History of Cholera Outbreaks in Iran during the 19th and 20th Centuries

Cholera is an acute infectious disease with high mortality if left untreated. Historically, between the 19th and 20th centuries seven great pandemics of cholera occurred and worldwide, thousands of people died. Based on an old theory, cholera was considered an air-born disease and the emergence of its outbreaks were attributed to bad weather or miasma. However later in the 18th century, British physician John Snow (1813-1858) explained the association of a terrible cholera outbreak in London in 1849 to contamination of the drinking water supply with human excreta. Despite his finding, the causative agent of this dreaded illness was unidentified until later in the 19th century. In 1854, Filippo Pacini (1812-1883) an anatomist from Italy and then in 1883, Robert Koch (1843-1910) the German bacteriologist, discovered ‘vibrio cholerae’ as the etiologic agent. During the major pandemics of cholera in 19th and 20th centuries this illness reached Iran and led to vast depopulation and a crucial impact on the country’s socioeconomic status. Poor public health conditions, lack of a well-organized public health authority for implementing preventive and quarantine measures as well as Iran’s specific geographic location were the main facilitating factors of the emergence of various epidemics, including cholera in Iran. The present paper briefly reviews the cholera outbreaks in Iran during the 19th and 20th centuries.