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Cholera is a disease that causes a lot of public health concern in many developing countries.

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Epidemiology of Cholera

Abstract

The study of diseases in populations is referred to as epidemiology. Public health specialists like epidemiologists who are involved in preventive medicine use epidemiological methods to detect the outbreak, risk factors and spread of diseases like cholera. With knowledge acquired from the risk factors, public health specialists can use it to further carry out research investigations and implement measures on how to control the disease. The bacteria causing cholera, Vibrio cholerae can mutate to become resistant to the antibiotics used to treat cholera. On mutating, controlling the bacteria is difficult as new drugs have to be generated to be able to control them again. With manufacturing of new drugs and interventions by public health specialist to create awareness to the public on the importance of drinking clean water and maintaining high hygiene standards, this illness can be controlled (Hinman, 2016).Thus, all these measures will enable the combating of cholera majorly in developing countries when well adhered to.

Introduction

Cholera is a disease that causes a lot of public health concern in many developing countries. It can be ranked as an emerging and re-emerging disease in countries that are still developing.The illness is caused by toxigenic strains of bacteria known as Vibrio cholerae that causes an acute diarrheal sickness. For many decades, cholera has claimed an approximate of 120,000 individuals annually throughout the globe(Morens, 2013). The epidemiology of this disease has been characterized by various key principles like; most cases of cholera are concentrated in specific areas in specific seasons, infection rates are usually high in children aged between 1 to 5 years and the resistance to antibiotics most of the time change from year to year. Due to this, it has been an epidemiologist subject of concern for many centuries. By putting a lot of time in studying the disease, it has helped to develop new epidemiological ways that have led to the understanding of cholera's transmission and also in developing the science of infectious disease epidemiology. The father of epidemiology, John Snow, came up with a way to trace back the source of cholera to drinking contaminated water. It was because of this information, he was able to come up with preventive measures and cures for the illness(Morens, 2013). With further studies in 1883, Robert Koch discovered that the causative agent of cholera was a c-shaped bacillus that lived in water.Therefore, for in-depth understanding of cholera, we have to understand the methods used to collect data so that we can come up with accurate conclusions about the epidemiology of cholera.

Purpose

Since cholera is an endemic disease in most parts of the globe, there has to be an awareness of the disease concerning its spread, prevention and treatment. This should be done in areas that are prone to the out break of the disease because most people affected are not well educated on its effects. The disease is capable o f killing a person in a matter of few hour if left unchecked. Researches have indicated on their studies that, annually the world health organization gets an estimate of 1.3 to 4.0 million cases of cholera(Bespalova et al., 2018). The numbers estimated above are very alarming and without quick action the disease can be difficult to treat and control because of the changing nature of the bacterium. With enough information to the public, their health status will be protected and therefore avoiding serve cases of this illness.

Various methods have been implemented to prevent the occurrence of cholera. This includes providing clean and safe water to the public, administering vaccines which also act as preventive measures among other measures. With these objectives laid out to the public, people will be well aware of what they should always do to prevent the outbreaks of this illness.

Methodology

In order to achieve the objective of the research, I had to use secondary data sources to attain these objectives. The data used here mainly originated from other researchers who did research on this illness. Additionally, some of the data used might have been used to solve other problem other than the problem that I am tackling. The data is both qualitative and quantitative and because it is secondary, it can be located easily, quickly and at affordable costs. Both the qualitative and quantitative data gave deep insight on the epidemiology of cholera. For instance, qualitative data gave me the number of individuals that are infected with cholera each year. Also, it highlighted me on the number of people that die annually because of unattended cholera cases globally. On the other hand, qualitative data through the work of other individuals such as John Snow and Robert Koch, I was able to understand what means cholera was spread from individual to another and what caused it.

The data gathered enlighten me on some of the lifestyles people live that made them to be susceptible to this disease. With this data at hand, I was able to know what methods people used to treat their water before drinking and how they disposed their waste. All this information enabled me to formulate the purpose for the research to raise awareness about cholera.

