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The paper presents an analysis and assessment of risks of complication of epidemiological situation regarding cholera in the Russian Federation and a forecast for 2024. It briefly characterizes the dynamics of the epidemic process around the world during the last decade (2013–2022). The forecast of cholera importation into the Russian Federation, due to activity of the epidemic process in endemic countries, has been confirmed. In 2023, two cases of cholera importation from India were reported. It was established that the toxigenic strains isolated from patients belonged to the currently dominant in the world “post-Haitian” group, including in India and Bangladesh, with the genotype ctxB7 tcpACIRS rtxA4a VSP-IIΔ0495-0512. Furthermore, non-toxigenic Vibrio cholerae O1 strains were isolated from samples of biological material from persons arriving from India, containing preCTX prophage and distinct from the strain (ctxAB– tcpAEТ–) isolated from a patient with acute intestinal infection (Zaporozhye Region, Melitopol). Nontoxigenic NAG vibrios were isolated from 13 patients with acute intestinal infections, which is 1.9 times more than in 2022. Regardless of importations, a strain of V. cholerae O1 (ctxB1+tcpAEТ) of the “pre-Haitian” group was isolated from a water sample of a surface reservoir. 52 non-toxigenic V. сholerae O1 strains were found on the territory of 11 constituent entities of the Russian Federation, which is 18.9 % more than in 2022. In 2024, epidemiological risks of cholera importation from endemic countries to any administrative territory of the Russian Federation remain. The risks of epidemic manifestations of cholera are especially high in the territories of the constituent entities of the Russian Federation which are under ongoing emergency, due to migration processes, and the impact of other risk-forming factors that contribute to an increase in the degree of contact of the population with water bodies contaminated with cholera vibrios. If epidemic foci of cholera are to emerge in a neighboring country, there will be a high probability of spread of this infection in the stated constituent entities of the Russian Federation and in other territories of southern Russia. In the absence of epidemic manifestations of cholera, the possibility of occasional detection of toxigenic O1 serogroup strains in water samples due to unidentified introductions from cholera-affected areas cannot be ruled out.

Introduction: An upsurge of diarrheal cases occurred in Dhaka, Bangladesh, with approximately 30% of the cases being identified as cholera in 2022. To combat this situation, a reactive Oral Cholera Vaccination campaign was organized in five highly cholera-affected areas of Dhaka city. The paper is a descriptive tale of experience gathering, organization and implementation of reactive oral cholera vaccination campaign. Study design: This is a descriptive report of a reactive oral cholera vaccination campaign. Methods: Population density maps were generated using GIS technology before launching the campaign. The target population comprised individuals aged over one year, excluding pregnant women, totaling 2,374,976 people residing in above mentioned areas. The campaign utilized Euvichol-Plus, an OCV with adherence to the necessary cold chain requirements. Total 700 teams, each consisting of six members, were deployed across the five zones. The campaign was conducted in two rounds, where first round took place in June–July 2022, followed by second round in August 2022. During the campaign, data on adverse events following immunization (AEFI) was collected. Expert teams from various government and non-government organizations monitored regularly and ensured the campaign's success. Results: The first round achieved a coverage rate of 99%, whereas in the second round, 86.3% of individuals among the first dose recipients. During the campaigns, a total of 57 AEFIs were reported. Conclusions: This campaign serves as a model for a multispectral approach in combating cholera epidemics, highlighting the collaborative efforts of policymakers, health authorities, local communities, and health partners.

The purpose of this paper is to analyze the process of establishing a quarantine system based on medical inspection by Shanghai Customs. England was the first to introduce a quarantine system based on medical inspection during the nineteenth century; with the majority of the Shanghai Customs administration being English, this system was able to be adopted with ease, and it was later transformed and accepted in Joseon. This paper further investigates the details of the actual medical inspection conducted by the Customs Medical Officer (CMO) who worked at the forefront of the actual quarantine as a medical inspector. In the nineteenth century, International Sanitary Conferences were held in Paris, Vienna, and Constantinople to discuss the process of quarantine and public health. Furthermore, the Public Health Act was passed in England in 1872. This Act established port sanitary authorities in each of England’s ports to carry out medical inspections. This medical inspection enabled healthy and infected people to be separated from each other instead of conventional isolation. The duties of the CMO would consist of boarding any incoming ship to check for any infected people. Any infected persons would then be sent to a non-quarantine hospital, and the ship was sanitized. This concept of quarantine based on medical inspection was borrowed by Shanghai Customs. The unique political situation in Shanghai, which consisted of multiple imperial concessions, necessitated the adaptation of England’s medical quarantine concept to suit the special environment in which the Shanghai Customs was located, and by 1875, the Shanghai Customs quarantine medical inspection system was established. In this system, patients found in the Customs quarantine medical inspection were sent to a non-quarantine hospital in the settlement. Due to the extraterritoriality, the extent of the authority of the Customs Medical Officer was dependent on agreements with the possibility to be granted a one-time or temporary position after conferring with the Shanghai local government and consuls in each country. The Treaty Ports of Joseon were similar to Shanghai with regards to the presence of the Customs system alongside different settlements. The Joseon ports went through another transformation when the Commissioner of Shanghai Customs, H. F. Merrill, who also served as the Chief Commissioner of Seoul, accepted the Shanghai Customs’ modified concept of medical inspection in 1887. The process of acceptance and transformation of the medical quarantine concept leading to the ‘England-Shanghai-Joseon’ connection shows that the concept of medical quarantine in the nineteenth century spread from England to Joseon through Shanghai Customs as a medium.

