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Where Are They Now? Diseases That Killed You in Oregon Trail

You have died of dysentery.

These are five words familiar to anyone who has attempted to caulk a wagon and ford rivers en route to the Willamette Valley. Oregon Trail not only taught generations of kids about Western migration in 19th-century America, it also familiarized them with various strange-sounding diseases. Let’s catch up with some of those diseases and find out if they're just as nasty today.

1. Everyone Has Cholera

Then: The number one killer of the actual Oregon Trail, cholera is an infection of the intestines caused by ingesting the bacteria Vibrio cholerae. Spread through contaminated food or water, cholera released an enterotoxin that effectively flooded the intestines with excess water. This led to continual watery diarrhea, causing severe dehydration and often death. The worst outbreaks occurred on the Oregon Trail in 1849, 1850 and 1852. The only available treatment in the game was a medicine known as laudanum—understood today to be pure opium.

Now: According to the Centers for Disease Control, cholera remains a global pandemic. Though there is still no vaccine for the disease (in the U.S.), it can be treated with a regimen of fluids and electrolytes, as well as antibiotics. The best defense remains stringent sanitation regulations, a luxury afforded primarily to industrialized countries. The World Health Organization has recorded recent outbreaks in Mexico (November 2013), Sierra Leone (August 2012), Democratic Republic of Congo (July 2011), Haiti (November 2010, October 2010), Pakistan (October 2010) and a severe outbreak in Zimbabwe (June 2009, March 2009, February 2009, January 2009, December 2008).

2. Joseph Has Diphtheria

Then: Caused by Corynebacterium diphtheriae, diphtheria is an airborne bacterial disease. It usually showed up first in the nose and throat, but could also surface as skin lesions. A gray, fibrous material would grow over airways, causing difficulty breathing and sometimes uncontrollable drooling, as well as a deep cough and chills. Diphtheria was most common on the Trail during the winter months.

Now: Routine childhood immunizations have nearly erased diphtheria in the U.S. According to the U.S. National Library of Medicine, there are less than five cases here a year. Though it is still a problem in crowded nations with poor hygiene, diphtheria is now rarely fatal.

3. You Have Dysentery

Then: Dysentery, a.k.a. shigellosis, was not as widespread on the trails as its peer cholera. During the 19th century, dysentery was a bigger problem on the Civil War battlefields. Like cholera, dysentery spread via contaminated water and food, thriving in hot and humid weather. Unlike cholera, dysentery lived in the colon and caused bloody, loose excrement. The rise of dysentery in the 1800s was partially due to infected warm cow’s milk, an ideal incubator for shigellosis.

Now: Dysentery is still a major threat to the developing world. Not only is there no effective vaccine, recent strains are increasingly resistant to antibiotics—the only proven line of defense in tandem with fluids. 

4. Sally Has Measles

Then: Evolved from the rinderpest virus, the highly contagious measles ravaged the United States in the 19th century. It was not measles, but complications like bronchitis and pneumonia, that made it life threatening. Measles was spread through contaminated droplets—coughing, sneezing, wiping one’s nose and then touching anything. It caused nasty rashes, fever, and conjunctivitis.

Now: A vaccine was discovered in the mid-20th century, virtually eradicating measles from the developed world. It is now part of the trifecta inoculation MMR (Measles-Mumps-Rubella) most American children receive in infancy and again at age 6. Though relatively contained, measles is still endemic: In 2009, there was an outbreak in Johannesburg and other parts of South Africa. New Zealand saw a small spike in August 2011, with nearly 100 cases popping up in Auckland. And as of May 16, 2014, there have been 15 outbreaks in the U.S., resulting in 216 cases of measles in 18 states, "the highest number of cases reported in the United States during this time period in 18 years," Dr. Greg Wallace, head of measles activities at the Centers for Disease Control and Prevention, told CNN. (Notably, that number doesn't include the latest cases from an outbreak in Ohio.) Most of the people who got measles were unvaccinated and got the disease while traveling; measles then spread among unvaccinated members of the community when the travelers returned home.

5. Mary Has Died of Typhoid Fever

Then: Unfamiliar with the virtues of boiling water first, Oregon Trail pioneers contracted typhoid like many other diseases—from contaminated water. Caused by Salmonella Typhi, typhoid was spread when an infected person “sheds” the bacteria. Sparing you the gross details, let’s just say the bacteria lived in a person’s blood and intestines. The major symptom was high fever, followed by weakness and loss of appetite. In the warmer months, typhoid was a real killer.

Now: Still a killer, though not in the Western world. The CDC says it’s preventable with good sanitation and antibiotics, but even Westerners are not immune when traveling in developing countries. The CDC strongly recommends anyone planning travel to a "non-industrialized" nation get vaccinated—and avoid any tap water or food cooked in unclean water.

This story originally appeared in 2011.

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Jamie McCarthy/Getty Images for Bill & Melinda Gates Foundation
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Medicine
Bill Gates is Spending $100 Million to Find a Cure for Alzheimer's
Jamie McCarthy/Getty Images for Bill & Melinda Gates Foundation
Jamie McCarthy/Getty Images for Bill & Melinda Gates Foundation

Not everyone who's blessed with a long life will remember it. Individuals who live into their mid-80s have a nearly 50 percent chance of developing Alzheimer's, and scientists still haven't discovered any groundbreaking treatments for the neurodegenerative disease [PDF]. To pave the way for a cure, Microsoft co-founder and philanthropist Bill Gates has announced that he's donating $100 million to dementia research, according to Newsweek.

