January 3, 2012

If you had to catch any infectious disease...

... before the invention of treatment for that disease - which one would it be and why?

That was the extra credit question on the final for my fall class on Health and Disease in Ancient Populations, helpfully proposed by my friend Laura.

Curious about the results, I tallied them up:

  • The top scorer was the treponemal disease pinta, with 6 responses.  This totally makes sense - pinta is a skin disease.  Unlike its cousins bejel, yaws, and venereal syphilis, it doesn't cause bone changes and doesn't kill you.  Every student who chose pinta suggested they could live with something that discolored their skin but didn't generate any more serious damage.
    Pinta (credit)
  • Tied for second place, with 4 votes each, are the related diseases of tuberculosis and leprosy, both caused by a mycobacterium.  These diseases can cause bony changes - the final stages of both TB and leprosy involve quite severe resorption or erosion of bone, resulting in the classic disfigurement of leprosy (in the nose, mouth, fingers, and toes) and the dowager's hump of tuberculosis.  Most students who chose these diseases noted that the diseases carry low mortality rates and that only a small percentage of cases actually progress to the later stages that involve severe bone changes.

Normal and leprous feet (credit)
  • And with 1 vote each: typhoid fever and measles.  Typhoid fever can be pretty nasty - it's been suggested as a cause of the 5th century BC Plague of Athens.  But a person can also carry typhoid fever and not be particularly sick, as in the infamous case of Typhoid Mary.  And measles is a childhood disease that most people got prior to modern vaccines, kind of like chicken pox.  Both diseases caused quite a number of deaths in the past, but if you survived them, you'd be doing ok.
I plan to pose this question again in the future.  If any of you out there use it, please let me know which diseases your students would opt to have!  Or feel free to tell me in the comments which disease you'd prefer to catch...


AJCann said...

The answer is:


Even for the most virulent strains of the poliovirus, only 1% of infected people experience any symptoms - for most strains it would be at least an order of magnitude less. And in ancient communities (at least as far back as 1500 BC in Egypt), community "herd" immunity was high due to constant circulation of the virus - that link didn't break until the introduction of "improved" sanitation at the end of the 19th century.
AJ Cann

Kristina Killgrove said...

Polio's a good one, AJ! One of my students did her final research project on polio, and there is surprisingly little osteological evidence of polio in antiquity.

Anonymous said...

I guess I don't understand - why didn't anyone pick something like rhinovirus, which causes a common cold? As a cold can now be treated with nasal decongestants, I think it fits the criteria, even if it can't be cured yet.

Kristina Killgrove said...

The common cold doesn't leave marks on bone, so we didn't cover it in class. (The question was limited to diseases we'd covered in class.) That said, dental caries (which causes cavities) is technically an infectious disease. Not sure why no one picked that.

Anonymous said...

From Chris Morley

Does your class consider the raised rates of osteoporosis, fractures and osteosclerosis (an elevation in bone density) as a result of hepatitis infections (I was thinking mainly of Hep C)?
[Search Google Scholar; I'm mainly aware of Hep C bone changes because it can be an issue for Hepatitis C and HIV co-infected people: http://www.aidsmap.com/page/1495036/]

If I lived in the past before treatments, I might well consider hepatitis as an infection of choice: most people have few or no symptoms or recover spontaneously after a few weeks; many (with Hep C) may have chronic infection for the rest of their lives but this is usually symptomless; after decades any chronic infection can, in a minority of cases, lead to liver cirrhosis > then failure (and rarely to liver cancer), and occasionally cause the bone changes mentioned above.

Most people experience only temporary symptoms with any form of hepatitis and even chronic hepatitis C infection is rarely fatal except among a tiny fraction of those initially infected.

In the past most people would have died of something else long before hepatitis could cause any serious harm.

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