The aim of this paper is to point out the part of different epidemics in the reduction of population in Serbia during the First and Second Balkan Wars (1912 - 1913) and the First World War (1914 - 1918). In addition to suffering on the battlefield, the war conditions of life also led to the culmination of various diseases and the appearance of various major and minor, local, regional and world epidemics. By comparing data from the 1910-1913 census and in 1921 there was a population reduction of 526,430. (4,393,315: 3,866,885). Various infectious diseases took significantly more lives than all other causes combined, including war. According to accepted estimates, during the war years, infectious diseases took about 360,000 lives. The typhus epidemic, which affected the whole of Serbia during the first half of 1915, took about 135,000 lives. This paper is largely based on the analysis of church registers of the dead, and it points out several different local epidemics that affected the Serbian army and civilian population during the war years with great mortal consequences which took about 110,000 lives. These epidemics appeared during the all war years, associated or not associated with each other, and in different territories. These epidemics were: cholera, smallpox, diphtheria, dysentery, scarlet fever, whooping cough, etc.

The authorʼs systematic analysis of the registers of births, marriages, and deaths and the Status Animarum for Veli Brgud, as well as analysis of numerous other historical sources gathered a lot of data about life, epidemics, and many disasters that marked the lives of the village residents during the 19th century. This paper serves to present the information to the general public. Veli Brgud still remembers only one of those epidemics and disasters – the 1855 cholera, while others are completely forgotten. The paper tackles epidemics and disasters that depict the difficult life of the village during the 19th century. Additionally, the example of cholera serves to give an insight into the functioning of the then authorities on prevention and protection against the spread of infections, which can be deemed effective even from a time distance of almost 170 years.

In this paper, a compartmental model for the transmission of the co-infection of cholera and malaria was developed and analyzed. The reproduction numbers for each sub-model and the full model were calculated. In order to study the impact of each disease on the other, a sensitivity analysis was carried out and its results show that malaria infection is linked to an increased risk of cholera, whereas cholera infection is not associated with an increased risk of malaria. A set of seven variables’ controlling strategies, ranging from vector control to water sanitation and treatment, were added to the model; and their effect have been studied using the optimal control technique. Numerical simulations show the impact of these controlling strategies on the reduction of the new infections in humans and vectors as well as the reduction of the Cholera vibrio concentration in the environment. In order to find the most cost-effective controlling strategy, and all the three major cost-effectiveness analysis techniques were implemented to our model after we categorized all the controlling strategies into three scenarios, namely Cholera controlling strategy, Malaria controlling strategy, and Cholera–Malaria controlling strategy. The numerical results show that the most cost-effective controlling strategy in reducing the number of new infection is the vector control strategy.

India has been swept by pandemics of plague, influenza, smallpox, cholera and other diseases. The scale and impact of these events was often cataclysmic and writers offered a glimpse into the everyday life of ordinary people who lost their lives and livelihoods and suffered the angst and trauma of mental, physical and emotional loss. This paper focuses on the devastation caused by pandemics especially in the Ganges deltaic plains of India. Through selected texts of 20th century Hindi writers – Munshi Premchand, Phanishwar Nath Renu, Suryakant Tripathi Nirala, Bhagwan Das, Harishankar Parsai, Pandey Bechan Sharma – this paper aims to bring forth the suffering and struggles against violence, social injustices and public health crises in India during waves of epidemics and pandemics when millions died as they tried to combat the rampant diseases.

In a recent paper, Che et al. [5] used a continuous-time Ordinary Differential Equation (ODE) model with risk structure to study cholera infections in Cameroon. However, the population and the reported cholera cases in Cameroon are censored at discrete-time annual intervals. In this paper, unlike in [5], we introduce a discrete-time risk-structured cholera model with no spatial structure. We use our discrete-time demographic equation to ‘fit’ the annual population of Cameroon. Furthermore, we use our fitted discrete-time model to capture the annually reported cholera cases from 1987 to 2004 and to study the impact of vaccination, treatment and improved sanitation on the number of cholera infections from 2004 to 2019. Our discrete-time cholera model confirms the results of the ODE model in [5]. However, our discrete-time model predicts a decrease in the number of cholera cases in a shorter period of cholera intervention (2004–2019) as compared to the ODE model's period of intervention (2004–2022).

