Timeline of cholera

Cholera is an infectious disease caused by the bacterium Vibrio cholerae. It infects the small intestine. Cholera is still ACTIVE throughout the world. Estimates from 2010 say that between three- and five million people get cholera every year, and 58,000–130,000 people die from the disease every year.

Big picture

Time period	Key developments
5th century BC	Probable origin of cholera in the Indian subcontinent, where almost all of the cholera pandemics will later originate.
1816–1923	The first six cholera pandemics happen in an almost continuous period of time. Mostly as a result of increased commerce, but also migration and pilgrimage.
1879–1883	Major scientific breakthroughs happen: the first immunization by Pasteur, the first vaccine against cholera, and the identification of the bacterium vibrio cholerae by Filippo Pacini and Robert Koch.
1945–1948	Formation of the United Nations and World Health Organization (WHO).
1961 onwards	The seventh cholera pandemic breaks out, after a long hiatus. Oral rehydration therapy is introduced in the late 70s.
Present times	The seventh cholera pandemic continues today at a much smaller scale with outbreaks across the developing world. Epidemics occur after war, civil unrest, or natural disasters when water and food supplies become contaminated with vibrio cholerae in areas with crowded living conditions and poor sanitation.

Full timeline

Year/Period	Event type	Event	Present-day geographic location
460–377 BCE	Science development	Hippocrates is the first to mention the term cholera in his writings, although the exact disease he refers to is unknown.	Greece
1563	Science development	Cholera is first recorded in a medical report.	India
1817–1824	Epidemic	First cholera pandemic begins near Calcutta, reaching most of Asia. It is thought to have killed over 100,000 people.	India, Thailand, Philippines, Java, Oman, China, Japan, Persian Gulf, Iraq, Syria, Transcaucasia, Astrakhan (Russia), Zanzibar, and Mauritius.
1819	Epidemic	Cholera epidemic reaches the island of Java from Bengal.	Indonesia
1829–1851	Epidemic	Second cholera pandemic, known as the Asiatic Cholera Pandemic, arguably starts along the Ganges river. It is the first to reach Europe and North America. Like in the first one, fatalities reach six figures.	India, western and eastern Asia, Europe, Americas.
1830-1831	Epidemic	Cholera epidemic across Europe gives rise to the Cholera Riots in Russia and England.	Europe
1831	Science development	Scottish physician William Brooke O'Shaughnessy notices that the composition for the stool water in cholera ptients is very similar to that of their blood plasma. These values are found close to those of normal controls, except that the patients have markedly reduced water content. From this data, O'Shaughnessy suggests that replacing water and salt would be beneficial to them.	Great Britain
1832	Science development (treatment)	Medical pioneer Thomas Latta develops the first intravenous saline drip.	Scotland (Leith)
1832	Epidemic	Cholera claims 6536 victims in London and 20000 in Paris (out of a population of 650 000), and is responsible for about 100000 deaths in France as a whole. The epidemic reaches Russia, Quebec, Ontario and New York in the same year. In Portugal, cholera is brought to Oporto in on the boats that carry troops from Ostend to help the Liberal army during the civil war. From Oporto, cholera spreads throughout the country, and more than 40000 people perish. It is calculated that cholera killed more people than the war itself.	Europe, North America
1851–1938	Organization	The International Sanitary Conferences, largely inspired by the cholera pandemics, are held with the objective to standardize international quarantine regulations against the spread of cholera and other diseases.	Paris, Constantinople, Vienna, Washington, Rome, Venice, Dresden
1852–1860	Epidemic	Third cholera pandemic starts along the Ganges delta. Millions of infected in Russia. Death toll reaches one million.	Asia, Europe, Africa and North America
1853	Epidemic	Third cholera pandemic: Copenhagen cholera outbreak kills almost 5000 people in less than three months.	Denmark
1854	Scientific development	Italian anatomist Filippo Pacini publishes his paper "Microscopical observations and pathological deductions on cholera" in which he describes his discovery of micro-organisms which he names Vibrio, and its relation to cholera. Pacini becomes the first to isolate the cholera bacterium vibrio cholerae.	Italy
1854	Epidemic	Cholera epidemic reaches China, Japan; and Mauritius, where four outbreaks occur until 1862. In London, Broad Street cholera outbreak kills at least 500 people.	China, Japan, Mauritius, England
