Evaluation and use of surveillance system data toward the identification of high-risk areas for potential cholera vaccination: a case study from Niger.

In 2008, Africa accounted for 94% of the cholera cases reported worldwide. Although the World Health Organization currently recommends the oral cholera vaccine in endemic areas for high-risk populations, its use in Sub-Saharan Africa has been limited. Here, we provide the principal results of an evaluation of the cholera surveillance system in the region of Maradi in Niger and an analysis of its data towards identifying high-risk areas for cholera

WHAT YOU SHOULD KNOW ABOUT HOG CHOLERA

I. WHAT IS HOG CHOLERA? Hog cholera is a deadly, contagious disease that attacks swine only. The disease is caused by hog cholera virus, an agent so small (1/250,000 of an inch) that it can even pass through a fine porcelain filter. How do hogs act when they get the disease? They lie around hiding in their nest, have high fevers, are extremely weak and sick all over. They have little appetite, and often stand in a thinking attitude-motionless, tail relaxed, ears hanging limp, and the head slightly lowered as if in deep thought. Very few hogs ever recover. II. How IMPORTANT Is HOG CHOLERA? Hog cholera is the most important disease of hogs in the United States today. Farmers lose millions of dollars worth of hogs from cholera each year. And the expense of annually vaccinating millions of hogs costs even more. Many foreign markets are closed to pork from the United States because of the fear of importing hog cholera. The disease is important enough so that both state and federal governments have enacted regulatory measures and classed it as a reportable disease. In addition, the United States Congress has authorized the Secretary of Agriculture to enter into a marketing agreement with the hog cholera serum-virus industry. The original act was intended to provide that there should always be enough anti-hog cholera serum on hand to safeguard against sudden widespread outbreaks of the disease. Nevertheless, stocks of antiserum are being reduced every year

Elevation and cholera: an epidemiological spatial analysis of the cholera epidemic in Harare, Zimbabwe, 2008-2009

BACKGROUND: In highly populated African urban areas where access to clean water is a challenge, water source contamination is one of the most cited risk factors in a cholera epidemic. During the rainy season, where there is either no sewage disposal or working sewer system, runoff of rains follows the slopes and gets into the lower parts of towns where shallow wells could easily become contaminated by excretes. In cholera endemic areas, spatial information about topographical elevation could help to guide preventive interventions. This study aims to analyze the association between topographic elevation and the distribution of cholera cases in Harare during the cholera epidemic in 2008 and 2009. METHODS: We developed an ecological study using secondary data. First, we described attack rates by suburb and then calculated rate ratios using whole Harare as reference. We illustrated the average elevation and cholera cases by suburbs using geographical information. Finally, we estimated a generalized linear mixed model (under the assumption of a Poisson distribution) with an Empirical Bayesian approach to model the relation between the risk of cholera and the elevation in meters in Harare. We used a random intercept to allow for spatial correlation of neighboring suburbs. RESULTS: This study identifies a spatial pattern of the distribution of cholera cases in the Harare epidemic, characterized by a lower cholera risk in the highest elevation suburbs of Harare. The generalized linear mixed model showed that for each 100 meters of increase in the topographical elevation, the cholera risk was 30% lower with a rate ratio of 0.70 (95% confidence interval=0.66-0.76). Sensitivity analysis confirmed the risk reduction with an overall estimate of the rate ratio between 20% and 40%. CONCLUSION: This study highlights the importance of considering topographical elevation as a geographical and environmental risk factor in order to plan cholera preventive activities linked with water and sanitation in endemic areas. Furthermore, elevation information, among other risk factors, could help to spatially orientate cholera control interventions during an epidemic

Cholera revolts: a class struggle we may not like

Few have studied cholera revolts comparatively, and certainly not over the vast terrain from Asiatic Russia to Quebec or across time from the first European cholera wave of the 1830s to the twentieth century. Scholars have instead concentrated on the first European cholera wave in the 1830s and have tended to explain cholera’s social violence within the political contexts of individual nations, despite these riots raging across vast differences in political landscapes from Czarist Russia to New York City but with similar fears and conspiracy theories of elites inventing cholera to cull populations of the poor. Moreover, the history of cholera’s social toxins runs against present generalizations on why epidemics spawn blame and violence against others. Cholera riots continued, and in Italy and Russia became geographically more widespread, vicious, and destructive long after the disease had lost its mystery. The article then poses the question of why historians on the left have not studied the class struggles provoked by cholera, with riots of 10,000, murdering state officials and doctors, destroying hospitals, town halls, and in the case of Donetsk, an entire city. Finally, the article draws parallels between Europe’s cholera experiences and those in West Africa with Ebola in 2014

