Die storie

Disenterie

Disenterie


We are searching data for your request:

Forums and discussions:
Manuals and reference books:
Data from registers:
Wait the end of the search in all databases.
Upon completion, a link will appear to access the found materials.

Disenterie is 'n aansteeklike siekte van die ingewande. Die kieme word versprei deur besmette voedsel- en watertoevoer. Simptome is diarree, koors en pyn in die maag. Die siekte kom algemeen voor wanneer die sanitêre toestande sleg is en as die weer warm is. 'N Uitbraak van dysenterie in 1473 tussen 15 en 20 persent van die bevolking van die dorpe en dorpe wat deur siektes getref is. Disenterie kan nou suksesvol met antibiotika behandel word.


Watergedraagde siektes: Cholera en dysenterie: epidemiese dysenterie

Dysenterie is 'n ontsteking van die ingewande wat gekenmerk word deur die gereelde ontlasting met bloed en slym. Net soos cholera, word dysenterie versprei deur fekale besmetting van voedsel en water, gewoonlik in verarmde gebiede met swak sanitasie. In hierdie gebiede kom epidemies gereeld voor. 'N Vierjarige epidemie in Sentraal-Amerika, wat in 1968 begin, het tot meer as 500 000 gevalle en meer as 20 000 sterftes gelei. Sedert 1991 kom disenterie -epidemies voor in agt lande in Suider -Afrika (Angola, Burundi, Malawi, Mosambiek, Rwanda, Tanzanië, Zaïre en Zambië).

Epidemiese disenterie is 'n groot probleem onder vlugtelinge, waar oorbevolking en swak sanitasie die oordrag vergemaklik. Epidemies word gekenmerk deur ernstige siektes, hoë sterftesyfers, verspreiding van persoon tot persoon en veelvuldige weerstand teen antibiotika. Wêreldwyd ontwikkel ongeveer 140 miljoen mense elke jaar disenterie en ongeveer 600 000 sterf. Die meeste van hierdie sterftes kom in ontwikkelende lande voor onder kinders jonger as vyf jaar. In die Verenigde State kom daar jaarliks ​​slegs ongeveer 25 000 tot 30 000 gevalle voor.

Antigeen waarskuwing

In Afrika suid van die Sahara is diarree siektes die grootste oorsaak van dood onder kinders onder die ouderdom van vyf jaar. Daar word beraam dat elke kind vyf episodes van diarree per jaar het en dat 800 000 van die kinders aan diarree en gepaardgaande dehidrasie sal sterf.

Dysentery se wortels

Disenterie word meestal veroorsaak deur een van twee verskillende organismes: die een is 'n bakterie wat genoem word Shigella die ander word veroorsaak deur 'n amoeba. Shigella is die belangrikste oorsaak van bloedige diarree omdat dit selle wat die dikderm voer, vernietig, wat lei tot mukosale ulkusse in die ingewande. Die mukosale ulkusse veroorsaak bloedige diarree. As u tot 10 tot 100 bakterieë inneem, wat in 'n klein hoeveelheid besmette voedsel of water voorkom, kan dit siektes veroorsaak.

Amoebiese disenterie kom algemeen voor in streke waar menslike ontlasting as kunsmis gebruik word. Die amoebas wat disenterie veroorsaak, kan siste vorm, soos bakteriese spore wat onaktief kan raak en baie bestand is teen omgewingsomstandighede. Met ander woorde, hulle kan 'n lang tyd buite die liggaam leef en dan weer aktiveer en siektes veroorsaak as toestande gunstig word.

Siste en lewende amoebas word in die ontlasting van 'n besmette persoon uitgeskei, maar slegs die siste kan buite die liggaam oorleef. Die amoebiese infeksie is ligter in vergelyking met bakteriële disenterie. Ten spyte hiervan is amoebiese disenterie moeiliker om te behandel en te genees bakteriese disenterie reageer beter en vinniger op behandeling.

Beide tipes disenterie besmet mense van verskillende ouderdomme, geslagte en etniese agtergronde, alhoewel kinders meer vatbaar is.

Kragtige feit

Die twee hoofoorsake van dysenterie is die Shigella bakterie en 'n amoeba. Shigella kan ernstige siektes en epidemies veroorsaak, hoewel dit goed reageer op behandeling. Disenterie wat deur die amoeba veroorsaak word, is ligter as die neef van die bakterie, hoewel dit baie moeilik is om te behandel en te genees en dikwels chronies word.

Simptome

Pasiënte met bakteriële disenterie het dikwels koors, maagkrampe, rektale pyn en bloedige stoelgang. Soms gaan groot dele van die dermvlies verby met veral stinkende stoelgang wat geelwit slym en/of bloed bevat. In byna die helfte van die gevalle, Shigella veroorsaak nie bloedige diarree nie.

