Cholera

The Red Wine Diet

The Red Wine Diet

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Cholera is a severe form of contagious diarrhoea caused by the bacterium Vibrio cholerae. It has been a scourge for hundreds of years, occurring in epidemic waves that rapidly affected large areas of population. The first massive outbreak occurred in 1817 when the disease spread throughout India and into Russia. The second pandemic began in Russia in 1829. It spread across the Atlantic to New York and Montreal, and eventually invaded Latin America. The current seventh cholera pandemic began in Asia in 1961 and had spread to Africa by the mid-1970s. In 1991, cholera appeared in epidemic proportions in Peru and quickly spread throughout South and Central America. Within two years, more than 450 000 cases of cholera, resulting in more than 4000 deaths, were reported in the Americas. While this illustrates the magnitude of the epidemic disease, cholera continues to exist as a constant smouldering threat, especially in Asia and Africa.

The cholera bacillus does not invade the body as such, but causes its disease by producing a protein toxin. This toxin causes a profuse watery diarrhoea to such an extent that a patient can become severely dehydrated and die within 24 h. Fortunately, only about 1% of patients who are infected with the cholera bacillus develop severe disease, with most experiencing mild to asymptomatic infection, and approximately 10% having moderate diarrhoea without severe dehydration.

The history of wine's ability to protect against cholera goes back almost as far as the science of microbiology itself. In the epidemic that struck Paris in the late nineteenth century, it was noted that the street denizens, who subsisted largely on wine, seemed to be spared from the illness. Dr Alois Pick was intrigued by this observation, and set up experiments to examine it further. Cholera bacilli were added to wineskins containing red or white wine, water, or a wine—water mixture. The wine and wine—water mixtures eradicated the bacilli within 15 min, while the wineskins filled with water failed to have any effect (Majno 1975).

In a more modern approach to wine's protective effect against cholera, experiments were performed to assess its activity against cholera toxin. As mentioned above, severe illness from cholera is the result of massive fluid loss from the small intestine. The cholera toxin is made up of two parts, or subunits. When both penetrate cells of the small intestine, they induce an intense loss of sodium, chloride and water. This toxin-induced diarrhoea can be so severe that a patient can lose 10 litres of fluid per day through stool losses, making it almost impossible to stay hydrated. A preventive strategy to counteract this effect would be important in preventing or modifying the disease.

Table 14.2 Relative amounts of intestinal fluid secretion after injection of test substance into isolated intestinal segments (Roberts et al. 2000).

Test substance

Amount of secretion (mg/cm)

Normal saline (control)

5—10*

Cholera toxin

200—250

Red wine + toxin

10—20*

Boiled red wine + toxin

10 —15*

Grape juice + toxin

120—150**

Apple juice + toxin

180—230

Ethanol 12% + toxin

120—150**

* Statistically significantly reduced secretion when compared with cholera toxin, grape juice + toxin, apple juice + toxin and ethanol 12% + toxin.

** Statistically significantly reduced secretion when compared with cholera toxin and apple juice + toxin.

* Statistically significantly reduced secretion when compared with cholera toxin, grape juice + toxin, apple juice + toxin and ethanol 12% + toxin.

** Statistically significantly reduced secretion when compared with cholera toxin and apple juice + toxin.

Scientists in the USA designed experiments to look at wine's effect on cholera toxin (Roberts et al. 2000). Laboratory rats were anaesthetized and portions of their small intestine ligated, to produce six 10 cm loops, each separated by 1 cm. The blood supply to the bowel loops remained intact. Bowel segments were randomly injected with 1 ml of several different test solutions. These included: cholera toxin, red wine with and without cholera toxin, alcohol-free red wine with and without cholera toxin, grape juice with and without cholera toxin, ethanol 12% with and without cholera toxin, and apple juice with and without cholera toxin. These were all compared to a physiological control of normal saline (NaCl 0.9%). The results are summarized in Table 14.2. The saline controls as well as all the other test solutions were well absorbed in the absence of cholera toxin. Cholera toxin by itself caused a 33-fold increase in the amount of fluid secreted. Red wine and boiled red wine completely inhibited cholera toxin-induced secretion, grape juice and ethanol had smaller inhibitory effects, and apple juice had no effect (Roberts et al. 2000).

From these two experiments, performed 100 years apart, it appears that wine can protect against the severe effects of cholera through two different mechanisms.

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Alcohol No More

Alcohol No More

Do you love a drink from time to time? A lot of us do, often when socializing with acquaintances and loved ones. Drinking may be beneficial or harmful, depending upon your age and health status, and, naturally, how much you drink.

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