Abstract Cholera is a recurring issue in Nigeria, with outbreaks predominantly affecting the Northern states. In 2021, Nigeria experienced its most significant cholera epidemic in a decade, resulting in thousands of fatalities and cases. The spread of cholera and other waterborne diseases in Nigeria is linked to various factors such as flooding, conflict, and water scarcity. The country's poor drinking water quality and lack of equitable access to clean water exacerbate the problem, particularly in the conflict‐affected areas of the North. This paper discusses the interaction of conflict‐related displacement, water shortages, and cholera transmission in Northern Nigeria and provides insights into how these factors impact water resources and public health. This information can inform initiatives and policies to reduce the impact of conflict on water resources and enhance access to clean water in impacted areas. The article suggests that the primary challenges in eliminating cholera in the region include a lack of information due to severe security situations, bureaucratic requirements for delivering essential supplies, and a chronic shortage of water. A successful response to cholera in conflict and displacement situations also requires community engagement and the security and safety of humanitarian personnel. Long‐term solutions to the uprisings in the region are necessary to put an end to the issues related to banditry and insurgency.

This paper is concerned with a class of age-structured cholera model with general infection rates. We first explore the existence and uniqueness, dissipativeness and persistence of the solutions, and the existence of the global attractor by verifying the asymptotical smoothness of the orbits. We then give mathematical analysis on the existence and local stability of the positive equilibrium. Based on the preparation, we further investigate the global behavior of the cholera infection model. Corresponding numerical simulations have been presented. Our results improve and generalize some known results on cholera models.

In this paper, we provide an overview of how spatial video data collection enriched with contextual mapping can be used as a universal tool to investigate sub-neighborhood scale health risks, including cholera, in challenging environments. To illustrate the method’s flexibility, we consider the life cycle of the Mujoga relief camp set up after the Nyiragongo volcanic eruption in the Democratic Republic of Congo on 22 May 2021. More specifically we investigate how these methods have captured the deteriorating conditions in a camp which is also experiencing lab-confirmed cholera cases. Spatial video data are collected every month from June 2021 to March 2022. These coordinate-tagged images are used to make monthly camp maps, which are then returned to the field teams for added contextual insights. At the same time, a zoom-based geonarrative is used to discuss the camp’s changes, including the cessation of free water supplies and the visible deterioration of toilet facilities. The paper concludes by highlighting the next data science advances to be made with SV mapping, including machine learning to automatically identify and map risks, and how these are already being applied in Mujoga.

India has been swept by pandemics of plague, influenza, smallpox, cholera and other diseases. The scale and impact of these events was often cataclysmic and writers offered a glimpse into the everyday life of ordinary people who lost their lives and livelihoods and suffered the angst and trauma of mental, physical and emotional loss. This paper focuses on the devastation caused by pandemics especially in the Ganges deltaic plains of India. Through selected texts of 20th century Hindi writers – Munshi Premchand, Phanishwar Nath Renu, Suryakant Tripathi Nirala, Bhagwan Das, Harishankar Parsai, Pandey Bechan Sharma – this paper aims to bring forth the suffering and struggles against violence, social injustices and public health crises in India during waves of epidemics and pandemics when millions died as they tried to combat the rampant diseases.

The article describes the history of medical care to the population of Pskov province in the first half of the XIX century. The picture of medical care for residents of the Pskov province was restored thanks to the analysis of a wide range of documents deposited in the files of the funds of the State Archive of the Pskov Region and the Russian State Historical Archive. The relevance of this study lies in the fact that its topic is poorly developed not only at the regional, but also at the all-Russian level. The appeal to this problem made it possible to identify diseases that acquired the scope of epidemics within the Pskov province in the first half of the XIX century. Using individual examples, the author examined the policy of the central and provincial authorities to combat the cholera epidemic in the social space of the Pskov province. The paper also presents the facts of the spread of other diseases, for example, nettle fever and intestinal infection. The author formulated the key features of the healthcare system of the Pskov province in the first half of the XIX century, made conclusions about the low level of organization of medical care. This article will allow us to form an idea not only about the history of medical care of the population in the Russian province, but also about the history of everyday life of the people.

The Housefly (Musca domestica Linnaeus, 1758) lives in close proximity to humans, posing a variety of health risks. They are mechanical vectors capable of spreading an arraying of infections and annoy humans. More than 100 types of pathogens, including bacterial, viral, and protozoan, are transmitted by houseflies, and in this review, we describe 5 of them: Cholera, Anthrax, Shigella, ORF Virus, and Ascariasis. Cholera is a rigorous flux ailment initiated via the Vibrio cholerae bacteria contaminating the intestines. The ailment is often modest or does not present symptoms, but it can also be dangerous and lead to death, while anthrax is a harmful infective illness brought about by Bacillus anthracis. Shigellosis (Shigella infection) is a gastrointestinal ailment caused by Shigella spp. Bloody diarrhea is the most common sign of shigella infection. Houseflies are a severe health hazard for humans, causing discomfort, disease, and even death. Studies that assess the impact of Houseflies on humans were briefed. Articles on PubMed, Google Scholar, and other online reports, 50 in number, were reviewed.The genesis and life cycle of houseflies, their mode of disease transmission, commonly transmitted diseases are all discussed in this paper. Biological, chemical, and cultural control are some of the common control strategies discussed.

