Cholera's Deadly Impact In Azerbaijan: A Grim Count

Cholera is a waterborne disease caused by the bacterium Vibrio cholerae, which is an autochthonous member of the aquatic environment. It is predominantly reported in developing countries and has been detected in environmental waters, including drinking water reservoirs, in Azerbaijan. Cholera is a life-threatening disease that can cause voluminous and watery diarrhoea and vomiting. It can kill within hours if left untreated, and it is transmitted through contaminated food or water.

The occurrence of cholera in Azerbaijan has been linked to the presence of V. cholerae in the environment, particularly in warmer summer months when the water temperature is optimal for the growth of the bacterium. The seasonality of cholera cases in the country suggests a correlation between the increase in air temperature and the incidence of the disease, with peaks occurring during warmer months.

While the exact number of cholera-related deaths in Azerbaijan is unknown, the disease has historically caused high mortality rates worldwide.

Cholera is a waterborne disease caused by the bacterium Vibrio cholerae

The disease is transmitted through the faecal-oral route, with infection occurring when contaminated water or food is ingested. It can also be spread through skin contact with contaminated human faeces. Cholera is most likely to be found and spread in places with inadequate water treatment, poor sanitation, and inadequate hygiene.

The Vibrio cholerae bacterium was first described by Félix-Archimède Pouchet in 1849 and was correctly identified as a bacterium by Filippo Pacini. The bacterium was confirmed as the cause of cholera by Robert Koch in 1884, and the cholera toxin was isolated by Sambhu Nath De in 1959.

Cholera can cause severe diarrhoea, vomiting, and dehydration, which can lead to death if left untreated. It is a fast-developing and highly contagious disease, but it is relatively easy to cure and prevent. Early and proper treatment is essential, and oral rehydration therapy is the mainstay of treatment. Antibiotics are also used in some cases.

The World Health Organization estimates that there are 1.3 to 4 million cases of cholera worldwide each year, with 21,000 to 143,000 deaths. However, the true number of deaths is likely higher, as many cases go unreported or undiagnosed.

Cholera has been a significant public health concern and has caused several pandemics throughout history. Improving access to clean water, sanitation, and hygiene practices are crucial in preventing the spread of cholera.

The disease is transmitted through contaminated water and food

Cholera is a highly contagious and often fatal disease that is transmitted through the ingestion of contaminated food or water. It is caused by the bacterium Vibrio cholerae, which is typically found in water or food that has been contaminated by human faeces.

In Azerbaijan, the presence of Vibrio cholerae in drinking water reservoirs and other environmental waters poses a significant health risk to the population. The limited and insufficient treatment of water in the country, coupled with the contamination of water sources, increases the likelihood of cholera transmission.

Cholera is often spread through contaminated water sources, such as rivers, lakes, or reservoirs that are used for drinking water. Inadequate sanitation and sewage disposal systems can allow human faeces containing Vibrio cholerae to contaminate these water sources. When people drink water from these sources, they ingest the bacteria, leading to infection. This was particularly evident during the second cholera pandemic (1826-1837), where cholera spread across Western Asia, Europe, and the Americas through contaminated river waters.

In Azerbaijan, the detection of Vibrio cholerae in drinking water reservoirs is a concerning issue. The country's water treatment infrastructure faces challenges due to outdated facilities and a lack of necessary chemicals for effective disinfection, such as chlorine. As a result, the water supplied to households may still contain harmful bacteria, including Vibrio cholerae.

The consumption of contaminated water is a significant risk factor for cholera transmission. When individuals ingest water contaminated with Vibrio cholerae, the bacteria can colonise their intestines and cause an infection. This is especially true in areas with limited access to safe drinking water and basic sanitation facilities, such as peri-urban slums or refugee camps.

Not only does contaminated water pose a risk, but food can also be a vehicle for cholera transmission. Consuming food that has been washed, irrigated, or prepared with contaminated water can introduce Vibrio cholerae into the body. This is of particular concern in areas where sanitation and hygiene practices are inadequate, and where food safety standards may not be strictly enforced.

To prevent the spread of cholera, it is crucial to ensure access to safe drinking water and to improve sanitation and hygiene practices. This includes treating water sources effectively, maintaining water distribution systems, and promoting proper food handling and storage practices to break the chain of infection.

By addressing these issues, the risk of cholera transmission through contaminated water and food can be significantly reduced, protecting the health and well-being of communities in Azerbaijan and beyond.

