Cholera, Migration, and Global Health – A Critical Review

Abstract

Cholera is an acute diarrheal infection caused by the ingestion of food or water contaminated with the bacterium Vibrio cholerae. The causative agent of this disease was originally described by Filippo Pacini in 1854, and afterwards further analyzed by Robert Koch in 1884. It is estimated that each year there are 1.3 million to 4 million cases of cholera, and 21000 to 143000 deaths worldwide from the disease. Cholera remains a global threat to public health and an indicator of inequity and lack of social development. A global strategy on cholera control with a target to reduce cholera deaths by 90% was launched in 2017. Before 1817, cholera was confined to India’s Bay of Bengal. However, primarily following trade and migration between India and Europe, by the 1830s, cholera had spread internationally. The global spread of cholera was the driving force behind the first International Sanitary Conference in Paris, in 1851. The global health significance of cholera is underscored by its inclusion as one of four priority diseases in the 1969 and 2005 International Health Regulations. This article reviews the evolution of seven cholera pandemics and their reciprocal impacts on migration and global health. Also discussed are global efforts to address cholera, particularly the International Health Regulations, the 1969 and 2005 version of which stipulated that cholera epidemics require mandatory reporting to the IHR. This article concludes with a brief case study of Yemen’s unprecedented cholera epidemic.