Gov't Intervention/Prevention - I'm not so sure about this section. Like I said above, I think the history section could use a re-organization, and I'm not sure that having a single subsection for "Gov't Intervention/Prevention" is going to do the trick. A lot of the country-specific info is pretty specific. Remember that this is just the section on "The History of Cholera". The measures by which the Canadian gov't staved off a cholera outbreak may be hard to justify squeezing into this article (though perhaps an article on Cholera prevention would have a narrow-enough focus for all of this!).

Cholera in Pop-Culture: The Language of an Epidemic

1. This might sound scroogy, but we can't have a section named this. We try to keep our section headings consistent from article to article. Perhaps instead "In pop culture" could be a sub-section under "Society and Culture".
2. In general, the discussion here is interesting, but again is fairly specific language for a section on "Cholera in Society and Culture". Perhaps instead we could make a Cholera in society article and have a longer discussion there. Or this kind of stuff could go into the more specific Cholera in Brazil, Cholera in Venezuela, etc. Some of this info could definitely be squeezed into the current "Society and Culture" section and would strengthen the current article!

A note to the proposers Welcome to Wikipedia! I can see you're somewhat new here. I appreciate all of the research that went into this proposal. However, starting your editing at these more developed and high-traffic articles can be extremely frustrating. Realize that this article has been edited more than 4,000 times by hundreds of editors. While there's lots of room for improvement, this article is approaching a form that we are somewhat content with. As such, pushing large changes into the article will be difficult and may result in frustrating resistance. In general, you'll find this to be the case with articles that get more action from editors and readers. With so much development already done, it can be really challenging to sink your teeth into these articles and make changes. Instead, I would highly recommend picking some less-developed articles where your efforts could hugely improve our encyclopedia. If you have any questions about that, or are looking for suggestions, feel free to contact me at my talk page, contact a WikiProject which covers an area of interest to you, or post to Wikipedia:Teahouse which was made for newer users to have their questions answered. Best of luck, and happy editing! Ajpolino (talk) 02:07, 14 May 2016 (UTC)

Cholera in animals

The following assertion from the second paragraph of the article is unsourced: "Humans are the only animal affected." I'm no expert, but a Google search for "cholera animals" turns up enough references to the contrary that I believe the assertion is wrong, or at least highly exaggerated. Quoting from the very first result (http://www.cfsph.iastate.edu/FastFacts/pdfs/cholera_F.pdf), for example:

What animals get cholera?

Most animals do not develop illness from cholera. Dogs may become infected if exposed to a very large number of the Vibrio cholerae bacteria in either food or water. Outbreaks have been reported in bison, cattle and dogs.

How can my animal get cholera?

Animals can be exposed to the bacteria through ingestion (oral). This may occur from exposure to feces from infected animals or people or from fecally contaminated water, food or raw shellfish.

How does cholera affect my animal?

Most animals infected will show no signs of illness. If illness occurs, animals will have large amounts of watery diarrhea and vomiting. They can become rapidly dehydrated, which can lead to death.

From the abstract of a paper published in The Journal of Infectious Diseases (https://www.jstor.org/stable/30061717?seq=1#page_scan_tab_contents):

A total of 1,287 specimens from 195 domestic animals (including poultry birds) in a community in Varanasi, a region not endemic for Vibrio cholerae, were investigated during the period from July 1972 to September 1973 for the presence of V. cholerae in a search for reservoirs of infection during an epidemic and an interepidemic period. Fifty-four strains of V. cholerae, of which eight were of serotype 1 and the remaining 46 of other serotypes (so-called NAG vibrios), were isolated from 21 animals.

But I also got some results supporting the Wikipedia article's assertion, e.g. this from the WHO (http://www.who.int/ith/diseases/cho/en):

Transmission

Infection occurs through ingestion of food or water contaminated directly or indirectly by faeces or vomitus of infected individuals. Cholera affects only humans; there is no insect vector or animal reservoir host.

The latter is in the context of transmitting the disease to humans, though. Perhaps it's rare enough that it's not an issue in that context, and the writer (perhaps not well versed in veterinary medicine) overstated that fact?

I'm not a registered Wikipedia user and cannot make any edits myself to the article, since it's semi-protected.

83.226.32.84 (talk) 16:35, 25 August 2016 (UTC)

Minor improvement in wording requested

At the end of the fourth paragraph of section 3 "Mechanism": Change "The host can become rapidly dehydrated if ... is not taken ..." to be:

      "The host can become rapidly dehydrated unless ... is taken ...".

