Africa in the Time of Cholera: A History of Pandemics from 1817 to the Present

Abstract

Echenberg has nicely summarized the history of cholera for the well-known Africa Studies Series, organizing his work by combining the first six pandemics—1817–1947—for the initial half of this book and then considering the seventh pandemic—1947 to the present—as the last half of the book. This is an apt division as the present pandemic is largely caused by the El Tor variant of the gram-negative, motile bacillus, Vibrio cholerae 01, which became dominant in the world in 1961, and is less virulent than its predecessors. To understand cholera, one must realize that there are scores of species of the Vibrio genus living in warm estuaries and brackish waters in the world. Though several species can cause diarrhea in humans, only V. cholerae has the gene that produces the complex protein toxin which causes the intestine to release large quantities of fluid as “rice water stool”—up to two liters an hour...