As amoebiste met besmette voedsel of water ingeneem word, ontkiem hulle en ontwikkel tot lewende amoebas in die ingewande. Die siekte bly sag as die amoeba binne die ingewande beperk word. Soos bakteriële dysenterie, lei indringing van die dermwand tot koors, abdominale en rektale pyn en bloedige diarree. Amoebiese disenterie kan in chroniese vorm voorkom wanneer die amoebas die bloedvate van die ingewande binnedring en na ander dele van die liggaam vervoer word, wat amoebiese absesse van die lewer en brein veroorsaak. Ongeveer 40 persent van alle onbehandelde gevalle veroorsaak uiteindelik nie -intestinale infeksies, soos amoebiese hepatitis.

Siekteveroordeling

Die amoebiese vorm van disenterie leef buite die liggaam deur te vorm siste, wat soortgelyk is aan bakteriese spore. Siste het 'n taai buitemuur wat voorkom dat verskillende omgewingstoestande die amoebas doodmaak. Net soos 'n beer wat hiberneer, is die siste rustend totdat die toestande beter is; hulle val 'n liggaam binne wat die regte temperatuur en voedingstowwe het, dan word hulle wakker en veroorsaak siektes.

Diagnose van dysenterie

Dysenterie word gediagnoseer deur rektale deppers wat bewys lewer van dysenterie Shigella bakterieë of amoeba.

Beskikking oor dysenterie

Bakteriële disenterie verdwyn dikwels vanself, hoewel behandeling met antibiotika aanbeveel word om herhaling te voorkom. Dit is belangrik om te bepaal watter antibiotika die beste sal werk, omdat baie geneeskundige toetse uitgevoer word voordat die behandeling begin word, omdat baie organismes geneesmiddelbestand is. Shigella het eers in die veertigerjare weerstand begin kry en sedertdien weerstandbiedend geword teen verskeie klasse medisyne.

Dit is ook belangrik om dehidrasie wat met dysenterie gepaard gaan, te behandel. Hierdie simptome moet behandel word met orale rehidrasie soute of, indien ernstig, met binneaarse vloeistowwe.

'N Kombinasie van medisyne word gebruik om amoebiese disenterie te behandel: 'n amoïesdoder om die organisme uit die dermkanaal uit te roei, en 'n antibiotikum om moontlike sekondêre bakteriële infeksies uit te skakel.

Die uitwissing van die epidemie

Vroeë opsporing en kennisgewing van epidemiese dysenterie, veral onder volwassenes, laat vinnige reaksie toe om die verspreiding van die siekte te beveg. Handwas met seep en water kan sekondêre oordrag van Shigella infeksies onder huishoudelike lede. En onder groter groepe, soos in vlugtelingkampe, is die doeltreffendste strategieë om die oordrag van epidemies te beheer Shigella is om?

  • Versprei seep.
  • Voorsien skoon water.
  • Bevorder handewas voordat u eet of voorberei en na ontlasting.
  • Installeer en onderhou behoorlike rioolstelsels of behandelingsfasiliteite.

Ontwikkeling van 'n entstof

Daar is geen entstowwe vir dysenterie nie, alhoewel daar 'n groot behoefte is, veral omdat geneesmiddelweerstand dikwels behandelingsopsies beperk. Daar is tans verskeie moontlike entstowwe in die evalueringsfases.

Besmette water veroorsaak jaarliks ​​miljoene en miljoene gevalle van siektes. Ons het in hierdie afdeling cholera en dysenterie bespreek, maar daar is ook ander siektes. Verbeterde sanitasie is die sleutel tot die bestryding van hierdie siektes, maar totdat die toestande verbeter, is dit belangrik dat slagoffers behoorlike behandeling ontvang en die ernstige dehidrasie wat dikwels met diarree voorkom, voorkom.


Sensusrekords kan u baie min feite oor u voorvaders van die dysenterie vertel, soos beroep. Beroep kan u vertel van die sosiale en ekonomiese status van u voorouer.

Daar is 3 000 sensusrekords beskikbaar vir die van Dysentery. Soos 'n venster in hul daaglikse lewe, kan die sensusrekords van Dysentery u vertel waar en hoe u voorouers gewerk het, hul opvoedingsvlak, veteraanstatus en meer.

Daar is 642 immigrasierekords beskikbaar vir die van Dysentery. Passasierslyste is u kaartjie om te weet wanneer u voorouers in die VSA aangekom het en hoe hulle die reis onderneem het - van die skeepsnaam tot die aankoms- en vertrekhawe.

Daar is 1 000 militêre rekords beskikbaar vir die van Dysentery. Vir die veterane onder u voorouers in die Dysenterie, bied militêre versamelings insigte oor waar en wanneer hulle diens gedoen het, en selfs fisiese beskrywings.

Daar is 3 000 sensusrekords beskikbaar vir die van Dysentery. Soos 'n venster in hul daaglikse lewe, kan die sensusrekords van Dysentery u vertel waar en hoe u voorouers gewerk het, hul opvoedingsvlak, veteraanstatus en meer.

