The fifth cholera pandemic (1881–1896) was the fifth major international outbreak of cholera in the 19th century. The endemic origin of the pandemic, as with those of its predecessors, was in the Ganges Delta in West Bengal.Snowden, Naples in the time of cholera, 1884–1911, p. 59Kohn, Encyclopedia of Plague and Pestilence, p. 15 While the Vibrio cholerae bacteria had not been able to spread to western Europe until the 19th century, faster and improved modes of modern transportation, such as steamships and railways, reduced the duration of the journey considerably and facilitated the transmission of cholera and other infectious diseases.Hayes, The Burdens of Disease, p. 136; pp. 180–86 During the fourth 1863–1875 cholera pandemic, the third International Sanitary Conference convened in 1866 in Constantinople had identified religious pilgrimages to be "the most powerful of all causes" of cholera and again Hindu and Muslim pilgrimages were an important factor in the spread of the disease.Aberth, Plagues in World History, p. 105
In addition, the growing colonial rule of the British in India, and France's colonial war in Indo-China,Snowden, Naples in the time of cholera, 1884–1911, p. 62 with its increased military presence and economic exchanges multiplied the connections both inside Asia and between Asia and Europe. Therefore, cholera for the first time could spread significantly outside its original source habitat on the Indian subcontinent, where it had been home for centuries. The fifth cholera pandemic would be known in Europe as the 'eastern plague'. A better insight in the disease and improved sanitation limited mortality largely in Europe and North America, although some substantial outbreaks in Europe did happen.Aberth, Plagues in World History, p. 102
During this pandemic, there were significant scientific advances that improved the control of the disease. German microbiologist Robert Koch isolated Vibrio cholerae and proposed postulates to explain how bacteria caused disease. His work helped to establish the germ theory of disease. In 1892, the Russian-French bacteriologist Waldemar Haffkine, developed a cholera vaccine. (See: Scientific advances)
Spread of the pandemic
In 1881, the cholera bacterium spread both East and West, and eventually reached Europe and Latin America. From its endemic origin in the Ganges Delta in West Bengal, there was a virulent outbreak in the Punjab and Lahore in northwest India in the years 1881–82, with a very serious death rate. Other early outbreaks occurred in Korea in 1881, and in Thailand in 1882. The Islamic holy city Mecca (Arabia), with its yearly influx of Muslim pilgrims a notorious transmission hub for cholera,Kohn, Encyclopedia of Plague and Pestilence, p. 82 was hit during both these years. Further eastward outbreaks occurred in China (also in 1883), and in Japan, followed by the Philippines in 1882–83. In the following years cholera in Asia hit China in 1888, 1890, and 1895; Japan in 1885, 1886, 1890, 1891, and 1895; Korea in 1888, 1890, 1891, and 1895; and the Philippines in 1888–89.
In 1883 it reached Egypt and in the course of a few months, tens of thousands of victims died. (Seeː 1883 outbreak in Egypt) Further westward cholera outbreaks occurred in April 1884 in the naval base Toulon, France, with smaller outbreaks in Marseille, Paris, and other cities, affecting 10,000 people all over France. In 1885, some of the same areas were again infected. Italian migrant workers brought cholera from France to Italy, with a serious outbreak in the city of Naples in August–September 1884.Snowden, Naples in the time of cholera, 1884–1911, p. 104 There were minor outbreaks in Italy in 1886–87 without causing epidemics. The outbreak provoked a poisoning "phobia" directed primarily against Gypsies.
The pandemic also spread to Spain, with a minor outbreak starting in Alicante on the Mediterranean coast.Cholera Invades Spain. Great Alarm at Madrid And In The Provinces. The Dread Disease Appears in Alicante, The New York Times, September 3, 1884The Cholera Epidemic of 1884, Nature, October 30, 1884 But with a more virulent one at the end of 1885, with 160,000 cases and about 60,000 deaths. In 1890 there was another smaller outbreak. According to The New York Times in 1890, cholera had swept away about 120,000 of the inhabitants in the country.The Cholera In Spain, The New York Times, June 20, 1890 Quarantine measures for ships and immigrants based on the findings of the British physician, John Snow, prevented cholera outbreaks in Great Britain and the United States.Hayes, The Burdens of Disease, p. 147 However, the disease reached Latin America with serious outbreaks in 1886 (Argentina),The Cholera In Buenos Ayres, The New York Times, December 1, 1886 1887 (Chile), and 1888 (Argentina and Chile).
The pandemic reappeared in 1891 and originated in Bengal when 60,000 Hindu pilgrims arrived at a small village to celebrate a bathing festival unknown to the authorities (most likely the annual Makar Sankranti bath at Gangasagar Mela). The pilgrims caused new immense cholera outbreaks in northern India during 1891, with more than 580,000 cholera deaths in Assam, Bengal, and Uttar Pradesh.Kohn, Encyclopedia of Plague and Pestilence, p. 151 The disease continued westward in 1892, across the Punjab (with 75,000 cholera deaths), and raged on through Afghanistan and claimed 60,000 lives in Persia, and then reached Imperial Russia which suffered a staggering morbidity rate, exacerbated by the Russian famine of 1891–1892.Kohn, Encyclopedia of Plague and Pestilence, p. 283-84 Cholera's penetration in Russia began at Baku, a port on the Caspian Sea. The disease spread upstream along the Volga to reach Moscow and St. Petersburg, where morbidity was relatively minor. The official death toll for 1892 was 300,321. The epidemic faded during the winter and 42,250 cholera deaths were recorded in 1893.
