Medicine:Timeline of cholera

From HandWiki

This is a timeline of cholera, a disease caused by the bacterium Vibrio cholerae.

Summary

Time period Key developments
5th century BC Cholera most likely originates in the subcontinent of India, where most of the cholera pandemics will later start.[1][2]
1816–1923 The first six cholera pandemics occurred consecutively and continuously over time. Increased commerce, migration, and pilgrimage are credited for its transmission.[3]
1879–1883 Major scientific breakthroughs towards the treatment of cholera develop: the first immunization by Pasteur, the development of the first cholera vaccine, and the identification of the bacterium Vibrio cholerae by Filippo Pacini and Robert Koch.
1945–1948 The World Health Organization (WHO) is founded.
1961 onwards After a long hiatus, the seventh major cholera outbreak occurs. Oral rehydration therapy is introduced in the late 1970s.[4]
Recent The seventh cholera pandemic continues, although on a smaller scale, with outbreaks across the developing world. Epidemics occur after war, civil unrest, or natural disasters, when water and food supplies become contaminated with Vibrio cholerae, and also due to crowded living conditions and poor sanitation.[5]

Full timeline

Year/Period Event type Event Present-day geographic location
460–377 BCE Scientific development Greek physician Hippocrates is considered the first to mention the term "cholera" in his writings, although the exact disease he refers to is unknown.[6][7] Greece
1563 Scientific development Cholera is first recorded in a medical report.[8] India
1817–1824 Epidemic The first cholera pandemic begins near Calcutta, reaching most of Asia. Estimated death toll is over 100,000 people.[9] India , Thailand, Philippines , Java, Oman, China , Japan , Persian Gulf, Iraq, Syria, Transcaucasia, Astrakhan (Russia ), Zanzibar, and Mauritius.
1819 Epidemic Cholera epidemic reaches the island of Java from Bengal.[10] Indonesia
1848 The Public Health Act 1848 establishes the first local boards of health in England and Wales. The boards would ensure proper drainage in homes and dependable water supplies.[11] England and Wales
1829–1851 Epidemic The second cholera pandemic, also known as the Asiatic Cholera Pandemic, starts, likely along the Ganges river. It is the first to reach Europe and North America. As previously, fatalities reach six figures.[9] India, western and eastern Asia, Europe, Americas.
1830-1831 Epidemic Cholera epidemics across Europe give rise to the Cholera Riots in Russia[12] and England.[13] Europe
1831 Scientific development Scottish physician William Brooke O'Shaughnessy notices that the composition for the stool water in cholera patients is very similar to that of their blood plasma. These values are found close to those of normal controls, except that the patients have markedly reduced water content. From this data, O'Shaughnessy suggests that replacing water with salt would be beneficial to them.[14] Great Britain
1832 Scientific development (treatment) Medical pioneer Thomas Latta develops the first intravenous saline drip.[15] Scotland (Leith)
1832 Epidemic Cholera claims 6,536 victims in London and 20,000 in Paris (out of a population of 650,000), and is responsible for about 100,000 deaths in France as a whole. The epidemic reaches Russia, Quebec, Ontario and New York in the same year. In Portugal, cholera is brought to Oporto on the boats that carry troops from Ostend to help the Liberal army during the Liberal Wars. From Oporto, cholera spreads throughout the country, and more than 40,000 people perish. It is calculated that cholera killed more people than the war itself.[16] Europe, North America
1851–1938 Organization Due to the cholera pandemics, the International Sanitary Conferences are held with the objective to standardize international quarantine regulations against the spread of cholera and other diseases.[17] Paris, Constantinople, Vienna, Washington, Rome, Venice, Dresden
1852–1860 Epidemic The third cholera pandemic starts along the Ganges delta. Millions are infected in Russia. The death toll reaches one million.[9] Asia, Europe, Africa and North America
1853 Epidemic Third cholera pandemic: The Copenhagen cholera outbreak kills almost 5,000 people in less than three months.[18] Denmark
1854 Scientific development Italian anatomist Filippo Pacini publishes his paper "Microscopical observations and pathological deductions on cholera" in which he describes his discovery of a microorganism which he names Vibrio, and its relation to cholera. Pacini becomes the first to isolate the cholera bacterium Vibrio cholerae.[19][20] Italy
