by SONIA SHAH
Cholera outbreaks on two islands, divided by centuries, offer lessons on how to ameliorate conditions that could give rise to future epidemics
Nearly two centuries separate the two epidemics—one began four years ago this month and the other in the summer of 1832—but they are otherwise strikingly similar, and the parallels offer some lessons for public health officials today. A novel infectious agent, cholera, is introduced into an island population living in crowded and unsanitary conditions, killing thousands. The recent epidemic, of course, occurred on the impoverished island nation of Haiti. The earlier one unfolded 2,400 kilometers north, on the island of Manhattan. With narrative, interactive maps, “Mapping Cholera: A Tale of Two Cities,” provides a look at the searing pathways of two outbreaks.
The waterborne bacterial pathogen that causes cholera, Vibrio cholerae, most likely arrived in Haiti with United Nations peacekeepers from Nepal, whose camp discharged sewage into a stream that fed into the nation’s largest river, the Artibonite.1 The bacteria spread south to the capital city of Port-au-Prince, where dense urban crowds lacking reliable access to clean drinking water and sanitary systems were already reeling from a magnitude 7.0 earthquake that had hit in January 2010. Haiti had not been exposed to cholera for over a century—so the population had not acquired even limited immunity to infection. Within nine months, Haiti had more cholera victims than the rest of the world combined.2
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