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After spreading beyond India, the first cholera pandemic hit other parts of Asia and the African
coast the hardest.[4] It would not be until later epidemics of cholera that it would ravage Europe
and the Americas.[4] In March 1820, the disease was identified in Siam, in May 1820 it had spread
as far as Bangkok and Manila; in July the outbreak torched Vietnam; in spring of 1821 it
reached Java, Oman, and Anhai in China; in 1822 it was found in Japan, in the Persian Gulf,
in Baghdad, in Syria, and in the Transcaucasus; and in 1823 cholera
reached Astrakhan, Zanzibar, and Mauritius.[1]
When the epidemic reached Russia and specifically Astrakhan, their response was to formulate
an anti-Cholera program in 1823. [8] This program was headed by a German physician by the
name of Dr. Rehmann.[8] The Anti-Cholera program inspired the creation of a medical-
administration board by Tsar Alexander I that inspired similar medical administration across
Europe.[8]
In 1824, transmission of the disease ended. Some researchers believe that may have been due
to the cold winter of 1823–1824, which would have killed the bacteria in the water supplies. [1]
The spread of the first cholera pandemic was closely linked to warfare and trade. [4] According to
economic history professor Donato Gómez-Diaz, "[advances] in commercial exchange and
navigation contributed to cholera’s dispersion." [5] Navy and merchant ships carried people with
the disease to the shores of the Indian Ocean, from Africa to Indonesia, and north to China and
Japan.[9] During the Ottoman-Persian War of 1821–1823, cholera would affect both armies in
what is modern-day Armenia.[4] Hindu pilgrims spread cholera within the subcontinent, as had
happened many times previously, and British troops carried it overland to Nepal and Afghanistan.
In 1821, British troops spread cholera to Oman after becoming infected with it in India.[4]
Total deaths
The total deaths from the epidemic remain unknown. Scholars of particular areas have estimated
death tolls. For instance, some estimate that Bangkok might have suffered 30,000 deaths from
the disease. In Semarang, Central Java, 1,225 people died in eleven days in April 1821. [1] In total,
over 100,000 people died as a result of cholera on Java during the first pandemic. [10] Also in
1821, Basra, Iraq saw 18,000 deaths in less than a month's time. [10] In the same year, it is
estimated that up to 100,000 deaths occurred in Korea. [5] Vietnamese royal archives recorded
206,835 people died from the disease.[11] In the southwest of the Mekong Delta, the outbreak
swept through the constructing Vĩnh Tế Canal, killing thousand of workers (most of them
Cambodians) and triggered a Cambodian uprising in later that year.[12] The well-known
novelist Nguyễn Du died contracting the disease.[13]
As for India, the initially reported mortality rate was estimated to be 1.25 million per year, placing
the death toll at around 8,750,000.[14] However, this report was certainly an overestimation as
David Arnold writes: "The death toll in 1817–21 was undoubtedly great, but there is no evidence
to suggest that it was as uniformly high as Moreau de Jonnès presumed. [...] Statistics collected
by James Jameson for the Bengal Medical Board showed mortality in excess of 10,000 in
several districts. [...] Although reporting was sketchy, for the Madras districts as a whole the
mortality during the height of the epidemic appears to have been around 11 to 12 per 1,000. If
this figure were applied to the whole of India, with a population of some 120–150 million, the total
number of deaths would have been no more than one or two million." [15]