Jamaica's 1851 cholera outbreak

Eulalee Thompson, BE WELL

In the digital collection of the United States National Library of Medicine, I found an interesting 74-page book on Jamaica's last cholera outbreak in the early 1850s. With the recent outbreak of cholera in neighbouring Haiti and forecast of rainy days ahead (with implications for infectious disease outbreaks), this find, Statistical Report of the Epidemic Cholera in Jamaica published in London in 1852, held my attention.

The author of the publication, John Parkin, MD, was a medical doctor in those old British colonial days, who was specifically sent from the motherland to Jamaica to deal with the outbreak. He wrote: "The epidemic cholera, as is well known, commenced in the island of Jamaica, at Port Royal, on the 8th of October, 1851, and, in a few weeks, carried off a third of the population. It had been prevailing at Chagres, and on the Isthmus of Panama, for some time previously; and it was stated, that the disease had been imported into this island by one of the American steamers, which touch here on their voyage from the above port to New York. For this opinion, no good or sufficient evidence has been adduced; while the facts that have been collected, during the prevalence of the disease in other parts of the world, tend to negative such a conclusion."

About 40,000 deaths

Jamaica's cholera outbreak was part of the second cholera pandemic, known as the Asiatic cholera pandemic, which ran from 1829 to 1851 and reached Europe including London and Paris in 1832. Jamaica's death toll was high, 40,000 deaths, one-tenth of the island's 400,000 population. It was noted that few countries hit by cholera at the time surpassed Jamaica's cholera death rate.

In Parkin's remarkably detailed account of the outbreak as he travelled throughout the island treating patients, he wrote that from Port Royal, where the first cases were found, the disease spread quickly to Kingston, affecting 6,000 people of a population of 40,000.

Parkin noted, "It (cholera) prevailed in this town (Kingston), in a severe form, for about six weeks; and, during this period, spread with unusual rapidity to other parts of the Island. The first fatal case in Kingston was on the 11th October; on the 19th there were three deaths in the adjoining parish St Catherine's and, on the following day, Dr Palmer, of Spanish Town, who, in conjunction with four other practitioners, had made a post-mortem of one of the bodies, was attacked, and died in a few hours."

Spanish Town severely hit

The death toll from cholera rapidly continued in Spanish Town, at the time the capital of Jamaica, with 30 deaths on October 20, and Parkin noted that cholera continued "its destructive career" in the capital until the end of November. He noted "few towns having been more severely visited than this, the capital of Jamaica".

"It appeared at St Thomas, in the east, thirty miles from Kingston, on the other side, about the same time as at Spanish Town; and from these different points it spread east, west, north, and south. By the end of November, it had reached every part of the Island, excepting the parish of Manchester, in the centre, and the parishes of Westmoreland and Hanover, situated at the western and north-western extremity of the island," Parkin wrote.

Shortage of medicine

The "essential symptoms of cholera" as observed by Parkin in his 1851 notes were "the collapsed countenance; blueness of the body, particularly in Europeans, but scarcely perceptible in the negro; shrunken fingers; wrinkled, shrivelled skin; total suspension of all the secretions particularly the biliary, foecal, and renal, the non-generation of animal heat, with icy coldness of the extremities and tongue; arrest of the circulation, and total cessation of the pulse".

I had a more-things-change-the-more-they-remain-the-same moment when I read the section on the treatment of cholera. Parkin complained about shortage of drugs and supplies and just the great difficulty in getting the correct medical supplies. It appeared, though, that he was a resourceful doctor and quickly learned to make do with what was available.

"It would be needless to state that this treatment consisted in the administration of the different forms of carbon. The form almost exclusively adopted, in this instance, was that of carbonic acid gas, produced by the admixture of the bicarbonate of soda and lime-juice as the simple solution of the gas in water, commonly termed soda, or Seltzer water, could not be obtained in the districts where I was engaged," he wrote.

Eulalee Thompson is health editor and a professional counsellor; email: eulalee.thompson@gleanerjm.com.

What do you know about cholera?

Cholera,
sometimes known as Asiatic or epidemic cholera, is an infectious
gastro-enteritis caused by enterotoxin-producing strains of the
bacterium Vibrio cholerae.

Transmission to humans occurs through eating food or drinking water contaminated with Vibrio cholerae from other cholera patients.

It is characterised by severe diarrhoea with extreme fluid losses which
can result in dehydration and electrolyte loss that can lead to death.

Beside watery diarrhoea, other symptoms include vomiting, abdominal pain, rapid heart rate, dry skin and sometimes fever.

Prevent cholera spread through thorough and frequent hand washing and by using only safe, clean drinking water.