Aiming to further the Immunization Partners in Asia Pacific (IPAP)’s vision of a world where no one suffers from a vaccine preventable disease, the 8th Asian Vaccine Conference (ASVAC 2022) was held in Colombo, Sri Lanka and virtually from 15 to 18, September 2022 (www.asianvaccine.com). This conference followed those held in Siem Reap, Cambodia (2009), Manila, Philippines (2010), Jakarta, Indonesia (2011), Cebu, Philippines (2013), Hanoi, Vietnam (2015), Singapore (2017) and Naypyidaw and Yangon, Myanmar (2019). The ASVAC2022 themed “Immunization: in Era of Pandemics,” commenced with the EPI Managers’ Workshop, followed by pre-conference workshops and Vaccinology Masterclass, followed by the main conference featuring 5 plenary lectures, 6 partner-led symposia, free paper and poster presentations, and industry-supported lunch and evening sessions. There were over 1830 registered participants, with 112 attending in person and 998 virtually from 63 countries. The conference was organized by IPAP and hosted by the Vaccine and Infectious Disease Forum of Sri Lanka, Sri Lanka College of Pediatricians, Sri Lanka College of Microbiologists and College of General Practitioners of Sri Lanka, with the support of the Ministry of Health, Sri Lanka. The 9th ASVAC is scheduled to be held in Davao City, Philippines in late 2023.

It was in 1907 when Korea was annexed by Japan in the field of health care systems as the Gwangje Hospital, Uihakgyo the National Medical School and the Korean Red Cross Hospital were merged into the colonial Daehan Hospital, and massive cholera epidemic controls by the Japanese Army were enforced.However, despite their importance, the cholera epidemic of 1907 in Korea and preventive measures taken at that time have not yet been studied extensively as a single research subject. The purpose of this paper is to contribute to a more concrete and broader understanding of the Korea-Japan annexation of health care systems under the rule of the Japanese Resident-General of Korea by revealing new facts and correcting existing errors. In 1907, cholera was transmitted to Korea from China and Japan and spread across the Korean Peninsula, resulting in a major public health crisis, perhaps one of the most serious cholera outbreaks in the twentieth century Korea. Although Busan and Pyeongyang were the cities most infected with cholera, the targets for the most intensive interventions were Gyeongseong (Seoul) and Incheon, where the Japanese Crown Prince were supposed to make a visit. The Japanese police commissioner took several anti-cholera preventive measures in Gyeongseong, including searching out patients, disinfecting and blocking infected areas, and isolating the confirmed or suspected. Nevertheless, cholera was about to be rampant especially among Japanese residents. In this situation, Itō Hirobumi, the first Resident-General of Korea, organized the temporary cholera control headquarters to push ahead the visit of the Japanese Crown Prince for his political purposes to colonize Korea. To dispel Emperor Meiji’s concerns, Itō had to appoint Satō Susumu, the famous Japanese Army Surgeon General, as an advisor, since he had much credit at Court. In addition, as the Japanese-led Korean police lacked epidemic control ability and experience, the headquarters became an improvised organization commanded by the Japanese Army in Korea and wielded great influence on the formation of the colonial disease control systems. Its activities were forced, violent, and negligent, and many Korean people were quite uncooperative in some anti-cholera measures. As a result, the Japanese Army in Korea took the initiative away from the Korean police in epidemic controls, serving the heavy-handed military policy of early colonial period. In short, the cholera epidemic and its control in 1907 were important events that shaped the direction of Japan’s colonial rule.

Abstract Every year, about 4 million cases and 143,000 deaths due to cholera are recorded globally, of which 54% were from Africa, reported in 2016. The outbreak and spread of cholera have risen exponentially particularly in Africa. Coupled with the recent emergence of the Coronavirus Pandemic (COVID-19) in Africa, the local health systems are facing a double burden of these infectious diseases due to their cumulative impact. In this paper, we evaluate the dual impact of cholera and COVID-19 in Africa and suggest plausible interventions that can be put in place to cushion its impact.

Abstract Cholera is a waterborne disease that continues to pose serious public health problems in many developing countries. Increasing water and sanitation coverage is a goal for local authorities in these countries, as it can eliminate one of the root causes of cholera transmission. The SIWDR (susceptible–infected–water–dumpsite–recovered) model is proposed here to evaluate the effects of the improved coverage of water and sanitation services in a community at risk of a cholera outbreak. This paper provides a mathematical study of the dynamics of the water and sanitation (WatSan) deficits and their public health impact in a community. The theoretical analysis of the SIWDR model gave a certain threshold value (known as the basic reproductive number and denoted R 0 $\mathcal{R}_{0}$ ) to stop the transmission of cholera. It was found that the disease-free equilibrium was globally asymptotically stable whenever R 0 ≤ 1 $\mathcal{R}_{0} \leq 1$ . The unique endemic equilibrium was globally asymptotically stable whenever R 0 > 1 $\mathcal{R}_{0} >1$ . Sensitivity analysis was performed to determine the relative importance of model parameters to disease transmission and prevention. The numerical simulation results, using realistic parameter values in describing cholera transmission in Haiti, showed that improving the drinking water supply, wastewater and sewage treatment, and solid waste disposal services would be effective strategies for controlling the transmission pathways of this waterborne disease.

