Many more defenses now against cholera than in 1856

The cholera epidemic in central México concerns health officials here, but the disease is unlikely to be much of a problem even if cases are discovered here.

The World Health Organization notes that there has been a steady number of small cases in Costa Rica.  The available data said that Costa Rica has had a few cases reported each year and that 36 cases in 1994 was the most in one year. There was one death in 1996.

Cholera, a bacterial disease, has ravaged Haiti and the Dominican Republic since the earthquake there. There has been an epidemic in Cuba, and now four states in México report cases.

World Health said that the Ministry of Health in Mexico has reported 171 confirmed cases, including one death, of infection with Vibrio cholerae between Sept. 9 to Friday.

The disease is spread by water or food contaminated with fecal matter. The Mayo Clinic has attributed the Mexican outbreak to contaminated shellfish.

Reports of an epidemic here is not what the tourism industry needs as the high season approaches.

Health officials were wary when Mexican soccer fans came to a World Cup preliminary match. The truth is that hundreds of persons probably are walking around with the cholera bacteria and not showing any signs.

The Caja Costarricense de Seguro Social attributes a campaign of hand washing among school children for reducing all forms of diarrhea in that age group. The Caja said that there have been 254,219 reported cases of diarrhea this year. None is believed to be cholera.

The 7-year-old hand washing campaign received a boost with reports of bird flu.

Cholera also can be spread by hand. But the usual vehicle is contaminated water. Modern practices by the country’s water companies are a big barrier to such epidemics.

That was not the case in 1856 when Costa Rican troops fought and defeated units loyal to U.S. filibuster William Walker. The victory at the battle of Rivas, Nicaragua, quickly was followed by a raging epidemic among Costa Rican troops. When Juan Rafael Mora Porras, the president and military leader, ordered the troops back to Costa Rica, he inadvertently created a panic and conditions so that 10 percent of the country’s population died.

Roberto Le Franc Ureña summaries the existing literature in a paper he wrote for a University of Costa Rica historical magazine in 2007. He reported that the troops left a trail of cadavers along the roadways as they marched to the Central Valley. He also said some soldiers took a water route home via the Río San Juan. Those who died on the trip were dumped into the river, thereby spreading the bacteria to others, he noted.

An unrelated Facebook page recounts the story of a Desamparados couple who decided to make a will in the face of the epidemic. They were Manuel Morales Meléndez and María Josefa Fallas Retana. A short time later the man became one of the 10,000 who died from the disease, the report says. The page is interesting because it contains photographs of the longhand will that the couple dictated.

Le Franc reports that in May 1856, the month after the epidemic began, public officials called on churchmen to add their efforts. A pilgrimage to the Dulce Nombre del Niño Jesús began then at the Iglesia de El Carmen in San José that has endured to this day.

A more upbeat tale also emerged from the epidemic. An elderly man named Bizcochio participated in the pilgrimage playing a violin each year. The tale is among those compiled Elías Zeledón in “Leyendas Costarricenses.” The man said he contracted cholera to such an extent that he appeared to be dead to those around him.

Although he could not talk or move, he was aware that he was heaped on a cart with other epidemic victims and taken to an open common grave.

After he and the other bodies were dumped into the trench, heavy rains came so that workmen did not cover the corpses with earth. The rain appears to have refreshed him and he managed to crawl from his grave and somehow make his way home.

He awoke the next day better and surrounded by his family. That was after his sister saw him standing at the front door returned from the grave. She collapsed, said the tale. The man participated in the pilgrimage each year as a way of thanking God for his delivery.

Modern medicine can treat the dehydration brought about by the cholera diarrhea. There also are vaccinations and antibiotics that did not exist in 1856.

Costa Rica does harbor some problems. Most of the Central Valley sewage flows into the Gulf of Nicoya, which is where many seafood products are harvested. That could be a source of infection if cholera becomes epidemic here.

Fortunately most of the country’s food products have not presented a bacterial or parasite problem as they have been in other countries where contaminated water is used for cultivation.

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