1854 Epidemic The cholera epidemic reaches China, Japan; and Mauritius, where four outbreaks occur until 1862.[21] In London, the Broad Street cholera outbreak kills at least 500 people.[22] China, Japan, Mauritius, England
1854 Scientific development The first demonstration, performed by John Snow during an epidemic in London, that the transmission of cholera is significantly reduced when uncontaminated water is provided to the population.[5][8] England
1854 Organization Cholera Hospital is established. It is built to treat cholera patients who are denied admittance to City Hospital in Manhattan during cholera epidemics in the same year.[23][24] United States (New York City )
1856–1857 Epidemic Cholera is recorded in several parts of Central America and Guyana.[21] Central America, South America
1863–1875 Epidemic The fourth cholera pandemic starts, again in the Ganges delta.[9] Asia, Middle East, Russia, Europe, Africa and North America
1865 Epidemic Fourth cholera pandemic: The Mecca pilgrimage becomes the scene of a major epidemic. It is calculated that 30,000 deaths occur out of 90,000 pilgrims.[21] Saudi Arabia (Mecca)
1865–1866 Epidemic Fourth cholera pandemic: Cholera arrives again in the United States. Deplorable sanitary conditions prove favorable for the spread of the disease.[21] United States
1869 Epidemic Fourth cholera pandemic: About 70,000 people are reported dead in what is then called Zanzibar.[21] Tanzania
1879 Scientific development Louis Pasteur succeeds in immunizing chickens against cholera.[25] France
1881–1896 Epidemic The fifth cholera pandemic begins in India. It is the first to reach South America.[9] Asia, Africa, Russia, Europe, South America
1883 Scientific development The identification of the bacterium Vibrio cholerae by Robert Koch takes place. Although not the first description, the discovery of the cholera organism is credited to Koch, who independently identifies the bacterium during an outbreak in Egypt.[5]
1885 Scientific development (drug) Spanish physician Jaume Ferran i Clua develops a cholera vaccine, which is the first to immunize humans against a bacterial disease. Ferrán vaccinates about 50,000 people in Valencia during a cholera epidemic.[16][26] Spain
1892 Scientific development (drug) The Russian bacteriologist Waldemar Haffkine, working at the Pasteur Institute, announces a new cholera vaccine.[27][28]
1893-1894 Epidemic An outbreak of cholera-morbid occurs in Santa Cruz de Tenerife (Canary Islands). The disease was brought by an Italian ship returning from Brazil . The epidemic to spread throughout the city and neighboring municipalities. The alarm spread in the other islands, which immediately became incommunicado with the island of Tenerife. It is estimated that 1,744 citizens (8.84% of the population) were attacked by the disease, of which 382 died (21.90%).[29] Spain
1899–1923 Epidemic The sixth pandemic kills more than 800,000 people in India, where it begins.[9] India, Middle East, North Africa, Eastern Europe and Russia.
1923 Scientific development The first studies on cholera phages are carried out. They are summarized in 1959.[30][20]
1935 Epidemic The new cholera biotype El Tor causes a major outbreak and epidemic in the Celebes Islands. The El Tor biotype (strain M66-2) is later isolated in Indonesia during an outbreak in 1937.[30] Indonesia
1935 Scientific development The serological classification of Vibrio cholerae is first described.[31]
1948 Organization The formation of the World Health Organization (WHO).[17] Geneva
1948 Scientific development (drug) The antibiotic tetracycline is introduced. It is used for treating several types of infections caused by susceptible bacteria, including Vibrio cholerae.[32]
1951–1959 Scientific development Indian pathologist Sambhu Nath De discovers that cholera is caused by a potent exotoxin (cholera toxin) affecting intestinal permeability. Nath De also demonstrates that bacteria-free culture filtrates of Vibrio cholerae are enterotoxic. Sambu Nath De also develops a reproducible animal model for the disease. These works are considered milestones in the history of the fight against cholera.[4]
1952 Scientific development (drug) Erythromycin is introduced. It is used for the treatment of cholera.[33][34]
1961–present Epidemic The seventh cholera pandemic starts in Indonesia. It continues today, albeit at a much smaller scale.[9] Asia, Africa, Americas, Europe, Oceania