As it is, the negation "is not taken" comes very late in the sentence. BMJ — Preceding unsigned comment added by BMJ-pdx (talk • contribs) 10:11, 28 November 2016 (UTC)

 Done I think your wording makes it slightly more clear. Thanks. Ajpolino (talk) 02:55, 29 November 2016 (UTC)

Semi-protected edit request on 23 March 2017

William Turner is another notable cholera victim. Easyfriday (talk) 06:39, 23 March 2017 (UTC)

Not done: please provide reliable sources that support the change you want to be made. DRAGON BOOSTER ★ 09:42, 23 March 2017 (UTC)

Semi-protected edit request on 9 July 2017

Image Cholera patient being treated by medical staff in 1992 medical staff it's Oral rehydration therapy (ORT) and I want change medical staff with Oral rehydration therapy And be like Chorela patient being treated by Oral rehydration therapy in 1992 Builder8360 (talk) 18:44, 9 July 2017 (UTC)

Done jd22292 (Jalen D. Folf) (talk) 19:13, 9 July 2017 (UTC)

Other image for lead?

I propose to swap the first and second image of the article, i.e. moving the image of a person to be the photo for the lead. Why? Because the image of the disease-causing agent says nothing to a lay person... They all look the same. OK, sick persons also all look similar but it would give it more of a human touch and perhaps more relevant for lay persons. Or has it been decided that for these medical articles, there shall always be an image of the disease causing agent in the lead? EMsmile (talk) 13:48, 14 September 2017 (UTC)

Sure done. Doc James (talk · contribs · email) 14:07, 19 September 2017 (UTC)

Lancet

Seminar doi:10.1016/S0140-6736(17)30559-7 JFW | T@lk 11:32, 24 September 2017 (UTC)

How much info about toilets, and finding more references on sanitation

User:Bio-CLC and others: I've just made some edits to the page as I felt we shouldn't single out particular dry toilet options (Arborloo, UDDT). I think mentioning dry toilets in general as an option should suffice? I think the image of a dry toilet in Haiti is good, given that cholera is a real issue there, but the caption was too long and detailed. That's what the wikilinks are for if people want to find more information. More images on toilet would be an overkill.EMsmile (talk) 13:31, 29 September 2017 (UTC)

And I think we need to track down more references that talk about how lack of sanitation has led to cholera or perhaps more importantly how improved sanitation has helped to curb and epidemic (and maybe even how dry toilets can play a particular role there). There is the famous case of a tanker by the UN dumping fecal sludge into the environment which lead to cholera in Haiti after the earthquake. If we could track down a reliable reference for that, that might be useful. EMsmile (talk) 13:31, 29 September 2017 (UTC)

I have added that famous picture of the UN tank dumping fecal sludge to the article now.EMsmile (talk) 13:41, 29 September 2017 (UTC)

Just to clarify on the references: we don't need a reference to explain what a dry toilet (or an Arborloo is); we would need a reference to show that certain types of dry toilets have proven instrumental in curbing a cholera outbreak, or that it is government policy somewhere to use certain types of sanitation sytems during cholera risky times, such as floods. I am sure they exist, we just need to hunt them down. Sometimes, the health sector and the sanitation sector operate in total isolation from each other though...EMsmile (talk) 13:41, 29 September 2017 (UTC)

User:Bio-CLC I don't think the caption that goes with that photo from Haiti needs to be overly lengthy which is why I have shortened this "This is also called container-based sanitation, as buckets of feces and cover material are taken to a central composting facility." It is also not true that for all CBS, these buckets are taken to a central composting facility which is what your proposed caption implies. I really don't see a need to go into detail here regarding these kinds of toilets. Please remember, this article is about cholera and if people want to know more about these toilets, they can click on the wikilinks provided! EMsmile (talk) 00:13, 4 October 2017 (UTC)

OK, I will cut CBS out entirely here for simplicity. Is there a rule on how long captions can be? I was going to explain why I reverted but I did not see where to say that. Bio-CLC (talk) 00:24, 4 October 2017 (UTC)

A guide value is 3 lines for the caption, see here: WP:CAPTION. I have made a new suggestion, hopefully finding a good compromise between being succinct but still very briefly explaining the relevance of the image for the article. - About reverting an edit, there is normally always an edit summary field when you revert something, did you check towards the bottom of the page? It's super important to give an explanation for reverting. Better than reverting is always to try out an alternative wording to see if both people can reach a consensus as both have probably thought long and hard about their edits. EMsmile (talk) 10:06, 4 October 2017 (UTC)