The busy ports of Hamburg in Germany (Seeː 1892 outbreak in Hamburg), and New York City, the main exit and entry points for cross Atlantic emigration from Europe to the United States, were hit by serious cholera outbreaks in 1892. New York, the busiest port of the U.S. was hit by a combination of typhus fever and cholera in 1892 through Hamburg.Markel, Quarantine!, pp. 88–90 The main source of those epidemics were East European Jews, mainly from Imperial Russia, that tried to escape the appalling conditions, the 1891–1892 famine, and antisemitic restrictions (such as the expulsion of Jews from Moscow early in 1892) in their home country.Evans, Death in Hamburg, pp. 279–82Markel, Quarantine!, p. 11; p. 18
In Europe in 1892, the disease was alo prevalent in France. Germany and France were reinfected in 1893–94 but outbreaks did not reach epidemic levels. Latin America again suffered attacks several times in the 1890s. Brazil was hit with cholera in 1893–95, mainly along the railway in the Paraíba Valley, through ships carrying immigrants from Europe,Defenses Against Cholera, The New York Times, January 22, 1894The Cholera Cases In Brazil, The New York Times, January 9, 1895 Nos tempos do cólera, Folha de S. Paulo, 1 September 2002 Argentina in 1894–95, and Uruguay in 1895. The pandemic also reached the African continent, with outbreaks in 1893 (Tripolitania, Tunisia, Algeria, Morocco, and French West Africa), 1894 (Sudan, Tripolitania, and French West Africa), 1895 (Morocco and Egypt), and 1896 (Egypt).
In August 1895, the cholera outbreak reached the Sandwich Islands.
In the following years there were no new cholera outbreaks, but in 1899 it broke out again in many regions, leading to the 1899–1923 cholera pandemic.
1883 outbreak in Egypt
In late June 1883, the first cases of cholera in Egypt, recently occupied by the British Empire in 1882, occurred in the port city of Damietta on the Mediterranean coast and rapidly spread in the Nile Delta and throughout the country in the summer and autumn, "notwithstanding cordons maintained with a degree of severity and cruelty almost unexampled".Snowden, Naples in the time of cholera, 1884–1911, p. 83, quoting The Progress of Cholera, The Lancet (1883, vol. 2), p. 159. In the course of a few months, according to different estimates between 50,000 and 60,000 people died. The sources of the contamination most likely were Muslim pilgrims returning from Mecca and Indian troops serving in the British army. French and German bacteriologists were sent to Alexandria in 1883 to study the disease and determine its cause.Kohn, Encyclopedia of Plague and Pestilence, p. 83 (See: Scientific advances)
The approach of the British administration in Egypt was determined more by concerns that trade out of Indian ports towards Britain risked to be quarantined, as well as economic concerns about spending on public health. The rapid spread of the disease and the perceived incompetence of the population were used to justify British control of Egypt, despite that Egypt's established pre-colonial national health system had been talked about with appreciation by European observers. However, the imposed anti-contagionist policies by the British administration, favouring British shareholders in Egyptian and Indian companies and shipping lines, contributed to the lack of effective measures to combat the 1883 epidemic. Containing the epidemic was further complicated by European prejudices influenced by Orientalism that discredited the understanding by "Orientals" of health, science, and hygiene.
1892 outbreak in Hamburg
From mid-August to mid-September 1892 the city of Hamburg, Germany, was hit by a cholera epidemic.Kohn, Encyclopedia of Plague and Pestilence, p. 136 The main source of the outbreak were East European Jews, mainly from Imperial Russia, that were on their way to cross the Atlantic Ocean, trying to escape the appalling conditions, the 1891–1892 famine and cholera epidemic, and antisemitic restrictions (such as the expulsion of Jews from Moscow early in 1892) in their home country. Before they boarded, the emigrants were housed in special barracks, jointly financed by the city and the Hamburg America Line shipping company, that were built in the harbour. Conditions were often inadequate and communal latrines discharged their untreated excrement directly into the Elbe river flowing through the city.
In just two months, 8,594 people died. According to other estimates nearly 10,000 people died and many more suffered the appalling symptoms of the disease. No other city in western Europe was as seriously affected in this wave of the pandemic, with an average of 140 per day.Evans, Death in Hamburg, p. vii Although at the time it was fiercely contested, the infection of the city's water-supply was the main reason for the rapid spread of the cholera. Of those infected the case-mortality was about 50 per cent. The death rate of Hamburg's total population of more than 600,000 was 1.34 per cent according to the official statistics, but it may have even been higher.Evans, Death in Hamburg, pp. 292–93
In 1893 violent riots broke out, because the public objected to sanitary officers trying to enforce regulations for the prevention of spread of the disease. The crowd beat to death a sanitary officer and one of the policemen sent to protect them. Troops were called out and dispersed the crowd with fixed bayonets.Cholera Riot In Hamburg; Sanitary Officers Again Attacked By A Mob, The New York Times, October 11, 1893