1967 Scientific development (drug) Doxycycline is introduced as an antibiotic. It proves to be an effective treatment for cholera.[35][34]
1968 Scientific development (drug) Trimethoprim/sulfamethoxazole is introduced. It is used for treating cholera, as well as multiple other diseases.[36][37]
1971–2012 Epidemic Seventh cholera pandemic: Cholera is first reported in Cameroon in 1971. In the period between 2000 and 2012, 43,474 cholera cases are reported: 1,748 are fatal (mean annual case fatality ratio of 7.9%), with an attack rate of 17.9 reported cases per 100,000 inhabitants per year.[38] Cameroon
1974 Scientific development Researchers show that more than 108 Vibrio cholerae cells are required to induce infection and diarrhea.[31]
1976 Scientific development Researchers report that a combination of Vibrio cholerae O1 antigens such as lipopolysaccharides (LPS) and cholera toxin (CT) or choleragenoid (now termed Cholera Toxin B or CTB) induces more than 100-fold greater protection of rabbits against a challenge with live vibrios than does vaccination with either of the two antigens alone.[39]
1979 Scientific development (treatment) Oral rehydration therapy (ORT) is introduced as a technique of fluid replacement used to prevent or treat dehydration especially due to diarrhea. ORT rapidly becomes the cornerstone of programs for the control of diarrheal diseases. Oral rehydration therapy dramatically brought down the cholera case fatality rate from 30% in 1980 to around 3.6% in 2000.[4][40]
1984 Scientific development (drug) The FDA approves serotonin antagonist ondansetron. Ondansetron diminishes cholera toxin-evoked secretion.[41][42] United States
1984 Epidemic Seventh cholera pandemic: The cholera epidemic reaches Mali. 1,793 cases and 406 deaths are reported.[43] Mali
1986 Scientific development (drug) The FDA approves antibacterial norfloxacin. It proves to be effective for the treatment of cholera.[44] United States
1986 Scientific development The molecular technique for bacterial identification known as ribotyping is invented. It is used for characterizing cholera strains.[45][30]
1990 (circa) Scientific development The pulsed-field gel electrophoresis technique is first described. It is used to subtype bacterial strains. PFGE would be useful for the identification of the spread of specific clones in many cholera outbreak investigations.[46][30]
1990 (circa) Scientific development Randomly amplified polymorphic DNA analysis is first described. RAPD would be used for characterizing representative strains of Vibrio cholerae.[47][30]
1991 Scientific development (drug) The oral cholera vaccine Dukoral is introduced. It is manufactured by Crucell.[48] Netherlands
1992–1993 Epidemic A new strain of cholera, Vibrio cholerae serogroup O139 Bengal, emerges and causes outbreaks in Bangladesh and India . Disease from this strain becomes endemic in at least 11 countries.[5]
1994 Epidemic Seventh cholera pandemic: Cholera cases are notified[clarification needed] from 94 countries, the highest ever number of countries in one year.[31]
1998 Scientific Development Multilocus sequence typing analysis (MLST) is first described. MLST has better discriminatory ability for typing Vibrio cholerae than pulsed-field gel electrophoresis and provides a measure of phylogenetic relatedness.[49][30]
2001 Scientific development (drug) The FDA approves serotonin 5-HT3 receptor antagonist granisetron. Granisetron markedly diminishes cholera toxin-evoked secretion.[41][42] United States
2007 Scientific development (drug) Researchers from the University of Tokyo develop a type of rice that carries the cholera vaccine.[50][51] Japan
2007 Epidemic Iraq cholera outbreak: 4,667 cases reported. The median age of the patients is 11 years.[52] Iraq
2008 Epidemic Zimbabwean cholera outbreak: 98,741 cases and 4,293 deaths reported.[53][54] Zimbabwe, Botswana, Mozambique, South Africa and Zambia.
2009 Epidemic The World Health Organization reports more than 220,000 cases of cholera and almost 5,000 deaths worldwide.[55]
2009 Scientific development (drug) The oral cholera vaccine Shanchol is introduced. It contains dead whole cells of Vibrio cholerae serogroups O1 and O139. Shanchol is manufactured by Shantha Biotechnics.[48][56] India
2009 Epidemic A cholera outbreak in Papua New Guinea results in over 15,000 cases and more than 500 deaths.[57] Papua New Guinea
2010–present Epidemic The Haiti cholera outbreak kills over 9,500 people across four countries.[58] Haiti, Dominican Republic, Cuba, Mexico, Venezuela and Florida (U.S.)
