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

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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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Health
New Test Can Differentiate Between Tick-borne Illnesses
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Time is of the essence in diagnosing and treating Lyme disease and other tick-borne illnesses. Fortunately, one new test may be able to help. A report on the test was published in the journal Science Translational Medicine.

Ticks and the diseases they carry are on the rise. One 2016 study found deer ticks—the species that carries Lyme disease—in more than half of the counties in the United States.

The two most common tick-borne illnesses in the U.S. are Lyme disease and southern tick-associated rash illness (STARI). Although their initial symptoms can be the same, they’re caused by different pathogens; Lyme disease comes from infection with the bacterium Borrelia burgdorferi. We don’t know what causes STARI.

"It is extremely important to be able to tell a patient they have Lyme disease as early as possible so they can be treated as quickly as possible," microbiologist and first author Claudia Molins of the CDC said in a statement. "Most Lyme disease infections are successfully treated with a two- to three-week course of oral antibiotics." Infections that aren't treated can lead to fevers, facial paralysis, heart palpitations, nerve pain, arthritis, short-term memory loss, and inflammation of the brain and spinal cord.

But to date, scientists have yet to create an accurate, consistent early test for Lyme disease, which means people must often wait until they’re very ill. And it’s hard to test for the STARI pathogen when we don’t know what it is.

One team of researchers led by experts at Colorado State University was determined to find a better way. They realized that, rather than looking for pathogens, they could look at the way a person’s body responded to the pathogens.

They analyzed blood samples from patients with both early-stage Lyme disease and STARI. Their results showed that while all patients’ immune systems had mounted a response, the nature of that response was different.

"We have found that all of these infections and diseases are associated with an inflammatory response, but the alteration of the immune response, and the metabolic profiles aren't all the same," senior author John Belisle of CSU said.

Two distinct profiles emerged. The team had found physical evidence, or biomarkers, for each illness: a way to tell one disease from another.

Belisle notes that there’s still plenty of work to do.

"The focus of our efforts is to develop a test that has a much greater sensitivity, and maintains that same level of specificity," Belisle said. "We don't want people to receive unnecessary treatment if they don't have Lyme disease, but we want to identify those who have the disease as quickly as possible."

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The Body
11 Interesting Facts About Lymph Nodes

The human body is an amazing thing. For each one of us, it's the most intimate object we know. And yet most of us don't know enough about it: its features, functions, quirks, and mysteries. Our series The Body explores human anatomy, part by part. Think of it as a mini digital encyclopedia with a dose of wow.

The lymphatic system is a crucial part of your body's ability to fight off infection and viruses. It's a key player in the immune system that functions by circulating lymphatic fluid through a series of lymph vessels all throughout your body. This fluid gathers up anything foreign, such as viruses and bacteria from your body tissues and flushes them to your lymph nodes, where immune cells attack whatever isn't helping your body. 

Mental Floss spoke to Adriana Medina, an internal medicine doctor with a specialty in hematology and oncology at the Alvin and Lois Lapidus Cancer Institute at Sinai Hospital in Baltimore, Maryland, about these important tissues. 

1. THERE ARE HUNDREDS OF NODES.

They're about size and shape of a pea, and hundreds of them are scattered all throughout the body. In order to fight many little pathogens and clear out unhelpful debris, your body needs a lot of nodes to rally to these causes, according to Medina. 

2. LYMPH NODES ARE HOME TO IMPORTANT IMMUNE CELLS.

"The lymph nodes are in charge of harboring lymphocytes," says Medina. Your body makes two main types of these immune cells, B-lymphocytes and T-lymphocytes (or B- and T-cells), which are crucial to your body's ability to fight off infections of all kinds. There are many sub-classes of the T-cells because "they are very important to attack infection," says Medina.

3. LYMPHOCYTES ESCORT FOREIGN INVADERS OUT.

When your lymph nodes receive some sort of foreign debris they recognize isn't ours, Medina says, "the B-lymphocytes are in charge of making antibodies." These antibodies "leave with the toxic substance," and signal other immune cells to come in and attack the cells.

4. WHERE DO ALL THE TOXINS GO?

Once the lymphatic fluid has grabbed up its targets, most of it returns to your blood stream, Medina explains, which is why it's so important for lymph cells to do their job: kill what aims to harm you before it gets flushed back into your system.

5. THERE ARE MANY CAUSES OF SWOLLEN LYMPH NODES.

When your immune system senses a foreign invader, be it a virus, bacteria, vaccine, or even some medications, it preps the lymph nodes to make antibodies and lymphocytes to fight off the offender. This also increases the amount of lymphatic fluid in the node, which can make it swollen and tender. Most of the time swollen lymph nodes are not a big cause for concern.

6. A HARD, RUBBERY LYMPH NODE IS A PROBLEM.

A lymph node that is harder rather than soft and persists for several weeks is worth a doctor visit. While lymph nodes can be tender or swollen and mobile when infected, "when there is a [cancerous] malignance…they're hard, rubbery, they don't move, and they don't go away. The lymph nodes are always telling us something."

7. YOU ARE THE PUMP FOR YOUR LYMPHATIC SYSTEM.

Unlike your blood, which has the heart to pump it through your body, your lymphatic fluid doesn't have a pump. Instead, it relies upon gravity and pressure, which you create when you move around, as well as light massage.

8. WHERE YOU FIND VEINS, YOU FIND LYMPHATIC VESSELS.

The lymphatic system and the circulatory system are separate systems, but connected, running in tandem like underground networks of streams. "Lymphatic vessels are distributed along the body wherever we have arteries [or] veins," says Medina.

9. YOUR LYMPH NODES AND YOUR SPLEEN WORK TOGETHER.

"The spleen is like one big lymph node," Medina says of the organ that lives between your stomach and diaphragm. "The spleen is able to produce additional blood cells in case we need it to." Additionally, she explains, many toxic substances are filtrated through the spleen. However, if something happens to your spleen and it needs to be removed, you can live without it; you just may become more prone to infection and require more vaccinations to protect you against aggressive viruses.

10. STAGES OF CANCER ARE DETERMINED BY THE NUMBER OF AFFECTED LYMPH NODES.

The easiest cancers to treat are those that remain in the tissue where they first occur. However, in metastatic cancers, cancer cells migrate to the lymph nodes, which can cause cancer to spread. "When the cancer is detected in lymph nodes, we have to try to find out how many lymph nodes are involved," Medina says. "Lymph node involvements [determines] the prognosis of the cancer." When lymph node involvement occurs, "the treatment has to be more aggressive," she says, often adding radiation to a regime of chemotherapy and other drugs.

11. RESEARCHERS ARE TURNING THE BODY'S OWN LYMPHOCYTES INTO CANCER FIGHTING TREATMENTS.

Breakthroughs in immunotherapy known as Car T-cell therapy turn the body's own immune system into a weapon against cancer by engineering patients' own immune cells to recognize and attack their tumors, according to the National Cancer Institute. "What's happening—it's just beautiful—is that [researchers] are using B-lymphocytes to fight not only breast cancer, but leukemia and lymphomas," Medina explains. "The results are so good and encouraging, changing chances of survival."

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