Overview
Due to the fact cholera leaves no physical mark on the body there is no way of identifying it outside of the use of historical texts. Because of this we have no way to truly estimate how long cholera has existed as a human pathogen. Despite this cholera has left an immense imprint on our society and culture as well as the development of the field of Epidemiology.
Origins
how did it all begin?
The pathogen that causes cholera is believed to have originated in or around the Ganges River Delta in India. The first mention of cholera, however, comes from the father of western medicine, Hippocrates. In around 500 BC he used the word 'cholera' to describe an intestinal illness that causes diarrhea. It's thought that the word 'cholera' itself comes from the Greek word for gutter, 'choledra'. However, cholera was likely often just used as a synonym for any disease that causes diarrhea. The word cholera itself would not be linked to this specific pathogen until the 1800s.
Spread
How did cholera become the worldwide pathogen it is today?
Until 1817 cholera was confined entirely to India. The increase in transcontinental and overseas travel would change the whole story.
In 1817 one or two cholera victims hitched a ride on a ship or a caravan heading east, and they continued to shed the cholera bacterium even if they felt okay. This marked the start of the first 6 of the cholera pandemics that historians and epidemiologists describe. We are currently in the middle of the 7th cholera pandemic.
England
How did epidemiology get its start?
John Snow was an English physician living in London in 1854 when a cholera epidemic broke out (The third pandemic). The population of London was growing rapidly by the day and was higher than ever before, meaning what little sanitation practices there were and waste output/disposal could not keep up. Most people would just throw their waste(Bodily excrement, food scraps, dead animals, etc.) into mass open cesspools that lead to the sewers, often near water pumps that were used as sources of drinking water.
While the cholera epidemic was raging, John Snow set out to do some detective work to see if he could track the pattern of spread to see where the outbreak originated. And out he went, notebook and pen in hand, doing some essentially “shoe leather epidemiology”, because the idea of miasmatism, which was the most popular theory for the spread of many diseases at the time, including cholera, did not make sense to him (The idea that disease is spread by poor weather, bad air or poor smells).
He noticed that the disease seemed to strike somewhat randomly. Entire families would be wiped out in some houses, but others would be completely unaffected, so to try to make sense of this, he mapped out the cases and he noticed that many cases were in the same neighborhood. But there were outliers that stuck out to him, like a brewery in the main area affected with no cases and an isolated woman who died from the disease.
Through conversations with the woman's sons he learned that water from a particular pump in that area happened to be her favorite and they would often walk down there just to get some for her. The brewery could simply be explained by the fact the employees were drinking beer all day instead of water. He figured out through this that all of the cases were linked to a water pump known to be of higher quality, the “broad street pump” and when he presented this to the government they shockingly agreed and removed the pump handle making an early success for germ theory.
The bacterium was successfully isolate in 1833 and John Snow finally received the credit he deserve, despite having already passed. Cholera, being linked to water contamination lead to the creation of better sewage systems and in wealthy countries it essentially disappeared.