2011 Scientific development The multi-virulence locus sequencing typing technique is first described. MVLST is used for determining the genetic variation and relatedness of Vibrio cholerae strains of different serogroups.[59][30]
2012 Epidemic Sierra Leonean cholera outbreak: At least 392 people are reportedly killed and more than 25,000 others are infected.[60][61] Sierra Leone, Guinea
2014–2015 Epidemic A cholera outbreak in Africa. 1,475 reported deaths.[62] 84,675 reported cases.[62] Ghana, Nigeria, Niger, Togo, Benin, Democratic Republic of the Congo, Ivory Coast, Chad, Liberia, Guinea-Bissau, Guinea
2015 Scientific development (drug) The oral cholera vaccine Euvichol is introduced. Euvichol is manufactured by EuBiologics.[48] South Korea
2016 Scientific development (drug) The FDA approves Vaxchora for the prevention of cholera.[63] United States
2015–Present Epidemic Over 500,000 cases[64] with over 2000 deaths[65] amid widespread malnutrition during the Yemen Civil War.[66] Yemen

References

  1. ↑ Fabini, D. Orata; Keim, Paul S.; Boucher, Yan (2014). "The 2010 Cholera Outbreak in Haiti: How Science Solved a Controversy". PLOS Pathogens 10 (4): e1003967. doi:10.1371/journal.ppat.1003967. PMID 24699938. 
  2. ↑ Alam, Munirul; Orata, Fabini D.; Boucher, Yan (2015). "The out-of-the-delta hypothesis: dense human populations in low-lying river deltas served as agents for the evolution of a deadly pathogen" (in English). Frontiers in Microbiology 6: 1120. doi:10.3389/fmicb.2015.01120. ISSN 1664-302X. PMID 26539168. 
  3. ↑ Tatem, A.J.; Rogers, D.J.; Hay, S.I. (2006). Global Transport Networks and Infectious Disease Spread. Advances in Parasitology. 62. pp. 293–343. doi:10.1016/S0065-308X(05)62009-X. ISBN 9780120317622. 
  4. ↑ 4.0 4.1 4.2 Nair, G Balakrish; Narain, Jai P (2010). "From endotoxin to exotoxin: De's rich legacy to cholera". Bulletin of the World Health Organization 88 (3): 237–240. doi:10.2471/BLT.09.072504. PMID 20428396. PMC 2828792. http://www.who.int/bulletin/volumes/88/3/09-072504/en/. Retrieved 18 December 2016. 
  5. ↑ 5.0 5.1 5.2 5.3 Handa, Sanjeev (February 16, 2016). "Cholera: Background". MedScape. http://emedicine.medscape.com/article/962643-overview. Retrieved April 23, 2016. 
  6. ↑ Kousoulis, AA (2012). "Etymology of Cholera". Emerging Infectious Diseases 18 (3): 540. doi:10.3201/eid1803.111636. PMID 22377194. 
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  8. ↑ 8.0 8.1 "Origins of Cholera". http://www.choleraandthethames.co.uk/cholera-in-london/origins-of-cholera/. Retrieved April 23, 2016. 
  9. ↑ 9.0 9.1 9.2 9.3 9.4 9.5 9.6 "Cholera's seven pandemics". CBC News. May 9, 2008. http://www.cbc.ca/news/technology/cholera-s-seven-pandemics-1.758504. Retrieved April 23, 2016. 
  10. ↑ Macpherson, John (1869). On the Early Seats of Cholera in India, and in the East: With Reference to .... https://books.google.com/?id=75VeAAAAcAAJ&pg=PA25&dq=%22cholera%22+%22in+1800..1900%22#v=onepage&q=%22cholera%22%20%22in%201800..1900%22&f=false. Retrieved 14 December 2016. 
  11. ↑ Haley, Bruce (October 11, 2002). "Health and Hygiene in the Nineteenth Century". http://www.victorianweb.org/science/health/health10.html. Retrieved January 26, 2017. "The Public Health Bill, passed in 1848 because of the efforts of reformers like Smith and Chadwick, empowered a central authority to set up local boards, whose duty was to see that new homes had proper drainage and that local water supplies were dependable. The boards were also authorized to regulate the disposal of waste and to supervise the construction of burial grounds." 
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  28. ↑ Santa Cruz, Muy Benéfica. El cólera de 1893
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  31. ↑ "tetracycline". MedicineNet. http://www.medicinenet.com/tetracycline/article.htm. Retrieved 10 December 2016. 
  32. ↑ Wise, Robert I. (1955). "Origin of Erythromycin-Resistant Strains of Micrococcus Pyogenes in Infections". AMA Archives of Internal Medicine 95 (3): 419–26. doi:10.1001/archinte.1955.00250090057008. PMID 14349420. 
  33. ↑ 34.0 34.1 "Antibiotic Treatment". Centers for Disease Control and Prevention. https://www.cdc.gov/cholera/treatment/antibiotic-treatment.html. Retrieved 12 December 2016. 