Predictive Modeling of Cholera Outbreaks in Bangladesh

Despite seasonal cholera outbreaks in Bangladesh, little is known about the relationship between environmental conditions and cholera cases. We seek to develop a predictive model for cholera outbreaks in Bangladesh based on environmental predictors. To do this, we estimate the contribution of environmental variables, such as water depth and water temperature, to cholera outbreaks in the context of a disease transmission model. We implement a method which simultaneously accounts for disease dynamics and environmental variables in a Susceptible-Infected-Recovered-Susceptible (SIRS) model. The entire system is treated as a continuous-time hidden Markov model, where the hidden Markov states are the numbers of people who are susceptible, infected, or recovered at each time point, and the observed states are the numbers of cholera cases reported. We use a Bayesian framework to fit this hidden SIRS model, implementing particle Markov chain Monte Carlo methods to sample from the posterior distribution of the environmental and transmission parameters given the observed data. We test this method using both simulation and data from Mathbaria, Bangladesh. Parameter estimates are used to make short-term predictions that capture the formation and decline of epidemic peaks. We demonstrate that our model can successfully predict an increase in the number of infected individuals in the population weeks before the observed number of cholera cases increases, which could allow for early notification of an epidemic and timely allocation of resources.Comment: 43 pages, including appendices, 5 figures, 1 table in the main tex

The study of cholera and Max von Pettenkofer`s visit to Malta in 1868

An "eminent natural philosopher", Dr. Max Pettenkofer, came to Malta to study the manifestations of cholera in the Island. It appears that what prompted Pettenkofer to come to Malta was the fact that the cholera epidemics of Gibraltar and of Malta had been closely followed and discussed in Munich, and his opponents had quoted these two places as illustrations of the fallacies of his soil-moisture theory. The gist of his study is that a scanty rainfall in the first five months of the year predisposed the Island to cholera epidemics but an abundant rainfall during the same period diminishes considerably the chances of cholera outbreaks on a large scale. Pettenkofer's speculations met with some opposition in Malta, particularly by Dr. A. Ghio and also by the most outspoken critic Dr. Gavino Gulia, Professor of Forensic Medicine and Natural History at our University. Dr. Gulia was convinced of the infectiousness of cholera and in support of his stand he reported the death of a follower of Pettenkofer, a Dr. Obermeyer. The latter had carried some post-mortem specimens and faeces from choleric patients to his bedroom for microscopical examination when he was attacked by the illness.peer-reviewe

The Health Impacts of Climate Change: A Study of Cholera in Tanzania

Increased temperatures and changes in patterns of rainfall as a result of climate change are widely recognized to entail serious consequences for human health, including the risk of diarrheal diseases. Indeed, there is strong evidence that temperature and rainfall patterns affect the disease pattern. This paper presents the first study that links the incidence of cholera to environmental and socioeconomic factors and uses that relationship to predict how climate change will affect the incidence of cholera. Specifically, the paper integrates historical data on temperature and rainfall with the burden of disease from cholera in Tanzania, and uses socioeconomic data to control for impacts of general development on the risk of cholera. Based on these results we estimate the number and costs of additional cholera cases and deaths that can be attributed to climate change by year 2030 in Tanzania. The analyses are based on primary data collected from the Ministry of Health, Tanzania, and the Tanzania Meteorological Agency. The result shows a significant relationship between cholera cases and temperature and predicts an increase in the initial risk ratio for cholera in Tanzania in the range of 23 to 51 percent for a 1 degree Celsius increase in annual mean temperature. The cost of reactive adaptation to cholera attributed to climate change impacts by year 2030 in Tanzania is projected to be in the range of 0.02 to 0.09 percent of GDP for the lower and upper bounds respectively. Total costs, including loss of lives are estimated in the range of 1.4 to 7.8 percent of GDP by year 2030. Lastly, costs of additional cholera cases and deaths attributed to climate change impacts in Tanzania by the year 2030 largely exceed the costs of preventive measures such as household chlorination.climate change,health impacts,adaptation costs,Tanzania

Building the bastard : confidence through preparation in Shakespeare\u27s King Lear.

This thesis is to chart my discovery that confidence is essential to an actor’s craft. This thesis focuses on my performance as Edmund in King Lear, as well as my production the previous summer playing Hussein in Ayad Akhtar’s Disgraced. I draw from a variety of sources, such as meditation and formal acting exercises, to achieve confidence. Most importantly, I distill my missteps as an actor for a better understanding of what hinders confidence when building a role for performance