An island at risk: geographic epidemiologic analysis of the 1848 – 1850 cholera epidemic in Ireland

Cholera is one of the foremost water-borne diseases of citizens in developing countries without adequate access to clean water or sanitation facilities. Every year, 3 to 5 million people worldwide are infected by cholera, of which more than 100,000 die. Cholera is a re-emerging disease whose spread remains difficult to predict. One way to improve our ability to predict cholera epidemics is to learn from the dynamics of past epidemics. Studying historical cholera epidemics improves our understanding of the natural history of cholera before there were effective public health interventions or public understanding of transmission. Recent examples of studies that revisited cholera epidemics include Bingham and colleagues who studied the role of the water supply in the London outbreak of 1849, and Kuo and colleagues (5) who identified the changing geographical patterns of cholera in Fukushima from 1882 and 1895. Here, the 1848 – 1850 cholera epidemic in Ireland is investigated. This epidemic was part of the second cholera pandemic, during which more than 45,698 cases and 19,325 deaths were reported to Ireland’s Central Board of Health. It began during the Irish famine (1845 – 1852), when, between the censuses of 1841 to 1851, the population of Ireland dropped by 1,622,739 people through starvation, disease, and emigration, to a total population of 6,552,385. Epidemiology of the cholera epidemic of 1848 – 1850 in Ireland The second cholera pandemic began in 1829 in India, and first arrived in Ireland in Dublin in March, 1832. This first arrival of cholera in Ireland spread to the principal towns, but subsided quickly. The famine of Ireland began with the potato blight in 1845, which led to migration of Irish people to cities and workhouses in search of work and food. The first reported case of this epidemic was a man just arrived from Edinburgh and took place on December 4, 1848 in a workhouse in Belfast