  34. ↑ "New Research on Doxycycline". Centers for Disease Control and Prevention. https://www.cdc.gov/rmsf/doxycycline/. Retrieved 13 December 2016. 
  35. ↑ Ho, Joanne M.-W. (2011). "Considerations when prescribing trimethoprim–sulfamethoxazole". Canadian Medical Association Journal 183 (16): 1851–8. doi:10.1503/cmaj.111152. PMID 21989472. 
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  38. ↑ Alexander, T. S. (2014). "Critical Analysis of Compositions and Protective Efficacies of Oral Killed Cholera Vaccines". Clinical and Vaccine Immunology (United States National Library of Medicine) 21 (9): 1195–205. doi:10.1128/CVI.00378-14. PMID 25056361. 
  39. ↑ Victora, CG; Bryce, J; Fontaine, O; Monasch, R (2000). "Reducing deaths from diarrhoea through oral rehydration therapy". Bulletin of the World Health Organization 78 (10): 1246–55. doi:10.1590/S0042-96862000001000010. PMID 11100619. 
  40. ↑ 41.0 41.1 Smith, Howard S.; Cox, Lorraine R.; Smith, Eric J. (2012-09-14). "5-HT3 receptor antagonists for the treatment of nausea/vomiting". Annals of Palliative Medicine 1 (2): 115–120. doi:10.3978/j.issn.2224-5820.2012.07.07. PMID 25841471. 
  41. ↑ 42.0 42.1 Sjöqvist, A; Cassuto, J; Jodal, M; Lundgren, O. (1992). "Actions of serotonin antagonists on cholera-toxin-induced intestinal fluid secretion.". Acta Physiologica Scandinavica 145 (3): 229–37. doi:10.1111/j.1748-1716.1992.tb09360.x. PMID 1355626. 
  42. ↑ Tauxe, Robert V.; Holmberg, Scott D.; Dodin, Andre; Wells, Joy V.; Blake, Paul A. (1988). "Epidemic cholera in Mali: High mortality and multiple routes of transmission in a famine area". Epidemiology and Infection 100 (2): 279–89. doi:10.1017/s0950268800067418. PMID 3356224. 
  43. ↑ "NORFLOXACIN". United States National Library of Medicine. https://livertox.nlm.nih.gov/Norfloxacin.htm. Retrieved 13 December 2016. 
  44. ↑ Dalsgaard, A; Echeverria, P; Larsen, J L; Siebeling, R; Serichantalergs, O; Huss, H H (1995). "Application of ribotyping for differentiating Vibrio cholerae non-O1 isolated from shrimp farms in Thailand". Applied and Environmental Microbiology 61 (1): 245–51. doi:10.1128/AEM.61.1.245-251.1995. PMID 7534053. 
  45. ↑ Filippis, Ivano; McKee, Marian L. (2012-11-07). Molecular Typing in Bacterial Infections. p. 62. ISBN 9781627031851. https://books.google.com/?id=ZS68IkRmwcMC&pg=PA62&lpg=PA62&dq=%22PFGE%22+%22cholera%22#v=onepage&q=%22PFGE%22%20%22cholera%22&f=false. Retrieved 18 December 2016. 
  46. ↑ Chhotray, GP; Pal, BB; Khuntia, HK; Chowdhury, NR; Chakraborty, S; Yamasaki, S; Ramamurthy, T; Takeda, Y et al. (2002). "Incidence and molecular analysis of Vibrio cholerae associated with cholera outbreak subsequent to the super cyclone in Orissa, India". Epidemiology and Infection 128 (2): 131–8. doi:10.1017/S0950268801006720. PMID 12002529. 
  47. ↑ 48.0 48.1 48.2 "Oral Cholera Vaccine (OCV): What You Need To Know". https://www.stopcholera.org/sites/cholera/files/oral_cholera_vaccine_what_you_need_to_know_0.pdf. Retrieved 10 December 2016. 
  48. ↑ Faruque, Shah M.; Nair, G. Balakrish (2008). Vibrio Cholerae: Genomics and Molecular Biology. ISBN 9781904455332. https://books.google.com/?id=fP67F_eOSgQC&pg=PA45&lpg=PA45&dq=%221998%22+%22+multilocus+sequence+typing%22+%22cholera%22#v=onepage&q=%221998%22%20%22%20multilocus%20sequence%20typing%22%20%22cholera%22&f=false. Retrieved 18 December 2016. 
