The recent outbreak of cholera in Haiti is a serious health crisis, infecting more than 70,000 people and resulting in the deaths of more than 1600 as of December 1, 2010. Cholera is caused by the bacterium Vibrio cholera, and causes severe diarrhea. If detected quickly, it is easily treatable. The cause of the outbreak is still unknown, although it has been linked to Nepalese soldiers who are part of the relief forces for the massive earthquake in January of this year. The ultimate cause is poor sanitation leading to contaminated water supplies, because people get cholera from ingesting contaminated water or food.

In the U.S. and the rest of the developed world, the primary form of transmission is contaminated seafood, but it wasn’t so long ago that cholera and other water-borne diseases such as typhoid and typhus were common in the U.S. In Chicago, there were routine outbreaks of these diseases in the 19^th century, due primarily to poor sanitation practices, most notoriously the discharge of wastewater to Lake Michigan, from whence most of Chicago’s drinking water was (and is) derived. My agency, the Illinois State Water Survey, was formed in 1896 to research water quality and its role in disease outbreaks. Chicago famously reversed the flow of the Chicago River and built several canals to send its wastewater out of the Lake Michigan watershed, down the Illinois River. Residents of Peoria and St. Louis were not pleased, but Chicago did it anyway (some things don’t change!). The American Public Works Association considers the river reversal one of the top ten public works projects of the 20^th century.

One of the great success stories of the western world in the late 19^th and early 20^th centuries was the development of adequate sanitation and the protection of water resources. In a poll conducted in 2007 by the British Medical Journal, the development of sanitation was voted the greatest medial advance since 1840.

These days, outbreaks of water-borne diseases such as cholera are most common in areas ravaged by natural disasters or wars. Refugees are crowded together, and maintaining proper sanitation is a struggle. Such a decimated and impoverished country as Haiti was especially vulnerable to this cholera outbreak. The World Health Organization estimates that 2.6 billion people lack adequate sanitation, the primary reason why 1 billion people lack access to safe water. The sanitation that we have taken for granted for nearly a century is still out of reach for nearly half the world’s population.