1830 Vienna / 1991 Mexico  

WHO estimates that about 10% of diseases globally are attributable to water‐quality, sanitation, or hygiene‐related problems.1 Human exposure to waterborne infections occurs by contact with contaminated drinking water, recreational water, or food.1 Cholera is an acute diarrhea infection caused by eating or drinking food or water that is contaminated with the bacterium Vibrio cholerae.2 After consuming the contaminated food or water, it takes between 12 hours and 5 days for a person to show symptoms. Researchers have estimated that every year there are up to 4.0 million cases and 143,000 deaths in the world due to the infection.2 Cholera type D can kill within hours if untreated.2 Most people infected do not show symptoms, though the bacteria remains in their feces for up to 10 days. This allows the bacteria to go back into the environment and infect others.2

Cholera is often predictable and preventable. It is eliminated by access to clean water and sanitation facilities and maintaining good hygiene practices.2 Cholera mostly affects the population that does not have access to these basic services of clean water and sanitation facilities. Cholera is ”an indicator of inequity and lack of social development”, according to WHO.2 Oral cholera vaccines and education of food hygiene are useful tools made available and administered by the government in controlling cholera outbreaks.2

Government intervention is key for treatment and prevention of cholera. Unfortunately, cities cannot always be prepared. When a large ice jam on the Danube river caused the banks of the city of Vienna to burst, the overflow of the surrounding rivers and brooks lead to a major outbreak of the disease.3 In response, the Viennese government acted directly after the cholera outbreak of 1830 that killed 2,000 people by covering all of Vienna’s streams.3 Two main sewers nicknamed the “cholera sewers” were built parallel to the River Wien, which led to the Danube.3 Some governments, such as Mexico, have observed the surrounding countries outbreaks and prepared in advance for their countries.Before the occurrence in 1991, the rural physician of the community where the first case occurred was trained on cholera diagnosis and management.4 Supplies for diagnosis and treatment were available at the local clinic and timely reporting of the case at both local and national levels by the epidemiological surveillance system have been utilized as effective measures of disease control.4

Emperor Francis I viewing construction of the "cholera sewer" at St. Charles' Church in 1832.

Sources: “Vienna's Sewer System in the Modern Period,” Vienna’s sewer system in the modern period, December 4, 2015, https://www.wien.gv.at/english/environment/sewer-system/history/modern-period.html.

  1. J.A. Patz et al., “Climate Change and Infectious Diseases - WHO,” World Health Organization (WHO), accessed March 3, 2021, https://www.who.int/globalchange/publications/climatechangechap6.pdf.
  2. “Cholera,” accessed March 3, 2021, https://www.who.int/health-topics/cholera#tab=tab_1.
  3. “Vienna's Sewer System in the Modern Period,” City of Vienna, December 4, 2015, https://www.wien.gv.at/english/environment/sewer-system/history/modern-period.html.
  4. Filiberto Malagón, “Malaria Eradication in Mexico: Some Historico-Parasitological Views On Cold War, Deadly Fevers by Marcos Cueto, Ph.D,” Philosophy, Ethics, and Humanities in Medicine 3, no. 1 (2008): p. 15, https://doi.org/10.1186/1747-5341-3-15.