1854	Scientific development	First demonstration by John Snow, during an epidemic in London, that the transmission of cholera is significantly reduced when uncontaminated water is provided to the population.	England
1854	Organization	Cholera Hospital is established. It built to treat cholera patients who are denied admittance to City Hospital in Manhattan during a cholera epidemics in the same year.	United States (New York City)
1856–1857	Epidemic	Cholera is recorded in several parts of Central America and Guyana.	Central America, South America
1863–1875	Epidemic	The fourth cholera pandemic starts again in the Ganges delta.	Asia, Middle East, Russia, Europe, Africa and North America
1865	Epidemic	Fourth cholera pandemic: The Mecca pilgrimage becomes the scene of a major epidemic. It is calculated that 30000 deaths occur out of 90000 pilgrims.	Saudi Arabia (Mecca)
1865–1866	Epidemic	Fourth cholera pandemic: Cholera arrives again to the United States. Deplorable sanitary conditions make favorable for the spread of the disease.	United States
1869	Epidemic	Fourth cholera pandemic: About 70000 people are reported dead in Zanzibar.	Tanzania
1879	Scientific development	Louis Pasteur succeeds in immunizing chicken from cholera.	France
1881–1896	Epidemic	Fifth cholera pandemic begins in India. It is the first to reach South America.	Asia, Africa, Russia, Europe, South America
1883	Scientific development	Identification of bacterium vibrio cholerae by Robert Koch. Although not the first description, the discovery of the cholera organism is credited to Koch, who independently identifies the bacterium during an outbreak in Egypt.
1885	Scientific development ([...])	Spanish physician Jaume Ferran i Clua develops a cholera vaccine, which is the first to immunize humans against a bacterial disease. Ferrán vaccinates about 50,000 people in Valencia during a cholera epidemic.	Spain
1892	Scientific development ([...])	Russian bacteriologist Waldemar Haffkine, working at Pasteur Institute, announces a new cholera vaccine.
1899–1923	Epidemic	The sixth pandemic kills more than 800,000 people in India where it begins.	India, Middle East, North Africa, Eastern Europe and Russia.
1923	Scientific development	The first studies on cholera phages are carried out. Later summarized in 1959.
1935	Epidemic	New cholera biotype El Tor causes major epidemic outbreak in Celebes Islands. El Tor biotype is also isolated in Indonesia (strain M66-2) during an outbreak later in 1937.	Indonesia
1935	Science development	The serological classification of vibrio cholerae is first described.
1948	Organization	Formation of the World Health Organization (WHO).	Geneva
1948	Scientific development ([...])	Antibiotic tetracycline is introduced. It is used for treating several types of infections caused by susceptible bacteria, including vibrio cholerae.
1951–1959	Scientific development	Indian pathologist Sambhu Nath De discovers that cholera is caused by a potent exotoxin (cholera toxin) affecting intestinal permeability. Nath De also demonstrates that bacteria-free culture filtrates of vibrio cholerae are enterotoxic. Sambu Nath De also develops a reproducible animal model for the disease. These works are considered milestones in the history of the fight against cholera.
1952	Scientific development ([...])	Erythromycin is introduced. It is used for the treatment of cholera.
1961–present	Epidemic	The seventh cholera pandemic, starting in Indonesia, continues today at a much smaller scale.	Asia, Africa, Americas, Europe, Oceania
1967	Scientific development ([...])	Doxycycline is introduced as antibiotic. It is proved to be an effective treatment for cholera.
1968	Scientific development ([...])	Trimethoprim/sulfamethoxazole is introduced. It is used for treating cholera among multiple other diseases.
1971–2012	Epidemic	Seventh cholera pandemic: cholera is first reported in Cameroon in 1971. In the period between 2000 and 2012, 43474 cholera cases are reported: 1748 are fatal (mean annual case fatality ratio of 7.9%), with an attack rate of 17.9 reported cases per 100000 inhabitants per year.	Cameroon
1974	Scientific development	Researchers show that more than 10⁸ vibrio cholerae cells are required to induce infection and diarrhoea.
1976	Scientific development	Researchers report that a combination of vibrio cholerae O1 antigens such as lipopolysaccharides (LPS) and cholera toxin (CT) or choleragenoid (now termed Cholera Toxin B or CTB) induces more than 100-fold greater protection of rabbits against a challenge with live vibrios than does vaccination with either of the two antigens alone.