Epidemiology

There have been seven pandemics of cholera ever since it begun in 1817. With the seventh pandemic excluded, the pandemics have occurred in India subcontinent and spread to other countries after a long period of time. Cholera has become a seasonal disease in endemic regions like South Asia having outbreaks that are explosive and may occur once or twice in an annum. From period to period, the pandemic wave of this disease has rolled across the globe causing a heavy death toll. Cholera outbreak has two unique features which are; it simultaneously appears in specific areas and when the outbreak occurs it is explosive in nature. Vibrio cholerae was thought to only affect human being until the 1970s. it was discovered that these bacteria could also live in the environment freely. The vast number of host that the bacteria were exposed to contributed to their success because they could obtain nutrients and nourish themselves(Savel'eva et al., 2018). Its is because of this that the bacteria cause an explosive spread of the disease when they strike because the disease can be transferred from both human to human and environment to human.

Give that bacteria could live freely in the environment, there was a shift in balance towards an environmental hypothesis. The hypothesis stated that the seasonal explosive outbreak of cholera was brought about by seasonal blooming of the aquaticVibrio cholerae. Seasonal blooming of aquaticVibrio choleraeleads to a lot of contamination of safe drinking water thus when contaminated without treatment individuals are vulnerable to cholera(Savel'eva et al., 2018). Cholera is usually a disease that indicate the lack of social development and thus it is a worldwide threat to the public health. Most of the developing world has a rapid population growth and with this comes low living standards for these individuals. The unsanitary conditions that they are exposed to makes them susceptible to cholera which keeps on emerging and re-emerging in these locations.

Each year, there is an approximate population of 1.3 to 4 million people that are infected with cholera throughout the entire globe. From this number, an approximate of 100,000 to 120,000 are said to die yearly because they are unattended to in time. When these numbers are looked at, they are not a real picture because there are many unreported cases to the World Health Organization because of limited health-care system(Bespalova et al., 2018). These numbers are very concerning and thus we have to take action really quick to manage this illness. Any public health action that is aimed at reducing the direct transmission of cholera will have a very big impact on the rate at which it spreads(Bae, 2017). In simple terms, any small measure taken to reduce the rate of fecal to oral transmission, will have a great impact. This can be as very simple as just washing hands before having a meal.

The moment these simple measures are employed, the public hygiene will be increased and thus be effective and efficient to reduce cholera transmission. Later on, when much permanent measures are put in place like sewage treatment, the occurrence of cholera would have been reduced greatly. Additionally, by controlling the environment to human transmission, it will be much easier to control human to human transmission by use of vaccination to prevent its occurrence. Even though all these causes of cholera can be controlled, the presence of hyper-infective state of cholera is not well understood by the public. Due to this, epidemiologist should put more time in researching it so that they can understand the prevalence of this state and mechanisms(Bespalova et al., 2018). With more studies put into it, we will be able to understand what the infective dosage of cholera is overtime. For the next near future, cholera will play a great role as a catalyst to bring to light new ideas about infectious diseases. The new ideas will help the public to protect its health by coming up with new effective and efficient ways to prevent, control and cure this illness.

Conclusion

John Snow's achieved his goals by logically organizing his remarks. His work has illuminated a lot of light to the current epidemiologist work in researching infectious diseases. It has been more than a century and a half since Dr. Snow published his findings on cholera. Despite all this time the epidemiologists and medical approaches to combat this illness have not been that fruitful. Cholera has remained a real threat to the public health globally and it has also indicated how social development in many developing countries is still staggering. The illness has continued to challenge the ever-increasing proportion of susceptible population that live unsanitary conditions like slums and refugee camps. The purification units and treatment centers that are installed throughout developing countries are just interim measures to control cholera. The steady decline in spread of cholera brought about by these measures should not be seen as victories. Thus, these governments should come up with more long-term solution to the spread of cholera.

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