Making the connection between AMR and toilets

User:Bio-CLC , you asked why I removed this which you had added: "and growing resistance of this bacterium to chemicals". I had explained that in the edit summary as follows: " I split the long sentence into two so that the references can go at the end of the sentence. The point about antimicrobial resistance is not central to the argument here (also the reference was too specific to SA).". The bottom line is that we are working here on a Wikipedia article from the medical field. This means we need to stick to their very high standards for referencing. Your reference is about "in a rural community of the Eastern Cape Province of South Africa" - which doesn't make for a good reference about a general point on antimicrobial resistance. See WP:MEDRS. Also this is a great video which explains it really well: * Click on the thumbnail picture to the right to see a July 2017 video made by WikiProject Medicine. It describes how to edit articles for medical content, including how to cite sources correctly.

A video on "How to edit Wikipedia, for medical students", July 2017

In my opinion you have fallen into the trap of this: Citation needs to truly supports content. • Source 1 says A leads to B • Source 2 says B leads to C • Now we say A leads to C. • This is prohibited. You instead need to find a source that says A leads to C.

By the way, how about heading across to the article on antimicrobial resistance and starting a conversation on the talk page there how sanitation can better be included there? It is sorely missing! Again we need good references though, not just our own logic. EMsmile (talk) 13:59, 4 October 2017 (UTC)

Image for mechanism

I think this image would be of use in the mechanism section. Perhaps someone could also make a better description of the figure than the one I provided?

The role of biofilm in the intestinal colonization of Vibrio cholera

Mv2421 (talk) 19:16, 28 October 2017 (UTC)

Done Doc James (talk · contribs · email) 20:53, 28 October 2017 (UTC)

References

Semi-protected edit request on 12 December 2017

Countries affected by cholera (red-2006, yellow-previous to that).

Unambiguous: Remove the "countries affected by cholera" map under Epidemiology.

Rationale: The "Countries affected by cholera" map in Epidemiology is OUTRAGEOUSLY factually incorrect, I have no idea how or where anyone made this map. For instance: Haiti is missing? There are also tons of other countries which have had Cholera outbreaks recently but which have not had any/many recent cases in the past couple years (e.g. Cuba). The data are also VERY suspect -- you are telling me that Venezuela, Colombia, Guatemala and Brazil are affected by cholera, but Panama, Costa Rica, and Nicaragua are not? A two second google search can tell me that cholera has been in all of these countries in the past decades, although it is not common in any of them.

The map as-is is totally useless and massively incorrect and misleading. Please delete, or replace with a map showing incidence percentages or something actually useful, like most other diseases have.

Also a "countrywide" map is kind of bizarre, e.g. I doubt Beijing has much of a problem with cholera (though what do I know), although of course getting more granular data is very difficult. 2001:67C:10EC:4AC2:8000:0:0:15 (talk) 20:27, 12 December 2017 (UTC)

The map is an image that was uploaded to Wikimedia Commons, and it looks like it has not been updated since October 2006. I can see your reasoning, but from a technical standpoint we can't do anything about that map from the English Wikipedia; someone would have to change the file on Commons. I'll leave this request open here in case anyone is inclined to simply remove the map from the article. —KuyaBriBri<sup>Talk</sup> 20:54, 12 December 2017 (UTC)

@2001:67C:10EC:4AC2:8000:0:0:15 and Kuyabribri:  Removed. One issue with maps like these is that, other than making an article look colorful and nifty, they don't really accomplish anything. Is anybody actually learning this information by looking at the little map and seeing which (unlabeled) countries are red, yellow, and gray? As opposed to, you know, just reading the article? The request here doesn't have the sourcing we prefer but, for that matter, neither does the map. This is still obviously a valid enough collection of concerns that I just deleted the map because even creating an updated version could cause this same problem in 11 years. CityOfSilver 00:16, 13 December 2017 (UTC)

The maps gives a quick overview of where the disease used to occur and were it was occurring in 2006. Have restored and will clarify. Doc James (talk · contribs · email) 05:20, 13 December 2017 (UTC)

@Doc James: Like anybody, I don't like getting reverted, but if someone shows me how I was wrong, that's fine. But your edit summaries, "Disagree" and "adjusted," were so insubstantial you might as well have left them blank. This map has no value because it's extremely outdated, it paints cholera epidemics with such a broad brush even though diseases don't respect international boundaries, adding the year doesn't respond to the most obvious reasons for removing an obsolete, inaccurate graphic, and it's worthless as a reference for a reader anyway. I'm just restating what the anonymous editor and I have already said but your explanation for restoring is making me wonder if you read any of the other messages here. CityOfSilver 05:45, 13 December 2017 (UTC)

Here we have a map from 2010-2011 by WHO.[10]

And here is an even better one updated to 2014.[11]

Sure the prior map was a little out of date. Would be useful if someone updates it. Doc James (talk · contribs · email) 06:00, 13 December 2017 (UTC)

@CityOfSilver: Ah found the most recent version from 2016.[12] Which in many respects is similar to the 2006 one we have. Main difference is South America is doing well. Africa and Asia still struggling. Doc James (talk · contribs · email) 06:03, 13 December 2017 (UTC)

Thready??

