INDIA ABROAD March 3, 2017 24 SOUTH ASIA
By Donald G. Mcneil Jr.
wo hundred years ago,
the first cholera pandemic emerged from
It began in 1817, after
the British East India Co. sent
thousands of workers deep into
the remote Sundarbans, part of
the Ganges River Delta, to log the
jungles and plant rice. These
brackish waters are the cradle of
Vibrio cholerae, a bacterium that
clings to human intestines and
emits a toxin so virulent that the
body will pour all of its fluids
into the gut to flush it out.
Water loss turns victims
ashen; their eyes sink into their
sockets, and their blood turns
black and congeals in their capillaries. Robbed of electrolytes,
their hearts lose their beat.
Victims die of shock and organ
failure, sometimes in as little as
six hours after the first abdominal rumblings.
Cholera probably had festered
here for eons. Since that first
escape, it has circled the world in
seven pandemic cycles that have
killed tens of millions.
Artists of the 19th century
often depicted it as a skeleton
with a scythe and victims heaped
at its feet. It stalked revelers at a
masked ball in Heinrich Heine’s
“Cholera in Paris” and kills the
protagonist in Thomas Mann’s
“Death in Venice.” Outbreaks
forced London, New York and
other cities to create vast public
water systems, transforming
Today cholera garners panicky
headlines when it strikes unexpectedly in places like Ethiopia
or Haiti. But it is a continuing
threat in nearly 70 countries,
where more than 1 billion people
are at risk.
Now, thanks largely to efforts
that began in cholera’s birthplace, a way to conquer the long-dreaded plague is in sight.
A treatment protocol so effective that it saves 99.9 percent of
all victims was pioneered here.
The World Health Organization
estimates that it has saved about
50 million lives in the past four
Just as important, after 35
years of work, researchers in
Bangladesh and elsewhere have
developed an effective cholera
vaccine. It has been accepted by
the WHO and stockpiled for epidemics like the one that struck
Haiti in 2010. Soon, there may be
enough to begin routine vaccination in countries where the disease has a permanent foothold.
Merely creating that stockpile
— even of a few million doses —
profoundly improved the way
the world fought cholera, Dr.
Margaret Chan, secretary-general
of the WHO, said last year. Ready
access to the vaccine has made
countries less tempted to cover
up outbreaks to protect tourism,
That has sped up emergency
Above, two cholera patients in the
general ward of the International
Center for Diarrheal Disease
Research, in Dhaka, Bangladesh, Nov.
14, 2016. Left, an infant cholera patient
with his mother in the general ward of
the International Center for Diarrheal
Disease Research in Dhaka,
Bangladesh, Aug. 17, 2016. Below left,
people collect water from a local
water pump in Dhaka, Bangladesh,
Aug. 25, 2016. Some water pipes made
of rubbery plastic are pierced by
illegal connections that carry
pathogens, including the cholera
bacteria, down the line to victims.
A global pandemic rose from these
swamps.Now scientists may have
a way to stop it.
Ismail Ferdous/The New York Times