On his blog, Gates explained that Alzheimer's disease places a financial burden on both families and healthcare systems alike. "This is something that governments all over the world need to be thinking about," he wrote, "including in low- and middle-income countries where life expectancies are catching up to the global average and the number of people with dementia is on the rise."

Gates's interest in Alzheimer's is both pragmatic and personal. "This is something I know a lot about, because men in my family have suffered from Alzheimer’s," he said. "I know how awful it is to watch people you love struggle as the disease robs them of their mental capacity, and there is nothing you can do about it. It feels a lot like you're experiencing a gradual death of the person that you knew."

Experts still haven't figured out quite what causes Alzheimer's, how it progresses, and why certain people are more prone to it than others. Gates believes that important breakthroughs will occur if scientists can understand the condition's etiology (or cause), create better drugs, develop techniques for early detection and diagnosis, and make it easier for patients to enroll in clinical trials, he said.

Gates plans to donate $50 million to the Dementia Discovery Fund, a venture capital fund that supports Alzheimer's research and treatment developments. The rest will go to research startups, Reuters reports.

[h/t Newsweek]

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Eye Doctors Still Use This 100-Year-Old Test for Color Blindness

You may have seen them at your ophthalmologist's office: large circular diagrams made up of colored dots. People with normal vision are able to discern a number among the dots of contrasting colors. People who are color blind might see only a field of spots.

These elegant, deceptively modern drawings were published 100 years ago by a Japanese ophthalmologist, Shinobu Ishihara. Thanks to the designs' simplicity and diagnostic accuracy, the Ishihara test is still the most popular and efficient way to identify patients with color vision deficiencies.

Born in Tokyo in 1879, Ishihara studied medicine at the prestigious Tokyo Imperial University on a military scholarship, which required him to serve in the armed forces. After graduating in 1905, he worked for three years as a physician specializing in surgery in the Imperial Japanese Army, and then returned to the university for postgraduate studies in ophthalmology. In his research, Ishihara focused on identifying and recruiting soldiers with superior vision, thereby increasing the overall effectiveness of the military. And that became of prime importance to Japan beginning in 1914.

As World War I spread across Europe, Asia, and the Pacific, the Japanese army asked Ishihara to develop a better way to screen draftees for color vision problems. The most popular method at the time was the Stilling test, invented by German ophthalmologist Jakob Stilling in 1878 as the first clinical color vision test. (Previous tools had asked patients to identify the colors of wool skeins or illuminated lanterns—useful skills for sailors and railway conductors, but an imprecise method for diagnosing vision issues.)

"Though popular, 'the Stilling' retained a distinctly 19th-century flavor, more treatise-like and less diagnostically incisive," according to Eye magazine.


Shinobu Ishihara
Wellcome Images // CC BY 4.0

Japanese army officials requested a new diagnostic tool that was easier to administer and interpret. The test Ishihara began to develop was based, like Stilling's, on the principle of pseudo-isochromatism—a phenomenon in which two or more colors are seen as the same (or isochromatic) when they're actually different. A person with normal vision could easily see the difference, while people with red-green deficiency, the most common form of color blindness, would have difficulty distinguishing those two opposing colors. Those with blue-yellow color blindness, a less common type, would have a hard time discerning reds, greens, blues, or yellows.

Ishihara hand-painted circular designs comprised of small dots of different areas and colors so that variations in the design could be discerned only by color and not shape, size, or pattern. Hidden in the field of dots was a figure of a contrasting color that people with normal vision could see, while those with deficiencies could not. Other plates in the series were designed to show figures that would be visible only to people with deficiencies. When physicians displayed the diagrams, patients said or traced the visible figure within the circle without needing to use ambiguous color names, which standardized the possible results.

The earliest sets of Ishihara plates, produced in 1916, were reserved exclusively for the army's use and featured Japanese characters within the diagrams. In 1917, in an effort to sell the series internationally, Ishihara redesigned it with the now-familiar Arabic numerals and published a set of 16 plates as Tests for Colour Deficiency.

The tests were adopted throughout the world beginning in the early 1920s, and eventually grew into a set of 38 plates. But their popularity almost led to their undoing. Unauthorized publishers printed their own version of the plates to meet demand, throwing the accuracy of the diagnostic colors into doubt. "The plates have been duplicated along with an easily memorized key by cheap color processes in the tabloid press, and exposed in public places, reducing the fifth edition [of the collection] to a parlor game," one psychologist warned in the Journal of the Optical Society of America in 1943.

Despite those obstacles, the tests proved indispensable for both practicing physicians and researchers. Ishihara continued to refine the designs and improve the color accuracy of the images into the late 1950s, while he also served as the chair of the ophthalmology department and then dean of the medical school at Tokyo Imperial University. In addition to Tests for Colour Deficiency, he also published an atlas, textbook, lectures, and research studies on eye diseases. But he is remembered most for the iconic charts that seamlessly blend art and science.

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