Cholera likely arrived in the community through contaminated water sources, such as rivers, lakes, or poorly maintained wells. It could also have been introduced by travelers or traders carrying the bacteria.
Cholera spread in the community as people consumed contaminated water or food watered with that water. Public places, such as markets, where food is prepared or sold, may have also contributed to spreading the bacteria. Common sources of contamination would include drinking water or food washed with infected water.