Epidemiology of Endemic Cholera

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Abstract
A theory is presented to explain the long-recognized connection between the incidence of cholera and changing weather conditions in Bengal. The theory is that in hot, dry weather algae in the village water tanks raise the pH of the water so high that the cholera vibrio is favored over other organisms. The potentialities of these ponds of surface water which serve as the village water supply in spreading infection and the ability of the cholera vibrio to withstand a high pH have been noted. Results of weekly tests of the pH of six tanks for a 1-year period and observations of the relationship of the pH to weather and to incidence indicate that the pH is a factor to be taken into account. It is suggested that the tanks are the chief means for spread of the vibrio and that the endemic infection is primarily rural rather than urban. Cholera is endemic in Bengal, the major remaining focus of infection, because of polluted drinking water. The eradication of cholera from Bengal, and therefore from the world, depends largely on the success of the Pakistani and Indian Governments in replacing the village tanks with a source of safe water.

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