title: Environmental factors influencing epidemic cholera.
abstract: Cholera outbreak following the earthquake of 2010 in Haiti has reaffirmed that the disease is a major public health threat. Vibrio cholerae is autochthonous to aquatic environment, hence, it cannot be eradicated but hydroclimatology-based prediction and prevention is an achievable goal. Using data from the 1800s, we describe uniqueness in seasonality and mechanism of occurrence of cholera in the epidemic regions of Asia and Latin America. Epidemic regions are located near regional rivers and are characterized by sporadic outbreaks, which are likely to be initiated during episodes of prevailing warm air temperature with low river flows, creating favorable environmental conditions for growth of cholera bacteria. Heavy rainfall, through inundation or breakdown of sanitary infrastructure, accelerates interaction between contaminated water and human activities, resulting in an epidemic. This causal mechanism is markedly different from endemic cholera where tidal intrusion of seawater carrying bacteria from estuary to inland regions, results in outbreaks.
authors.affiliation: Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV, USA. asjutla@mail.wvu.edu
authors.forename: Antarpreet
authors.initials: A
authors.lastname: Jutla
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Whitcombe
authors.forename: Nur
authors.initials: N
authors.lastname: Hasan
authors.forename: Bradd
authors.initials: B
authors.lastname: Haley
authors.forename: Ali
authors.initials: A
authors.lastname: Akanda
authors.forename: Anwar
authors.initials: A
authors.lastname: Huq
authors.forename: Munir
authors.initials: M
authors.lastname: Alam
authors.forename: R Bradley
authors.initials: RB
authors.lastname: Sack
authors.forename: Rita
authors.initials: R
authors.lastname: Colwell
mesh_terms: D001208:Asia / Q000453:epidemiology; D002771:Cholera / Q000453:epidemiology*; D004777:Environment; D058872:Epidemics; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D011891:Rain; D045483:Rivers / Q000382:microbiology; D012621:Seasons; D012623:Seawater / Q000382:microbiology; D013696:Temperature; D014734:Vibrio cholerae / Q000302:isolation & purification*; D014871:Water Microbiology
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