1979	Scientific development (treatment)	Oral rehydration therapy (ORT) is introduced as a technique of fluid replacement used to prevent or treat dehydration especially due to diarrhea. ORT rapidly becomes the cornerstone of programmes for the control of diarrhoeal diseases. Oral rehydration therapy dramatically would brought down the cholera case fatality rate from 30% in 1980 to around 3.6% in 2000.
1984	Scientific development ([...])	United States FDA approves serotonin antagonist ondansetron. Ondansetron diminishes cholera toxin-evoked secretion.	United States
1984	Epidemic	Seventh cholera pandemic: cholera epidemic reaches Mali. 1793 cases and 406 deaths are reported.	Mali
1986	Scientific development ([...])	United States FDA approves antibacterial norfloxacin. It is proved to be effective for the treatment of cholera.	United States
1986	Scientific development	Molecular technique for bacterial identification ribotyping begins. It would be used for characterizing cholera strains.
1990 (circa)	Scientific development	Pulsed-field gel electrophoresis technique is first described. It is used to subtype bacterial strains. PFGE would show to be useful for the identification of spread of specific clones in many cholera outbreak investigations.
1990 (circa)	Scientific development	Randomly amplified polymorphic DNA analysis is first described. RAPD would be used for characterizing representative strains of vibrio cholerae.
1991	Scientific development ([...])	Oral cholera vaccine Dukoral is introduced. It is manufactured by Crucell.	Netherlands
1992–1993	Epidemic	New strain of cholera, new strain of cholera, Vibrio cholerae serogroup O139 Bengal emerges and causes outbreaks in Bangladesh and India. Disease from this strain becomes endemic in at least 11 countries.
1994	Epidemic	Seventh cholera pandemic: cholera cases are notified from 94 countries, the highest ever number of countries in one year.
1998	Scientific Development	Multilocus sequence typing analysis (MLST) is first described. MLST has better discriminatory ability for typing vibrio cholerae than does pulsed-field gel electrophoresis and provides a measure of phylogenetic relatedness.
2001	Scientific development ([...])	United States FDA approves serotonin 5-HT₃ receptor antagonist granisetron. Granisetron markedly diminishes cholera toxin-evoked secretion.	United States
2005	Scientific development	Small molecule virstatin is found to inhibit virulence expression in vibrio cholerae.	United States
2007	Scientific development ([...])	Researchers from the University of Tokyo develop a type of rice that carries the cholera vaccine.{{cite news\|last1=Sinha	title=Breakthrough in cholera cure\|url=http://timesofindia.indiatimes.com/home/science/Breakthrough-in-cholera-cure/articleshow/2118293.cms\|accessdate=14 December 2016\|publisher=The Times of India\|date=June 13, 2007}}
2007	Epidemic	Iraq cholera outbreak. 4667 cases reported. The median age of the cases is 11 years.	Iraq
2008	Epidemic	Zimbabwean cholera outbreak. 98741 cases and 4293 deaths reported.	Zimbabwe, Botswana, Mozambique, South Africa and Zambia.
2009	Epidemic	The World Health Organization reports more than 220,000 cases of cholera and almost 5,000 deaths worldwide.
2009	Scientific development ([...])	Oral cholera vaccine Shanchol is introduced. It contains killed whole cells of vibrio cholerae serogroups O1 and O139. Shanchol is manufactured by Shantha Biotechnics.	India
2009	Epidemic	Papua New Guinea cholera outbreak results in over 15000 cases and more than 500 deaths.	Papua New Guinea
2010–present	Epidemic	Haiti cholera outbreak kills over 9,500 people across four countries.	Haiti, Dominican Republic, Cuba, Mexico, Venezuela and Florida (U.S.)
2011	Science development	Multi-virulence locus sequencing typing technique is first described. MVLST would be used for determining the genetic variation and relatedness of vibrio cholerae strains of different zerogroups.
2012	Epidemic	Sierra Leonean cholera outbreak. At least 392 people are reportedly killed and more than 25,000 others are infected.	Sierra Leone, Guinea
2014–2015	Epidemic	Cholera outbreak in Africa. 1,475 reported deaths, 84,675 reported cases.	Ghana, Nigeria, Niger, Togo, Benin, Democratic Republic of the Congo, Ivory Coast, Chad, Liberia, Guinea-Bissau, Guinea
2015	Scientific development ([...])	Oral cholera vaccine Euvichol is introduced. Euvichol is manufactured by EuBiologics.	South Korea
2016	Scientific development ([...])	United States FDA approves Vaxchora for the prevention of cholera.	United States

