Epidemiologists routinely turn to models to predict the progression of an infectious disease. Fighting public suspicion of these models is as old as modern epidemiology, which traces its origins back to John Snow’s famous cholera maps in 1854. ~Zeynep Tufekci
Just when I think I have a satisfactory vocabulary, a new word inserts itself. Epidemiologists attempt to determine what diseases are occurring where, when, to whom, and why. Determining causal relationships assists in stopping the spread, a chore which isn’t quite over yet.
Cholera and typhoid today
I have most often heard of these diseases in the context of centuries past, with mention of families who are long dead. As in, gone for more than 100 years. That is mostly true in the United States, but not so much in South and Southeast Asia, Africa and some Latin American countries. according to the Mayo Clinic and the Cleveland Clinic.
The World Heath Organization estimates that up to 4,000,000 people may suffer from cholera annually, with more than 122,000 dying of this disease. Typhoid illness has an even greater frequency, with up to 9,000,000 people impacted and 110,000 deaths. Consider that cases are likely to be underreported, which means the situation may be much worse than these estimates reflect.
The down and dirty symptoms
Skip this section if you prefer gentle content, and don’t say I didn’t warn you.
The symptoms of both of these diseases are unpleasant and each one makes a sinus infection look like a day in the park. In the spring. While riding in an enclosed carriage. Seriously. Here’s the scoop:
- Cholera: Diarrhea, vomiting, dehydration
- Typhoid: Headache, chills, nausea, vomiting, diarrhea, stomach pain, muscle aches
Neither is on my bucket list, and I’m sure no one has ever welcomed the experience. However, for anyone reading this post from the comfort of a U.S. home, those illnesses would likely be easier burdens to bear than for those who actually contract the disease. There’s a reason for that. We have options that aren’t available to all.
Stuff you might not have known (not fun facts)
- Cholera (Mayo Clinic)
- Undercooked seafood, particularly shellfish, can contain harmful bacteria, depending on the source.
- Manure fertilizer or irrigation water that contains raw sewage can negatively impact produce grown in that field. This means raw, unpeeled fruits and vegetables from developing countries can be risky. That is, if it can’t be peeled (lettuce), it’s not as safe as a banana.
- Typhoid (Metropolisindia)
- Isn’t technically contagious, because it isn’t person to person contact that causes a spread. People can–and do–spread it with poor sanitation practices.
- Is more of a risk for small children, in part because they aren’t selective in making contact with the floor and other surfaces that might not be sanitary.
- Can cause severe internal bleeding and other life-threatening conditions if left untreated and may incubate in the body after recovery.
Persistent causation
Both clinics mentioned explain that the biggest single factor in spreading typhoid and cholera is water. That is, water infected with cholera or typhoid bacteria strains. We don’t usually hear of cases in this country because we have access to clean water and we know how diseases spread–some of them, anyway. When we’re sick, we self-isolate and we wash our hands frequently, especially after bio breaks. Our municipal water treatment plants help to make our water safe, and we anticipate that there is little chance of waste water polluting water we consider potable.
In countries where there is extreme poverty, the likelihood of modern plumbing and access to treated water plummets. When you add in overcrowding and the lack of vaccines, the potential for disease of all kinds to spread morphs into a certainty.
Three sons. Two didn’t survive a day and one lived less than a year. These were from early in the 20th century (not the 19th), but there are many examples similar to this one that date further back. Life in an agrarian culture was no picnic, whether it was 1850 or 1920. While many in the community were well-read and highly intelligent, none of them would have had access to information we take for granted today.
Why did I mention this dreadful topic?
Good question. I occasionally walk through old graveyards and cemeteries and I am intrigued by the history that headstones can reflect. While I won’t be able to learn the cause in each case of infant death (all those under 5 years of age), there’s a real possibility most succumbed to childhood diseases. Records exist that reflect the demise of whole families in Cades Cove due to typhoid, for example.
Were those residents less concerned with their health and welfare than others in that era? Probably not. But they may have had more primitive living arrangements than 19th century city dwellers. A big factor, though, is a lack of knowledge of cause and effect regarding the spread of disease. If they had known that their one water dipper that the entire family shared could have disastrous effects on the longevity of their offspring, they could have altered their habits.
We don’t know everything today, either. But we do know enough to protect ourselves from at least two diseases. Those two wiped out a combined percentage of U.S. citizens at close to the same level as our recent pandemic, based on rough estimates. Most readers have clean water, soap, and the ability to select food that is likely free of bacteria that leads to typhoid or cholera or who knows what else.
It’s true that there’s only a small chance of developing either disease here in the U.S. It’s also true that other hazards exist–physical risks and otherwise–that we don’t always manage well. We’re luckier than people who lived more than a century ago. We shouldn’t blow our advantage.
What is heartbreaking is that we have scientific knowledge today, but some reject it. I heard from a friend this week that her grandson’s kindergarten class has had an outbreak of whooping cough, a disease that should not exist due to vaccinations.
I take your point, but there may be reasons for some people’s decisions that we aren’t privy to. Perhaps there are some children in the school who did not spend their very early years in this country (didn’t get their vaccinations as an infant?) or perhaps there are cultural reasons. I get some vaccinations and others I don’t. That’s all I’ve got. 😉
Drinking from same dipper in the 30’s I got Typhoid. Tho my parents and 2 siblings did not get it i am now told it does not spread that way. My mother told me my fever was too high for 3 weeks. No ice no meds. Dr came in his buggy every other day. No ine else in my family had it.
Contaminated water is definitely one way it spreads, but there are other ways as well. Perhaps yours was the result of handling something that had that bacteria on it and your siblings didn’t handle the same thing. 🤷🏼♀️
We are only one generation from hand dug wells and water not treated by chlorine which makes water safe. Further, homes that had hand dug wells also had out houses frequently not too far from the wells. It is a miracle that we are not all dead. If you believe Google, only 74% of the world’s population have access to clean, treated drinking water……so 2 billion people are drinking water not treated. This would include my son and his family in Indonesia.
Yes, it is amazing we are alive. I am wondering also, though, whether people who live in unhygienic conditions fare better than those who visit in those places, but weren’t born to it. Do they develop at least some immunity?
Believe in science. It’s why we are all not dead at an early age (So sayeth the engineer. 😊)
I believe in science that most scientists have agreed upon for a great many years. The nature of science is such that it should always be questioned to maintain its credibility. I think we’re set on typhoid and cholera.
Many are always skeptical ,of new science until it has shown to be reliable. True then , true now.
Gasoline cars replacing horses just one example.
Science in itself is based on peer review and scrutiny. Being able to reproduce the same results by different peers. Unfortunately with the age of internet and instant information transfer, everyone thinks they are a scientist and have ”Researched the science”. Researching on google is not research. It it’s important to start informed and keep up. You can’t do this by looking at one source. Especially the internet whose algorithms are geared to one’s personal biases. I had a professor in college who would make you take the opposite side of an opinion which you held and make you defend it. Ephphatha! Be Open.
True. Much of what I’ve decided about new vaccines is the efficacy compared to the hype. If it doesn’t/didn’t work as advertised, I know how to proceed.