Typhoid fever and cholera remain a huge public health problem on the African continent due to deteriorating infrastructure and declining funding for infrastructure development. The diseases are both caused by bacteria, and they are associated with poor hygiene and waste disposal systems. In this paper, we consider a nonlinear system of ordinary differential equations for the co-infection of typhoid and cholera in a homogeneously mixing population. The model's steady states are determined and analyzed in terms of the model's reproduction number. Impact analysis—how the diseases impact on each other—is carried out. Numerical simulations and sensitivity analysis are also given. The results show that the control of the diseases should be carried out in tandem for the greatest impact of disease control. The results have important implications in the management of the two diseases.

The subject of Turner’s mysterious unfinished painting, known today as Death on a Pale Horse, is a problem that has baffled generations of scholars. It has been proposed that it is a response to the death of Turner’s father in 1829 or to the cholera outbreak of 1832 but these suggestions are at best circumstantial. This paper offers a new interpretation of this enigmatic painting, linking it principally to the cause of political Reform.

Background: Over 700,000 Myanmar nationals known as the ‘Rohingyas’ fled into Cox’s Bazar, Bangladesh, in late 2017. Due to this huge displacement into unhygienic areas, these people became vulnerable to communicable diseases including cholera. Assessing the risk, the Government of Bangladesh (GoB), with the help of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) and other international partners, decided to take preventive measures, one of which is the execution of oral cholera vaccination (OCV) campaigns. This paper describes the implementation and delivery of OCV campaigns during humanitarian crises in Bangladesh. Methods: Seven rounds of OCV campaigns were conducted between October 2017 and December 2021. The OCV campaigns were conducted by applying different strategies. Results: Approximately 900,000 Rohingya Myanmar nationals (RMNs) and the host population (amounting to 528,297) received OCV across seven campaigns. In total, 4,661,187 doses of OCVs were administered, which included 765,499 doses for RMNs, and 895,688 doses for the host community. The vaccine was well accepted, and as a result, a high level of coverage was achieved, ranging from 87% to 108% in different campaigns. Conclusions: After successful pre-emptive campaigns in Cox’s Bazar humanitarian camps, no cholera outbreaks were detected either in the RMN or host communities.

Cholera is both an endemic and epidemic disease in many low and middle-income countries (LMICs). Strategies for cholera control include improving water, sanitation, and hygiene; providing early and effective treatment; and deploying oral cholera vaccine (OCV). This last strategy is relatively new, and countries considering its introduction are interested in knowing the potential cost not only of the vaccine, but also the cost of introduction. This paper describes the costing of OCV introduction in LMICs using a publicly available Excel-based tool known as the CholTool. It includes estimates of delivery cost categories which cover not only the service delivery costs (e.g. vaccine procurement, handling, storage, and transport; vaccination administration, monitoring supervision, and field support), but also the programmatic costs associated with introducing a new vaccine (i.e. microplanning, communication and training materials development, sensitization/social mobilization, and personnel training) to ensure that a comprehensive estimate is provided with health payer perspective. CholTool takes the user through a structured sequence of interlinked modules containing input parameter cells (assumptions), decision cells (variable selections), and formulas (calculations) to produce customized cost estimates based on standardized methods. The tool provides both financial and economic cost estimates, to ensure that both costs are available for consideration. Four examples of applications of CholTool are presented in three countries- one in Ethiopia, two in Malawi and one in Nepal. The estimates of economic delivery cost per dose (including service delivery and programmatic costs) were (in USD 2016): $2.89 in Ethiopia, $3.04 in Malawi1, $3.35 in Malawi2 and $3.06 in Nepal. A cost projection conducted before the campaign using the tool and a retrospective costing using the tool in Nepal resulted in no significant difference between economic delivery costs per dose.

This paper aims to study the quarantine system established by His Corean Majesty's Customs Service (HCMCS) between 1886 to 1893, and how they responded to the influx of infectious diseases such as cholera, led by the Customs Medical Officer of Joseon. The quarantine procedure was not able to operate in the first 11 years of opening the port due to limitations within HCMCS in the P. G. von Möllendorff period. However, as the Shanghai Customs officer, H. F. Merrill concurrently served as the Chief Commissioner, Seoul, HCMCS was directly connected to Shanghai Customs which was a direct model of Chinese Maritime Customs Service. This connection caused HCMCS to build a foundation that enabled the Shanghai quarantine measures to be referred to in 1886. In alignment with this, Acting Commissioner, Jenchuan, J. F. Schoenicke developed the quarantine system of Jenchuan Customs in 1886, using the quarantine system of Shanghai Customs as reference. Jenchuan Customs introduced new concepts, such as Observation Island, Yellow Flag, Free Pratique, and also enforced quarantine inspections on vessels coming from cholera-infected areas. Based on the quarantine system of the Shanghai Customs and Jenchuan Customs, Chief Commissioner, H. F. Merrill established conditions in 1887 for enforcing quarantine inspections on vessels arriving at the ports of Joseon. HCMCS conducted quarantine inspections on vessels coming from areas of infectious diseases, such as cholera, plague, yellow fever and smallpox, adopting concepts such as Customs Quarantine Officers, Quarantine boats, and Quarantine Hospitals. Quarantine hospitals affiliated with customs were founded at each trading port in order to treat patients with infectious diseases. Although His Corean Majesty's Hospital has been known as an ‘only Western-style hospital’ operated by the Joseon government, it should be noted that also these hospitals contributed medical activities. Meanwhile, document administration was accompanied to handle quarantine tasks. This was a complicated task with the authority structure of two lines: 1) Customs Quarantine Officer - Acting Chief Commissioner, Seoul - Acting Chief Commissioner, Seoul; 2) Superintendent – Dokpan. The actual quarantine of treaty port was implemented by Superintendent - Acting Chief Commissioner, Seoul. Matters of important decisions were accompanied by lower-level reports and higher-level instructions through the document administration procedure with the central government. The efficiency of this method was therefore limited whereas systematic administrative procedures were able to perform. This became the impetus that caused the third Chief Commissioner, Seoul, J. M. Brown to reform the framework of maritime affairs established in the Merrill period.

