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Lambeth 26,107 98 37
Cholera in the 1990s
Epidemic in Peru beginning 1991
From 1991-1994
Cases 1,041,422
Deaths 9,642 (0.9%)
Originated at coast, spread inland
World Cholera 2000-01
Why Has Cholera Re-emerged?
Deteriorating sanitary facilities as
larger population moves into shanty
towns
Trujullo, Peru fear of cancer from
chlorination so water untreated
Use of wastewater on crops
Africa civil wars and drought
caused migrations into camps
How Has Cholera
Re-emerged?
Simultaneous appearance along
whole coast of Peru
Traveled in ship ballast?
Traveled in plankton from Asia?
Always present in local zooplankton
(copepods) but dormant until
triggered by ???
Copepod Carrying Vibrio
cholerae
Cholera and El Nio
Periodic warming of water near
coast of Central and South America
Large plankton blooms, especially
in coastal waters with nutrients
from sewage runoff
Cholera and El Nio
Cholera in Bangladesh also seen to
fluctuate with El Nio, but with 11
month lag
Rita Colwell and multinational
group studying link between climate
and cholera
Satellite and surface data used to
show cholera incidence is related to
sea surface temperature
Cholera from Space
Cholera and Sea Surface
Temperature
Cholera in the 1990s
Cholera O139 emerges in Asia
Different O (coat) antigen, 99%
genetic identity
O antigen is how human immune
system recognizes and protects
against V. cholerae
More people susceptible
Cholera Antibiotic
Resistance
Cholera is
becoming
resistant to
several
antibiotics