The second cholera pandemic (1826–1837) spread from India to Europe, Great Britain, and the Americas

The second cholera pandemic (1826–1837), also known as the Asiatic cholera pandemic, was a defining epidemic disease of the 19th century. It caused more deaths than any other epidemic disease during that time. The pandemic originated in India, spreading across Western Asia to Europe, Great Britain, and the Americas, as well as east to China and Japan.

The first cholera pandemic (1817–1824) began near Kolkata, India, and spread throughout Southeast Asia to the Middle East, eastern Africa, and the Mediterranean coast. However, the second pandemic had a broader reach, affecting more countries in Asia, Europe, and North America. This was due to advancements in transportation and global trade, as well as increased human migration, including soldiers.

The second cholera pandemic is believed to have begun with outbreaks along the Ganges Delta in India, similar to the first pandemic. From there, the disease spread along trade routes to cover most of India. By 1828, it had travelled to China, and by 1829, it had reached the southern tips of the Ural Mountains in Russia. The epidemic then spread from Russia to the rest of Europe, with Russian soldiers bringing it to Poland in February 1831.

The second pandemic claimed hundreds of thousands of lives across Europe. In Russia, there were 250,000 cases of cholera and 100,000 deaths. In Hungary, up to 100,000 deaths occurred in 1831, while in Warsaw, 4,734 people fell ill and 2,524 died during the November Uprising. The epidemic also struck Great Britain in 1831, with 6,536 victims in London and 20,000 in Paris, out of a population of 650,000. It then spread to North America, reaching Quebec, Ontario, and Nova Scotia in Canada, as well as Detroit and New York City in the United States by 1832.

The scientific community's understanding of the causes of cholera varied during the second pandemic. In France, doctors associated cholera with the poverty of certain communities or poor environments. Russians believed the disease was contagious but did not understand its mode of transmission. The United States believed cholera was brought by Irish immigrants, while epidemiologists now understand that they were carrying the disease from British ports. Lastly, the British thought the disease might be a result of divine intervention.

Cholera is a disease of poverty, affecting people with inadequate access to safe water and basic sanitation

Cholera is a highly contagious disease that can cause diarrhoea, dehydration, and death. It is easily treatable and can be prevented with good sanitation and hygiene practices. However, rapid treatment is essential, as cholera can cause death within hours if left untreated.

The World Health Organization (WHO) estimates that there are 1.3 to 4 million cases of cholera and 21,000 to 143,000 deaths worldwide each year. The true number of deaths is likely higher, as many cases go unrecorded due to limitations in surveillance systems and fear of impact on trade and tourism.

Cholera outbreaks have occurred in Azerbaijan, where Vibrio cholerae has been detected in environmental waters, including drinking water reservoirs. The presence of V. cholerae in these water sources poses a potential health risk to the population due to the limited and insufficient treatment of water in the country.

Inadequate water treatment and sanitation infrastructure, as well as contaminated surface water, contribute to the risk of cholera outbreaks. Climate conditions, such as warmer temperatures during the summer months, also influence the detection of V. cholerae.

To reduce the risk of cholera, it is crucial to ensure access to safe drinking water and basic sanitation, improve hygiene practices, and promote health education. These measures are particularly important in areas with inadequate water and sanitation infrastructure, where the risk of cholera and other waterborne diseases is heightened.

The occurrence of cholera in Azerbaijan is linked to the presence of Vibrio cholerae in the country's drinking water reservoirs

Cholera is a waterborne disease caused by the bacterium Vibrio cholerae, which is an autochthonous member of the aquatic environment. The occurrence of cholera in Azerbaijan has been linked to the presence of Vibrio cholerae in the country's drinking water reservoirs.

Azerbaijan has historically experienced cholera during every pandemic since 1816. The first report of the presence of V. cholerae in the surface waters of Azerbaijan was published in 2013, which also highlighted its presence in drinking water reservoirs. This poses a potential health risk to the population due to the limited and insufficient treatment of water in the country.

The study found that the presence of V. cholerae in the warmer summer months was higher relative to the colder winter months. The optimal water temperature for the growth of V. cholerae in the Caspian Sea was significantly associated with the detection of the bacteria. The detection of V. cholerae in these water reservoirs, which serve as the source of municipal drinking water, underscores the importance of routine monitoring of environmental waters, especially drinking water reservoirs, to ensure public health safety.

The seasonality of cholera incidence in Azerbaijan is distinct, with increased occurrence during the warmer months. Technical reports and proceedings reviewed showed that with each increase in air temperature, V. cholerae could be isolated 6-8 weeks later, and the incidence of cholera peaked when the air temperature reached >25°C in September.

Frequently asked questions