In the State of Amazonas, Brazil, urban expansion together with precarious basic sanitation conditions and human settlement on river banks has contributed to the persistence of waterborne and intestinal parasitic diseases. Time series of the recorded cases of cholera, typhoid fever, hepatitis A and leptospirosis are described, using data from different levels of the surveillance systems. The sources for intestinal parasitosis prevalence data (non-compulsory reporting in Brazil) were Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana (LILACS) and the annals of major scientific meetings. Relevant papers and abstracts in all languages were accessed by two independent reviewers. The references cited by each relevant paper were scrutinized to locate additional papers. Despite its initial dissemination across the entire State of Amazonas, cholera was controlled in 1998. The magnitude of typhoid fever has decreased; however, a pattern characterized by eventual outbreaks still remains. Leptospirosis is an increasing cause of concern in association with the annual floods. The overall prevalence of intestinal parasites is high regardless of the municipality and the characteristics of areas and populations. The incidence of hepatitis A has decreased over the past decade. A comparison of older and recent surveys shows that the prevalence of intestinal parasitic diseases has remained constant. The load of waterborne and intestinal parasitic diseases ranks high among the health problems present in the State of Amazonas. Interventions aiming at basic sanitation and vaccination for hepatitis A were formulated and implemented, but assessment of their effectiveness in the targeted populations is still needed.

Abstract In this paper we develop a stochastic mathematical model of cholera disease dynamics by considering direct contact transmission pathway. The model considers four compartments, namely susceptible humans, infectious humans, treated humans, and recovered humans. Firstly, we develop a deterministic mathematical model of cholera. Since the deterministic model does not consider the randomness process or environmental factors, we converted it to a stochastic model. Then, for both types of models, the qualitative behaviors, such as the invariant region, the existence of a positive invariant solution, the two equilibrium points (disease-free and endemic equilibrium), and their stabilities (local as well as global stability) of the model are studied. Moreover, the basic reproduction numbers are obtained for both models and compared. From the comparison, we obtained that the basic reproduction number of the stochastic model is much smaller than that of the deterministic one, which means that the stochastic approach is more realistic. Finally, we performed sensitivity analysis and numerical simulations. The numerical simulation results show that reducing contact rate, improving treatment rate, and environmental sanitation are the most crucial activities to eradicate cholera disease from the community.

For a long time, in different periods, Shiraz water was supplied from wells, aqueducts (qanat) and springs, which were generally open and hence got polluted in different ways on its way to the residential area. The consumption of these polluted waters resulted in the outbreak of infectious and contagious diseases, at times, killing a lot of people. Mohammad Namazi, having faced with the issue of unhealthy drinking water and consulted various specialists, found that the unsanitary drinking water was responsible for most gastrointestinal diseases as well as contagious diseases. In addition to constructing educational and health facilities, Namazi decided to develop a proper piping system for drinking water. At that time, even in the capital of Iran, there was not such a system. The present descriptive study, together with the library research method by scrutinizing local papers and newspapers, aims to first address the effect of the contaminated waters on the spread of contagious diseases and then the role of water piping system in reducing diseases in Shiraz. Research findings show that water supply and sanitation are important in reducing diseases such as typhoid, typhus, cholera and many waterborne diseases.

The battle of Muslims with the Crusaders took place when disturbances in the region of Sham, especially in the north, prevented their confrontation with European forces; as a result, the circumstances were brought about for the establishment of European rule in Edessa, Antioch, Jerusalem and Tripoli. Internal conflicts in the northern cities of Sham and prolonged encounters with the Turkmens, Crusaders, and rulers of Mosul and southern Sham caused insecurity in these areas. This insecurity was intensified by factors, such as epidemics, consecutive famines and the maladministration of governors. In this paper, the researcher attempts to use statistical data to evaluate the impact of war, famine and disease on insecurity in Northern Sham on the verge of the Crusaders’ attack. For this purpose, primary sources such as “al-Kāmil fī al-tārīkh”, Ibn al-Qalanisi’s “Mudhayyal Ta’rikh Dimashq”, and “Zubdat al-halab min tarikh Halab” were examined; cases of insecurity were extracted and the severity of their impact was analyzed based on the words these sources used to describe the “insecurity” and its underlying factors.

