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Then vs. Now: What Happened to Dysentery?

Thankfully, dysentery is no longer a threat on cross-country trips.

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If you played Oregon Trail in the ‘90s, you’ve definitely heard of dysentery. You might not have known exactly what it was, but you quickly inferred that it was deadly and common. Indeed, the history of dysentery affected many more than just the pioneers traveling west.

Thankfully, dysentery is no longer a major threat on today’s cross-country road trips—so where did it go?

What *Is* Dysentery?

Dysentery refers to an episode of bloody diarrhea (hence its nickname, the “bloody flux”). Usually, it’s caused by consuming contaminated food or water, which could stem from bacteria, parasites, or chemicals.

Most commonly, dysentery is associated with a group of bacteria called Shigella or the amoeba Entamoeba histolytica. Today, infection with Shigella is called shigellosis, but the symptoms are the same: diarrhea, fever, and stomach cramps.

On the Oregon Trail, dysentery was common due to extremely unsanitary conditions. The travelers lacked access to purified water, as well as adequate storage and refrigeration of food. This led to episodes of diarrhea, which was severe enough to cause profound dehydration, which can be fatal.

History of Dysentery and Public Health

In the United States, three things helped reduce deaths from dysentery. The most obvious factor was the introduction of germ theory. The discovery that tiny infectious organisms could spread disease forever changed the understanding of health. For example, Kiyoshi Shiga identified the Shigella bacteria in 1898, which helped reveal how dysentery spreads.

The second factor is the formation of public health systems. It became increasingly clear that communities could contain contagious diseases with social interventions. As a result, many countries formed public health organizations in the 19th century. These systems fought for better sanitation in cities, clean water supplies, and personal hygiene. (Find out the history of personal hygiene here.)

Public health interventions significantly decreased rates of dysentery and other infections. For the cases that still occurred, the third factor came in handy: the invention of antibiotics in the 1940s. Most people with shigellosis recover without treatment after a week, but more severe cases may benefit from antibiotic prescriptions.

Dysentery + Shigellosis Today

Thanks to the efforts listed above, dysentery is rare in the United States today. Occasionally, outbreaks occur in daycares and schools. In 2016, there were about 12,600 cases of Shigella infections in the U.S., according to the Centers for Disease Control and Prevention. About 5,800 of those cases (47 percent) were in kids between ages 1 and 9.

Most cases of dysentery today happen in countries with weaker health infrastructures and lack of clean drinking water. Americans who travel to these countries are also prone to shigellosis, resulting in the “travelers' diarrhea” phenomenon.

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