  49. ↑ Kotar, S.L.; Gessler, J.E. (2014-03-08). Cholera: A Worldwide History. p. 288. ISBN 9781476613642. https://books.google.com/?id=N3wgAwAAQBAJ&pg=PA288&lpg=PA288&dq=Researchers+from+the+University+of+Tokyo+develop+a+type+of+rice+that+carries+the+cholera+vaccine#v=onepage&q=Researchers%20from%20the%20University%20of%20Tokyo%20develop%20a%20type%20of%20rice%20that%20carries%20the%20cholera%20vaccine&f=false. Retrieved 14 December 2016. 
  50. ↑ Sinha, Kounteya (June 13, 2007). "Breakthrough in cholera cure". The Times of India. http://timesofindia.indiatimes.com/home/science/Breakthrough-in-cholera-cure/articleshow/2118293.cms. Retrieved 14 December 2016. 
  51. ↑ Khwaif, JM; Hayyawi, AH; Yousif, TI (2010). "Cholera outbreak in Baghdad in 2007: an epidemiological study.". Eastern Mediterranean Health Journal 16 (6): 584–9. doi:10.26719/2010.16.6.584. PMID 20799583. 
  52. ↑ "Epidemiological Bulletin Number 41". World Health Organization. January 10, 2010. http://www.who.int/hac/crises/zwe/sitreps/zimbabwe_w1_10jan2010.pdf. Retrieved April 23, 2016. 
  53. ↑ "Zimbabwe cholera 'to top 100,000'". BBC. 26 May 2009. http://news.bbc.co.uk/2/hi/africa/8068232.stm. Retrieved 26 May 2009. 
  54. ↑ Schaetti, C; Weiss, MG; Ali, SM; Chaignat, CL; Khatib, AM; Reyburn, R; Duintjer Tebbens, RJ; Hutubessy, R (2012). "Costs of Illness Due to Cholera, Costs of Immunization and Cost-Effectiveness of an Oral Cholera Mass Vaccination Campaign in Zanzibar". PLOS Neglected Tropical Diseases 6 (10): e1844. doi:10.1371/journal.pntd.0001844. PMID 23056660. 
  55. ↑ "Vaccines". Centers for Disease Control and Prevention. https://www.cdc.gov/cholera/vaccines.html. Retrieved 10 December 2016. 
  56. ↑ Horwood, PF; Karl, S; Mueller, I; Jonduo, MH; Pavlin, BI; Dagina, R; Ropa, B; Bieb, S et al. (2014). "Spatio-temporal epidemiology of the cholera outbreak in Papua New Guinea, 2009-2011". BMC Infectious Diseases 14: 449. doi:10.1186/1471-2334-14-449. PMID 25141942. 
  57. ↑ "Haiti cholera outbreak". Pan American Health Organization. http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=28070+&Itemid=999999&lang=fr. Retrieved April 23, 2016. 
  58. ↑ Advances in Vibrio Research and Application: 2012 Edition. 2012-12-26. p. 80. ISBN 9781464997617. https://books.google.com/?id=bre_pmwAzIUC&pg=PA80&lpg=PA80&dq=%22MVLST%22+%22cholera%22#v=onepage&q=%22MVLST%22%20%22cholera%22&f=false. Retrieved 18 December 2016. 
  59. ↑ "Cholera outbreak easing". IRIN. 2012-09-23. http://www.irinnews.org/news/2012/09/24/cholera-outbreak-easing. Retrieved 13 December 2016. 
  60. ↑ "Cholera - rising with the downpours". IRIN. 2012-08-30. http://www.irinnews.org/news/2012/08/31/cholera-rising-downpours. Retrieved 13 December 2016. 
  61. ↑ 62.0 62.1 "Cholera in Ghana". UNICEF. 15 November 2014. http://www.unicef.org/cholera/files/Cholera_regional_update_W52_2014_West_and_Central_Africa.pdf. 
  62. ↑ "Vaxchora". FDA. https://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM506235.pdf. Retrieved 12 December 2016. 
  63. ↑ "Cholera count reaches 500 000 in Yemen" (in en-GB). http://www.who.int/mediacentre/news/releases/2017/cholera-yemen-mark/en/. 
  64. ↑ Jr, Donald G. Mcneil (2017-08-14). "More Than 500,000 Infected With Cholera in Yemen" (in en-US). The New York Times. ISSN 0362-4331. https://www.nytimes.com/2017/08/14/health/cholera-outbreak-in-yemen.html. 
  65. ↑ Yemen cholera cases pass 200,000, BBC News, June 24, 2017




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