Environmental disturbances have a strong impact on cholera transmission. Stochastic differential equations are an effective tool for characterizing environmental perturbations. In this paper, a stochastic infectious disease model for cholera is established and investigated. The dynamics of the stochastic cholera model are discussed. Firstly, the existence and uniqueness of the positive solution are proven. Then, the asymptotical stability of the disease-free equilibrium of the system is investigated. Furthermore, the asymptotical stability of the endemic equilibrium of the deterministic system corresponding to the stochastic system is obtained. Then, the theoretical results are verified by some numerical simulations. Finally, the optimal problem is considered as the theoretical basis for the control of cholera. Both theoretical and numerical results indicate that the random perturbations may make the model more realistic, which provides theoretical assessment for the control of cholera transmission.

Abstract Cholera remains a major public health problem in many countries. Poor sanitation and inappropriate clean water supply, insufficient health literacy and community mobilization, absence of national plans and cross-border collaborations are major factors impeding optimal control of cholera in endemic countries. In March 2017, a group of experts from 10 Asian cholera-prone countries that belong to the Initiative against Diarrheal and Enteric Diseases in Africa and Asia (IDEA), together with representatives from the World Health Organization, the US National Institutes of Health, International Vaccine Institute, Agence de médecine préventive, NGOs (Save the Children) and UNICEF, met in Hanoi (Vietnam) to share progress in terms of prevention and control interventions on water, sanitation and hygiene (WASH), surveillance and oral cholera vaccine use. This paper reports on the country situation, gaps identified in terms of cholera prevention and control and strategic interventions to bridge these gaps.

Cholera is an acute diarrheal disease caused by toxigenic strains of Vibrio cholerae O1 and O139 serogroups. It still remains a major global healthcare problem. According to WHO, about 100,000 people die from cholera every year, despite the modern methods of treatment, improvement in the quality of drinking water, sanitation and hygiene. In recent years, oral cholera vaccines have proved an effective tool for preventing and curbing cholera epidemics. According to the WHO Ending Cholera — A Global Roadmap, mass vaccination should help reduce the mortality resulting from cholera by 90 % worldwide by 2030 and eliminate the disease in 20 countries. The review outlines the main historical stages in the development of cholera vaccines: parenteral, chemical, inactivated and live oral vaccines. The paper compares active ingredients and excipients used in Dukoral®, mORC-VAX®, Shanchol®, Euvichol®, Vaxchora®, Oravacs® and the cholera bivalent chemical vaccine. The results of international multicenter clinical trials of oral inactivated, live and chemical cholera vaccines are analysed. Issues related to efficacy and safety studies of cholera vaccines are considered.

Abstract Background Cholera is a highly infectious diarrheal disease spread via fecal contamination of water and food sources; it is endemic in parts of Africa and Asia and recent outbreaks have been reported in Haiti, the Zambia and Democratic Republic of the Congo. If left untreated, the disease can be fatal in less than 24 h and result in case fatality ratios of 30–50%. Cholera disproportionately affects those living in areas with poor access to water and sanitation: the long-term public health response is focused on improving water and hygiene facilities and access. Short-term measures for infection prevention and control, and disease characterization and surveillance, are impaired by diagnostic delays: culture methods are slow and rely on the availability of infrastructure and specialist equipment. Rapid diagnostic tests have shown promise under field conditions and further innovations in this area have been proposed. Methods This paper is the protocol for a systematic review focused on identifying current technologies and methods used for cholera diagnosis in stool, and detection in water. We will synthesize and appraise information on product technical specifications, accuracy and design features in order to inform infection prevention and control and innovation development. Embase, MEDLINE, CINAHL, Proquest, IndMed and the WHO and Campbell libraries will be searched. We will include studies reporting on field evaluations, including within-study comparisons against a reference standard, and laboratory evaluations reporting on product validation against field stool or water samples. We will extract data according to protocol and attempt meta-analyses if appropriate given data availability and quality. Discussion The systematic review builds on a previous scoping review in this field and expands upon this by synthesising data on both product technical characteristics and design features. The review will be of particular value to stakeholders engaged in diagnostic procurement and manufacturers interested in developing cholera or diarrheal disease diagnostics. Systematic review registration PROSPERO CRD42016048428.