Is this a typo or does the word thready exist? If yes, what does it mean? Wiki-link it? It says "peripheral pulse is rapid and thready". EMsmile (talk) 18:52, 20 December 2017 (UTC)

EMsmile Thready in this case, is used as: (of a sound, especially the voice) scarcely audible. --Builder8360 (talk) 19:15, 22 December 2017 (UTC)

Thanks. Could we therefore replace it with "scarcely audible" as most laypersons would not know what "thready" stands for? EMsmile (talk) 23:10, 22 December 2017 (UTC)

References in "Prevention" Section

Here's a list of references that might help:

"Cloth filters or sari filtration, though very basic, have significantly reduced the occurrence of cholera when used in poor villages in Bangladesh that rely on untreated surface water" — Preceding unsigned comment added by Exasper8dCabbage (talk • contribs) 19:24, 31 January 2018 (UTC)

References

Additional mode of transmission, cannot do the edit myself (plus an awesome source that should be summarized further)

I think we should add this paragraph under the Cause->Transmission subheading, before the paragraph that starts with "Both toxic and non-toxic strains exist." What do you think? I do not have enough edits under my belt yet to do this myself! Can someone do this for me? Thanks!

Paragraph to be added:

V. cholerae also exists outside the human body in natural water sources, either by itself or through interacting with phytoplankton, zooplankton, or biotic and abiotic detritus. Drinking such water can also result in the disease, even without prior contamination through fecal matter. Selective pressures exist however in the aquatic environment that may reduce the virulence of V. Cholerae. Specifically, animal models indicate that the transcriptional profile of the pathogen changes as it prepares to enter an aquatic environment. This transcriptional change results in a loss of ability of V. cholerae to be cultured on standard media, a phenotype referred to as 'viable but non-culturable' (VBNC) or more conservatively 'active but non-culturable' (ABNC). One study indicates that the culturability of V. cholerae drops 98% within 24 hours of entering the water, and furthermore that this loss in culturability is associated with a loss in virulence.

Notes:

I did not do follow-through citations (if you see the journal article for the first sentence you will know what I mean). Is there a policy on that? Trying to 'be bold' with my edits but also don't have the time for that!

Also, like the title suggests, I think the 2009 Nelson source has more information that could be incorporated into this article, if someone had the time to go through and do that.

Ylok (talk) 23:41, 25 February 2018 (UTC)

User:Ylok done per here. Doc James (talk · contribs · email) 09:03, 26 February 2018 (UTC)

Doc James Thank you. Ylok (talk) 00:31, 27 February 2018 (UTC)

No worries. Thanks for joining us :-) You will become a confirmed editor shortly. Doc James (talk · contribs · email) 12:11, 27 February 2018 (UTC)

(: Ylok (talk) 01:04, 8 March 2018 (UTC)

References

Big difference in timelines

There is a big difference in timelines between the history section of this article, and the individual articles that are wikilinked. It is hard for me to tell which set of dates is right because I don't have access to the references, and also I think someone needs to judge which references are more reliable. LaurentianShield (talk) 19:46, 18 December 2017 (UTC)

Just to give one example: in the Cholera article, the "third" epidemic is said to have been from 1839–56, but the wikilinked article 1852–60 cholera pandemic (redirected from Third cholera pandemic says it was 1852–60. LaurentianShield (talk) 16:13, 29 December 2017 (UTC)

Agreed this was messed up. Rather than doing the audit, it seems more likely we'll highlight any potential problems by making the set of articles consistent with one another. I copied a lot of the prose out of Cholera into the introduction of Cholera outbreaks and pandemics, only to realize that the years were different. Hopefully, if there are mistakes in the current version, an expert is more likely to notice. RobLa (talk) 03:55, 4 April 2018 (UTC)

In fiction

There are a number of important books that could be mentioned in a separate section: Camus: La Peste, Mann: TOd in Venedig, and I just read a short report by Bram Stoker's mother about cholera in Ireland. — Preceding unsigned comment added by Cosine12 (talk • contribs) 00:08, 26 March 2020 (UTC)