SAMPLE EXCERPT:

(Roberts, 474)

The most significant prevention measure is sanitation, and the proper disposal of fecal matter, to which the United States initiated a hookworm campaign in 1913, which educated the American people on hookworm infection, as well as medicated those who were currently infected. (Roberts, 474-475) Because of those measures, hookworm disease is no longer as prevalent in America as in other parts of the world. (Roberts, 475) When medical treatment is received, the prognosis is good for someone with the disease.

Vibrio cholerae is the bacterium responsible for the epidemic called cholera. There have been no major outbreaks of this disease in the United States since the year 1911. (FDA/CFSAN) The symptoms of cholera, like most digestive system diseases, can vary depending on the severity of the case. Symptoms usually occur within an incubation period of six hours up to five days. (FDA/CFSAN) The onset is usually sudden, and the symptoms can include vomiting, nausea, severe diarrhea (rice water stools), dehydration, painful abdominal cramps, and shock. (FDA/CFSAN) If the symptoms persist and fluids are continually lost, death can occur.

Ingesting the bacteria causes the disease. The bacterium attaches itself to the small intestine, where it then produces a toxin. This particular toxin causes severe fluid loss, which can cause fatal cases of dehydration. Much like hookworm disease, the diagnosis of cholera can only come from the stools of the infected person.

The sporadic cases that have occurred in the United States in the past twenty years were when raw fish, or contaminated undercooked fish were eaten after being pulled from contaminated (fecal contamination) costal waters. (FDA/CFSAN) Poor sanitation is the most frequent cause of a cholera outbreak when the poor sanitation results in even poorer water conditions. Because the U.S. has such strict sanitation, cholera is all but eradicated. (FDA/CFSAN)

It is vital to treat cholera victims with intravenous fluids, including sodium chloride, potassium chloride, dextrose, and sodium bicarbonate to restore electrolytes and fluid levels. (FDA/CFSAN) Antibiotics may also be used to shorten the illness, but for the most part, the illness has to run its course. When adequate medical treatment is received, there are no complications, and the fatality rate is nearly zero. (FDA/CFSAN)

Before such high sanitation standards were possible, cholera was most certainly a violent a feared disease. In 1831, 13% of the population of Cairo was killed when cholera first struck. (McNeill, 261) The psychological fear that gripped people then was immense - cholera was described as having a horrific effect on those who witnessed someone die from the disease because of the way that "mortality was uniquely visible: patterns of bodily decay were exacerbated and accelerated, as in a time-lapse motion picture, to remind all who saw if of death's ugly horror and utter inevitability." (McNeill, 261) Rupturing capillaries caused the skin to take on a black and blue hue, which only accentuated the dehydrated state of the victim. (McNeill, 261)

Thankfully, cholera (along with hookworm disease) is no longer such a violent threat to the United States. Because the digestive system involves both the ingestion of food, and the riddance of waste materials, sanitation has been the most significant advancement in the treatment and prevention of so many diseases that affect the digestive system. It remains to be seen if there can be any further developments to prevent the onset of cirrhosis once someone has chronic hepatitis. However, the medical advances in vaccinations made in the past ten years certainly promises new hope for the thousands of Americans that are diagnosed with having HBV every year.

Works Cited

Carson-Dewitt, Rosalyn S. "Hookworm Disease." Gale Encyclopedia of Medicine. 1999 [Online edition] Accessed July 1, 2002 http://www.findarticles.com/cf_dls/g2601/0006/2601000682/p1/article.jhtml

Center for Disease Control (CDC). "Hookworm Infection Fact Sheet." Updated 08/15/99 [Online edition] Accessed July 3, 2002 http://www.cdc.gov/ncidod/dpd/parasites/hookworm/factsht_hookworm.htm

McNeill, William H. Plagues and Peoples. New York: Anchor Press. 1976. 369 pages

Palmer, Melissa. Hepatitis and Liver Disease: What you need to know.New York: Penguin Putnam, Inc. 2000. 457 pages

Roberts, Larry S. & Schmidt, Gerald D. Foundations of Parasitology. Missouri: The C.V. Mosby Co. 1981. 795 pages

U.S. Food & Drug Administration (FDA)-Center for Food Safety & Applied Nutrition. "Vibrio…