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Transmission
Cholera is an infectious disease that threatens Africa, Latin America and Asia. Specifically fresh and saltwater environments Cholera, has been found in two animal populations: shellfish and plankton.[12] Transmission is usually through the fecal-oral route of contaminated food or water caused by environmental conditions, whether it be due to poor sanitation or natural environmental factors.

Zooplankton has been found to a natural host for the disease, but a study done in Bangladesh have shown that Vibroe Cholerae can live in water as noncultured and can be cultured by transmission through animals. With in this study they found that certain environments can harbor the infection through biofilm, which creates seasonal endemics in the Bangladesh area.

Food Stigma
The transmission of cholera can happen when the virus is ingested. In the 2007-2009 outbreaks in Vietnam food had a bad stigma that it was contaminated with the virus. Where food was “safe” was in the home, outside food was dangerous, meaning food from restaurants and street vendors. This led to food stigma which did not help people in the developing world.The Ministry of Health in Vietnam claimed certain foods were risky for the population to eat. These foods were common for indigenous people to eat like, dog meat, shrimp paste and raw vegetables. This in cause made street vendors and restaurants that used this food stigmatized and lost business.

In an outbreak of Cholera in Venezuela in 1992-93 public health officials deems that crabs was the source of the outbreak, not the terrible water system they had in place. The people that ate the crabs were the indigenous who were living in the rain forest. Raw crab was to be avoided and was an “attempt to link cholera in the delta to the ‘customs’ and ‘culture’ of the indigenous” With in stigmatization of the crab it then led to the idea that cholera came from the indigenous and those people were to be avoided.

Susceptibility
About 100 million bacteria must typically be ingested to cause cholera in a normal healthy adult.[12] Children are also more susceptible, with two- to four-year-olds having the highest rates of infection.[12] Individuals' susceptibility to cholera is also affected by their blood type, with those with type O blood being the most susceptible.[12] Persons with lowered immunity, such as persons with AIDS or children who are malnourished, are more likely to experience a severe case if they become infected.[19] Susceptiblity goes beyond just the persons age or health there is also a stigma that comes with the disease Cholera.

Social Susceptibility
Social status also becomes a reason in society for who is more susceptible. With in the outbreak in Vietnam between 2007-2009 merchants and prostitutes were being accused of being contaminated with Cholera. This is because they are at the bottom of the hierarchy in Vietnam culture and can be seen as dirty because of their profession. With this in mind the Vietnam government stigmatized certain labor rules, liked being civilized. Being civilized made someone less susceptible to the disease, if you stick to the rules then you will be okay. This was during the Post reconstruction after WWII where Vietnam was just beginning to really recover from the war.

In the Orinoco Delta, Venezuela the indigenous people were constantly being stigmatized that they had cholera. The Warao indigenous ethnic group in the Delta was blamed for the Cholera outbreak in Venezuela in 1992-93. Over 500 people were killed during this outbreak most being indigenous people. Stigmatization of the indigenous people not believing in modern medicine also became a problem and the ‘root’ for how cholera spread. The public health officials fed on the scare that  indigenous dont believe in physicians and only used shamans, to wade off the evil spirit affecting the person. This led to blame on the indigenous for spreading Cholera. However this theory can be debunks by the huge migration of indigenous people moving closer to health facilities and urban areas.

Environment Susceptibility
When people live in a certain environments they become more susceptible to the disease because of access to information, healthy facilities and proper sanitation.

Orinoco Delta, Venezuela is a coastline that stretches 42,000 kilometers and has a population of 40,000 people. This delta is a very susceptible environment because of its lack of modern society. Medical building sparse so treatment was not easy to obtain when Cholera infected the Warao indigenous people of Delta Amacuro, Venezuela. These indigenous peoples lived in a fluvial region, with palm leaf thatches and houses built on stilts, for transportation they use dug out canoes. (Briggs) Since this environment was very rural there were issues for the people of delta to receive information and help about the virus once it started infecting. This led the indigenous people of the delta to become more susceptible to Cholera because they were not getting the information they needed to help prevent transmissions.

The outbreak in Vietnam between 2007-2009, there were reports of acute cholera concentrated in an urban environment. The environment of an urban area is easy for something like cholera to be transmitted. Specifically in Vietnam where their socioeconomic culture was expanding and urban areas were growing to fast for the government to properly install a water system. Without proper sanitation the virus was able to spread quickly. In October 2010 Haiti discovered its first case, since 1996, of acute diarrhea which came back positive as Vibrio Cholerae O1. This was just a few months before a huge earthquake devastated Haiti, only making the country more susceptible to the virus. The source was the Artibonite River, where 19% of Haitians have had access to proper sanitation since 2006. When living in a rural area, as many Haitians did, without having proper sanitation was the right mix for Cholera to thrive. In Figure 1. we can see that weekly, Cholera was affecting thousands of people leaving more and more people susceptible to mortality, because of lack of treatment and information Haitians were receiving.

Lack of information and health care can be another way a community can be more susceptible, “Early in the outbreak, the population knew little about cholera”. In a study done by Janell A. Routh in 2011 about the rapid deaths occurring during this cholera outbreak, she found that people were not receiving information about the disease and health facilities were too far for them. If people are not getting updated information or health care cholera can spread fast.