150 Jahre pandemische Ausbreitung der asiatischen Cholera von 1831 bis 1981

Abstract

The first occurrence of the Asiatic cholera in Europe in 1831 has been followed by a series of migrations of this disease always setting on from India and moving forward to many countries of other continents. These migrations keeping on for several years were called “pandemics” and have been counted since August Hirsch. He described 4 pandemics. Pollitzer is of the opinion that-after the end of the 6 th pandemic — since the disappearance of cholera from Russia in 1926 no further outbreak in Europe took place except a small epidemic occurrence in the Ukraine during World War II. He describes the world situation of cholera from 1927 to 1954 with the great epidemics in India during the thirties of this century causing several hundreds of thousands of fatal cases and spreading over the neighbouring countries in the fourties as well as to Egypt in 1947 and Syria in 1948. Pollitzer did not deduce from this phenomenon a new pandemic which was indeed described as the 7 th one first in the German medical journal “Die Medizinische Welt” in 1940, showing a map about the distribution of cholera to the west and east. During this pandemic the local outbreaks were very dangerous so that at first time mass campains with vaccinations against cholera were arranged in Afghanistan, Iran, Indochina, China and Manchuria. The first pandemics were spreading on land routes, later on also by sea, and at last in the 20 th century by air. It might be that during the 7th pandemic, cholera was imported by air from Pakistan to Egypt in 1947 on 22 September to El Korein. Since 1961, cholera once more started a new migration — the 8 th pandemic — coming from South East Asia and spreading by this time through the classical routes, westwards to the Black Sea, the Mediterranean countries, Africa, and even Europe. The new cholera migration since 1961 differs from the preceding ones in the way that the causative agent is of the biotope Cholera El Tor and not of the classical vibrio comma. During the 8 th pandemic we see in the map of cholera El Tor spread the importation via air from the Black Sea coast (Odessa, USSR) by Guinean students returning from USSR by air to have brought the germs out of an outbreak in USSR. Furthermore, importation by air took place from Africa to Europe, from Europe to Africa and to Australia. This fact is not surprising, because the biotype El Tor is more resistent to environmental factors and survives longer with virulence than the classical cholera vibrio. Mild cases and asymptomatic infections with biotype El Tor are more frequent than with the classical type. Therefore, these characteristics may play an important role in spreading epidemic cholera during the now 8 th pandemic in the world. This pandemic represents the third great cholera spread in our century and should, therefore, be considered as the 8 th pandemic in continuation of the counting since August Hirsch and Georg Sticker up to now.