History of Cholera: Outbreaks & Timeline

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

Did you know diarrhea can be deadly? This lesson will briefly describe cholera, where you'll learn about its history, such as its major outbreaks and the major figures that played a role in its discovery.

What Is Cholera?

We've all had bouts of diarrhea. Yes, even if we don't like admitting it. Most of the time, we ran to the toilet 2-3 times or for 2-3 days, and then things just kind of went back to normal. But did you know that a bout of diarrhea can be deadly? Yep, it can be when it's a diarrheal illness called cholera, caused by the bacterium Vibrio cholerae.

Vibrio cholerae

Cholera is actually an ancient problem, and that's what this lesson is all about: the history of cholera.

Early History

There is some evidence that points to outbreaks of cholera in the ancient world. The father of modern medicine, an ancient Greek physician called Hippocrates (c. 400 BCE), makes mention of it. Hippocrates heavily influenced a later Roman physician of Greek descent called Galen (c. 200 CE). He too described an illness that many presume was an outbreak of cholera. But cholera wasn't just a European problem. Reports of this illness have also been around in India since antiquity.

Recent History

The First Pandemic

Most of what we know about the history of cholera, however, comes to us from the 19th century onwards. In 1817, cholera caused a very lethal outbreak in India, which then spread to Myanmar, Bangladesh, and Sri Lanka. Three years later, an outbreak was reported in Thailand, Indonesia, and the Philippines. Over 100,000 people died as a result of the outbreak on the island of Java (Indonesia). A year later, in 1821, Iraq experienced an outbreak of cholera that killed 18,000 people over three weeks in a city called Basra. This outbreak spread through Turkey and to the Mediterranean Sea.

The Second Pandemic

But it wasn't until 1829 that another serious outbreak of cholera reached all the way into Europe and the Americas. Cholera emerged in the major cities of Russia, Moscow and St. Petersburg, and spread to Finland and Poland along various trade routes. Using these routes, it made its way to Germany and England. By 1832, cholera had spread to Canada and the United States, where 5,000 people died in New Orleans alone. The outbreak continued to spread south to Mexico and Cuba from there.

This person is severely dehydrated as a result of cholera.

The Third Pandemic

While the first two major outbreaks — technically, pandemics — were devastating, the third outbreak was the deadliest. It began in India in 1852 and spread quickly through the Middle East, Europe, Africa, the U.S., reaching the entire world. 23,000 people died in Great Britain alone in 1854. English physician John Snow was able to prove that the outbreak of cholera in London in 1854 was coming from contaminated water. The outbreak was contained when the water pump he identified as the source of the outbreak was effectively shut down.

John Snow

The Fourth-Seventh Pandemics

Cholera again reared its ugly head in 1863 and then 1881 throughout the world. As a result, hundreds of thousands of people died throughout Spain, Russia, China, and Japan. It was around this time that German bacteriologist Robert Koch identified Vibrio cholerae as the causative agent of cholera itself, although he was apparently unaware that Italian microbiologist Filippo Pacini had done the same thing in 1854.

The sixth outbreak lasted from 1899 until 1923 and was particularly bad in India, Egypt, and Russia. It wasn't until 1961 that the seventh pandemic began. While the prior pandemics began in the Indian subcontinent, this one actually started in Indonesia. It was particularly devastating to people in Africa. Problems with cholera continue to this day as more and more confined or country-specific outbreaks have occurred in places like Zimbabwe in 2008-2009 and even in the United Republic of Tanzania as recently as 2016.

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