hmmm, diseases
2 Apr 2011 09:01 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
kaigouWatching Jin and there's talk of a cholera epidemic four years before the show (a time-travelling history work) takes place -- that would be the massive cholera outbreak of 1858, apparently. In the show, there's word that cholera has returned and naturally the population of Edo (and the few doctors, especially those trained in Western/Dutch medicine) are panicked about it.
Naturally this prompted another foray into wiki and beyond, into pdfs and google-books history analyses and texts, because hell if I know jack about cholera. It's just not an illness I've run into, or that has ever been a threat, in the part of the world where I live (though it does continue to be a threat in many other parts of the world). I had thought it was a virus, but it's not; it's a bacterium.
Doesn't that mean that if you were exposed to cholera and managed to be one of the one-in-two to one-in-twenty who survived (honestly, a 50% death rate is just unfathomable)... that your body would have developed the antibodies? Wouldn't that mean that epidemics would be separated by generations, because it'd take time before a large enough percentage of the population existed that had not been exposed? So you might have an outbreak four years later, but wouldn't it be substantially smaller due to a large part of the (surviving) population having developed antibodies -- in other words, city-newcomers and young children would be struck, but anyone who'd been around four years earlier might not be affected?
Or do bacteria mutate, such that a return of cholera could actually be a different strain? I know viruses mutate (and that's why they're so difficult to treat and/or inoculate, something to do with having to inoculate against the specific virus and if you're exposed to a different strain, the inoculation does little to nothing)... but I thought the life-cycle of bacteria changes was much slower, comparatively. At least, that's my uneducated reasoning, given how long it's taken bacteria to develop antibiotic-resistance. (I thought viruses develop a resistance much faster, because they change/mutate faster.)
Just curious; hoping someone might know because I'm failing at the google to find any article that answers that specific question.
Incidentally, wiki also notes that in terms of treatment: "Rice-based solutions are preferred to glucose-based ones due to greater efficiency." I wonder who first realized that, and was able to compare the two. I presume someone in Asia, since I doubt a rice-based anything would've been first on the list in Europe, rice not being a major staple of diet for most of European history. At least, that's my guess. Hell if I know, really.
Man, watching historical dramas (from any country) always ends up with me running to wiki to look stuff up, even moreso when it's not my own country's history. Get into time-travel stories and it's even worse, because characters will know or reference something and I'm lost. Although this time, at least, I got that one reference -- when the from-the-now doctor asks a young woman of Edo, "what year is it?" She replies, "the second year of Buncho" (something like that). He draws a complete blank -- he's a doctor, after all, not a historian. He waffles about, trying to figure it out, then lands on a definitive historical landmark: "have the black ships arrived?" Ah, she answers, that was ten years ago. Ahaha, do the math, it's 1862.
The show's full of nice little touches like that, like when the young lady offers to run back and get the medicines she'd missed. The doctor -- with patient at hand, needing attention -- asks how long that'll take. She replies, "a moment." How long, he asks, is a moment? She says, indignant, "a moment is a moment." Frustrated, he finally asks, "how much of the day will pass?" We take "hours" and "minutes" for granted now. It's almost incomprehensible to think of a time in which there's no knowledge of the passage of time, even when we don't have a clock right there on our wrist.
Well, incomprehensible... but not nearly as much as trying to fathom a disease that took out one person in every twenty.
(Incidentally, some of the epidemiology articles I've found suggest that Japan's deathrate was lower due to the Japanese habit of boiling water prior to drinking.)
Naturally this prompted another foray into wiki and beyond, into pdfs and google-books history analyses and texts, because hell if I know jack about cholera. It's just not an illness I've run into, or that has ever been a threat, in the part of the world where I live (though it does continue to be a threat in many other parts of the world). I had thought it was a virus, but it's not; it's a bacterium.