1817–24 cholera pandemic1829–51 cholera pandemic1852–60 cholera pandemic1853 Copenhagen cholera outbreak1854 Broad Street cholera outbreak1863–75 cholera pandemic1881–96 cholera pandemic1899–1923 cholera pandemic1961–75 cholera pandemic2007 Iraq cholera outbreak2009 Papua New Guinea cholera outbreak2012 Sierra Leonean cholera outbreak2014–15 African cholera outbreak5-HT3 antagonistAmericasAntibioticAstrakhanBacteriaBangladeshBBCBengalBlood plasmaCalcuttaCameroonCBC NewsCenters for Disease Control and PreventionCentral AmericaChinaCholeraCholera HospitalCholera RiotsCholera toxinCrucellDenmarkDiarrheaDiarrhoeaDoxycyclineDrugs.comDukoralEgyptEl TorEmerging Infectious DiseasesEnterotoxinErythromycinEuBiologicsEuropeExotoxinFDAFilippo PaciniGanges riverGel electrophoresisGenevaGranisetronGreeceGuineaGuyanaHaiti cholera outbreakHippocratesIndiaIndonesiaInternational Sanitary ConferencesIraqIRINJapanJaume Ferran i CluaJavaJohn SnowJournal of Infection PreventionLiberal WarsLipopolysaccharidesLouis PasteurMaliManhattanMauritiusMeccaMedicineNetMedScapeMulti-virulence locus sequencing typingMultilocus sequence typing analysisNational Institutes of HealthNational Science FoundationNetherlandsNew York CityNorfloxacinNorth AmericaOmanOndansetronOntarioOportoOral rehydration therapyPan American Health OrganizationPapua New GuineaPasteur InstitutePersian GulfPhilippinesPLOSPortugalPulsed-field gel electrophoresisQuebecRandomly amplified polymorphic DNAResearchGateRibotypingRobert KochRussiaSaline dripSambhu Nath DeSciELOSerotoninSerotonin antagonistSeventh cholera pandemicShantha BiotechnicsSierra LeoneSouth KoreaSpainSulawesiSyriaTanzaniaTetracyclineThailandThe New York TimesThe Royal SocietyThe Times of IndiaThird cholera pandemicThomas LattaTimeline of global healthTimeline of malariaTranscaucasiaTrimethoprim/sulfamethoxazoleUCLAUNICEFUnited NationsUnited StatesUnited States National Library of MedicineUniversity of MichiganUniversity of New MexicoValenciaVibrio choleraeVirstatinWaldemar HaffkineWilliam Brooke O'ShaughnessyWorld Health OrganizationZanzibarZimbabwean cholera outbreak

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