Victoria Koski-Karell,1,2 Paul E Farmer,2–4 Benito Isaac,5 Elizabeth M Campa,5 Loune Viaud,5 Paul C Namphy,6 Ralph Ternier,5 Louise C Ivers2–4 1Department of Anthropology, University of Michigan, and University of Michigan Medical School, Ann Arbor, MI, 2Partners In Health, 3Department of Global Health and Social Medicine, Harvard Medical School, 4Department of Medicine, Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; 5Zanmi Lasante, Cange, 6Direction Nationale de l'Eau Potable et de l'Assainissement, Port-au-Prince, Haiti Abstract: Since the beginning of the cholera epidemic in Haiti 5 years ago, the prevalence of this deadly water-borne disease has fallen far below the initial rates registered during its explosive outset. However, cholera continues to cause extensive suffering and needless deaths across the country, particularly among the poor. The urgent need to eliminate transmission of cholera persists: compared to the same period in 2014, the first 4 months of 2015 saw three times the number of cholera cases. Drawing upon epidemiology, clinical work (and clinical knowledge), policy, ecology, and political economy, and informed by ethnographic data collected in a rural area of Haiti called Bocozel, this paper evaluates the progress of the nation's 10-year Plan for the Elimination of Cholera. Bocozel is a rice-producing region where most people live in extreme poverty. The irrigation network is decrepit, the land is prone to environmental shocks, fertilizer is not affordable, and the government's capacity to assist farmers is undermined by resource constraints. When peasants do have rice to sell, the price of domestically grown rice is twice that of US-imported rice. Canal water is not only used to irrigate thousands of acres of rice paddies and sustain livestock, but also to bathe, wash, and play, while water from wells, hand pumps, and the river is used for drinking, cooking, and bathing. Only one out of the three government-sponsored water treatment stations in the research area is still functional and utilized by those who can afford it. Latrines are scarce and often shared by up to 30 people; open defecation remains common. Structural vulnerabilities cut across all sectors – not just water, sanitation, health care, and education, but agriculture, environment, (global and local) commerce, transportation, and governance as well. These are among the hidden sicknesses that impede Haiti and its partners' capacity to eliminate cholera. Keywords: water, sanitation, WASH, oral cholera vaccination, elimination

INTRODUCTION: in Cameroon, cholera has periodically resurfaced since it was first reported in 1971. In 2003, Cameroon adapted the integrated disease surveillance and response (IDSR) strategy to strengthen surveillance in the country. This study was an in-depth description and assessment of the structure, core and support functions, and attributes of the current cholera surveillance system in Cameroon. It also discussed its strengths and challenges with hope that lessons learned could improve the system in Cameroon and in other countries in Africa implementing the IDSR strategy. METHODS: semi-structured key informant interviews, peer reviewed articles, and government record review were conducted in the Far North and Centre Regions of Cameroon. We used the matrix and conceptual framework from the World Health Organization (WHO) and Centers for Disease Control and Prevention, WHO Regional Office for Africa Technical Guidelines to frame the study. Site visits included the WHO country office, the ministry of public health (MoPH), two Regional Public Health Delegations (RPHDs), eight health districts (HDs) and health facilities (HFs) including two labs. RESULTS: cholera surveillance is passive but turns active during outbreaks and follows a hierarchical structure. Cholera data are collected at HFs and sent to HDs where data are compiled and sent to the RPHD in paper format. RPHDs de-identify, digitalize, and send the data to the MoPH via internet and from there to the WHO. The case definition was officially changed in 2010 but the outdated definition was still in use in 2013. Nationally, there are 3 laboratories that have the ability to confirm cholera cases; the lack of laboratory capacity at HFs hampers case and outbreak confirmation. The absence of structured data analysis at the RPHD, HD, and HF further compounds the situation, making the goal of IDSR of data analysis and rapid response at the HD very challenging. Feedback is strongest at the central level (MoPH) and non-existent at the levels below it, with only minimal training and supervision of staff. In 2012, mobile phone coverage expanded to all 183 HDs and to HFs in 2014 in the Far North and North Regions. The phones improved immediate reporting and outbreak control. Further, the creation of cholera command and control centers, and introduction of laptops at all RPHDs are major strengths in the surveillance system. Completeness and timeliness of reporting varied considerably among levels.

INTRODUCTION: despite some improvement in provision of safe drinking water, proper sanitation and hygiene promotion, cholera still remains a major public health problem in Malawi with outbreaks occurring almost every year since 1998. In response to 2014/2015 cholera outbreak, ministry of health and partners made a decision to assess the feasibility and acceptability of conducting a mass oral cholera vaccine (OCV) as an additional public health measure. This paper highlights the burden of the 2014/15 cholera outbreak, successes and challenges of OCV campaign conducted in March and April 2015. METHODS: this was a documentation of the first OCV campaign conducted in Malawi. The campaign targeted over 160,000 people aged one year or more living in 19 camps of people internally displaced by floods and their surrounding communities in Nsanje district. It was a reactive campaign as additional measure to improved water, sanitation and hygiene in response to the laboratory confirmed cholera outbreak. RESULTS: during the first round of the OCV campaign conducted from 30 March to 4 April 2015, a total of 156,592 (97.6%) people out of 160,482 target population received OCV. During the second round (20 to 25 April 2015), a total of 137,629 (85.8%) people received OCV. Of these, 108,247 (67.6%) people received their second dose while 29,382 (18.3%) were their first dose. Of the 134,836 people with known gender and sex who received 1 or 2 doses, 54.4% were females and over half (55.4%) were children under the age of 15 years. Among 108,237 people who received 2 doses (fully immunized), 54.4% were females and 51.9% were children under 15 years of age. No severe adverse event following immunization was reported. The main reason for non-vaccination or failure to take the 2 doses was absence during the period of the campaign. CONCLUSION: this documentation has demonstrated that it was feasible, acceptable by the community to conduct a large-scale mass OCV campaign in Malawi within five weeks. Of 320,000 OCV doses received, Malawi managed to administer at least 294,221 (91.9%) of the doses. OCV could therefore be considered to be introduced as additional measure in cholera hot spot areas in Malawi.