Doesn't that mean that if you were exposed to cholera and managed to be one of the one-in-two to one-in-twenty who survived (honestly, a 50% death rate is just unfathomable)... that your body would have developed the antibodies? Wouldn't that mean that epidemics would be separated by generations, because it'd take time before a large enough percentage of the population existed that had not been exposed? So you might have an outbreak four years later, but wouldn't it be substantially smaller due to a large part of the (surviving) population having developed antibodies -- in other words, city-newcomers and young children would be struck, but anyone who'd been around four years earlier might not be affected?
Or do bacteria mutate, such that a return of cholera could actually be a different strain? I know viruses mutate (and that's why they're so difficult to treat and/or inoculate, something to do with having to inoculate against the specific virus and if you're exposed to a different strain, the inoculation does little to nothing)... but I thought the life-cycle of bacteria changes was much slower, comparatively. At least, that's my uneducated reasoning, given how long it's taken bacteria to develop antibiotic-resistance. (I thought viruses develop a resistance much faster, because they change/mutate faster.)
Just curious; hoping someone might know because I'm failing at the google to find any article that answers that specific question.
Incidentally, wiki also notes that in terms of treatment: "Rice-based solutions are preferred to glucose-based ones due to greater efficiency." I wonder who first realized that, and was able to compare the two. I presume someone in Asia, since I doubt a rice-based anything would've been first on the list in Europe, rice not being a major staple of diet for most of European history. At least, that's my guess. Hell if I know, really.
Man, watching historical dramas (from any country) always ends up with me running to wiki to look stuff up, even moreso when it's not my own country's history. Get into time-travel stories and it's even worse, because characters will know or reference something and I'm lost. Although this time, at least, I got that one reference -- when the from-the-now doctor asks a young woman of Edo, "what year is it?" She replies, "the second year of Buncho" (something like that). He draws a complete blank -- he's a doctor, after all, not a historian. He waffles about, trying to figure it out, then lands on a definitive historical landmark: "have the black ships arrived?" Ah, she answers, that was ten years ago. Ahaha, do the math, it's 1862.
The show's full of nice little touches like that, like when the young lady offers to run back and get the medicines she'd missed. The doctor -- with patient at hand, needing attention -- asks how long that'll take. She replies, "a moment." How long, he asks, is a moment? She says, indignant, "a moment is a moment." Frustrated, he finally asks, "how much of the day will pass?" We take "hours" and "minutes" for granted now. It's almost incomprehensible to think of a time in which there's no knowledge of the passage of time, even when we don't have a clock right there on our wrist.
Well, incomprehensible... but not nearly as much as trying to fathom a disease that took out one person in every twenty.
(Incidentally, some of the epidemiology articles I've found suggest that Japan's deathrate was lower due to the Japanese habit of boiling water prior to drinking.)
no subject
Date: 3 Apr 2011 09:28 am (UTC)If a cholera patient is systematically rehydrated with isotonic fluid (basically boiled water with the correct proportion of salt and sugar dissolved in it) the infection is self-limiting -- the guts flush themselves clean within 48 hours, and the hydrated patient can recover.
Antibodies, though, imply the bacteria got into the body and the immune system got a chance to recognize it. Which doesn't happen. So you don't develop immunity to cholera.
no subject
Date: 3 Apr 2011 05:19 pm (UTC)So basically, if you survive cholera via staying hydrated enough, then the bacteria get wiped out before they've gone systemic, or does the cholera bacterium never actually go systemic to get that far? I guess that means systemic is required to develop antibodies?
The show did have patients being treated with a salt-sugar-water solution orally. (Then later by a jury-rigged intravenous saline drip.) In some ways, the show's writing is particularly deft, for mixing basic medicinal issues/procedures with a few modern nods, like when the back-in-time doctor (the Jin of the title) figures out the right proportion of salt, sugar, and water... and mutters to himself, "I've just made a sports drink."
I wonder how many people watching suddenly went, "wait, that's a sports drink? Salt, sugar, and boiled water?"
All in all, cholera does sound like an interesting beastie, but it's one I'd prefer spent its beastie time somewhere other than in me. Nothing personal, of course! Just... entirely professional. We're just not meant to be together, cholera. It's not you, really, it's me... who wants to be totally somewhere ELSE when you show up.
(thank you again for the clear & simple explanation!)