Daar is 642 immigrasierekords beskikbaar vir die van Dysentery. Passasierslyste is u kaartjie om te weet wanneer u voorouers in die VSA aangekom het en hoe hulle die reis onderneem het - van die skeepsnaam tot die aankoms- en vertrekhawe.

Daar is 1 000 militêre rekords beskikbaar vir die van Dysentery. Vir die veterane onder u voorouers in die Dysenterie, bied militêre versamelings insigte oor waar en wanneer hulle diens gedoen het, en selfs fisiese beskrywings.


Oorsake en simptome

Oorsake

Die mees algemene tipes dysenterie en hul oorsaaklike agente is soos volg:

    . Basillêre dysenterie, wat ook bekend staan ​​as shigellose, word veroorsaak deur vier spesies van die genus Shigella: S. dysenteriae, die mees virulente spesie en die een wat die meeste geneig is om epidemies te veroorsaak S. sonnei, die sagste spesie en die algemeenste vorm van Shigella in die Verenigde State gevind S. boydii en S. flexneri. S. flexneri is die spesie wat Reiter se sindroom veroorsaak, 'n tipe artritis wat as 'n laat komplikasie van shigellose ontwikkel. Ongeveer 15,000 gevalle van shigellose word elke jaar by die CDC aangemeld vir die Verenigde State, maar die CDC beweer dat die werklike aantal jaarlikse gevalle tot 450,000 kan wees, aangesien die siekte baie onder aangemeld word. Ongeveer 85 persent van die gevalle in die Verenigde State word veroorsaak deur S. sonnei. Die Shigella organismes veroorsaak diarree en pyn wat verband hou met dysenterie deur die weefsels wat die kolon omring, binne te dring en 'n enterotoksien af ​​te skei, of skadelike proteïen wat die dermvoering aanval.
  • Amebiese disenterie. Amebiese disenterie, wat ook derm genoem word amebiasis en amebiese kolitis, word veroorsaak deur 'n protosoon, Entamoeba histolytica. E. histolytica, wie se wetenskaplike naam "weefseloplosbaar" beteken, is slegs die tweede na die organisme wat veroorsaak word malaria as 'n protosoale oorsaak van dood.E. histolytica kom gewoonlik die liggaam binne die siste fase van sy lewensiklus. Die siste kan gevind word in voedsel of water wat deur menslike ontlasting besmet is. In die spysverteringskanaal breek die siste af, wat 'n aktiewe vorm van die organisme vrystel wat 'n trofozoïet genoem word. Die trofozoïete val die weefsels in die ingewande binne, waar dit gewoonlik in die ontlasting van die pasiënt uitgeskei word. Soms dring hulle egter deur die voering en dring die bloedstroom binne. As dit gebeur, kan die trofozoiete na die lewer, long of ander organe vervoer word. Betrokkenheid van die lewer of ander organe word soms metastatiese amebiasis genoem.
  • Balantidiasis, giardiasis, en kriptosporidiose. Hierdie drie derminfeksies word almal veroorsaak deur protosoë, Balantidium coli, Giardia lamblia, en Cryptosporidium parvum onderskeidelik. Alhoewel die meeste mense wat met hierdie protosoë besmet is, nie ernstig siek word nie, kan die siekte -agente disenterie by kinders of immuungekompromitte veroorsaak. Daar word jaarliks ​​ongeveer 3 500 gevalle van kriptosporidiose by die CDC aangemeld in die Verenigde State, en ongeveer 22 000 gevalle van giardiasis.
  • Virale disenterie. Virale disenterie, wat soms reisigersdiarree of viraal genoem word gastro -enteritis, word veroorsaak deur verskeie families van virusse, insluitend rotavirusse, kalicivirusse, astrovirusse, norovirusse, en adenovirusse. Daar is jaarliks ​​ongeveer 3,5 miljoen gevalle van virale disenterie by babas in die Verenigde State, en jaarliks ​​ongeveer 23 miljoen gevalle by volwassenes. Die CDC skat dat virusse verantwoordelik is vir 9,2 miljoen gevalle van disenterie wat verband hou met voedselvergiftiging elke jaar in die Verenigde State. Terwyl die meeste gevalle van virale disenterie by babas deur rotavirusse veroorsaak word, is calicivirusse die algemeenste siekte -agente by volwassenes. Norovirusse was verantwoordelik vir ongeveer die helfte van die uitbrake van disenterie op vaartuie wat in 2002 by die CDC aangemeld is.
  • Disenterie veroorsaak deur parasitiese wurms. Beide sweepwurm (trichuriasis) en platwurm- of plukwurmbesmetting (schistosomiasis) kan die gewelddadige diarree en maagkrampe veroorsaak wat verband hou met disenterie. Schistosomiasis is die tweede mees algemene tropiese siekte ná malaria. Alhoewel die siekte selde in die Verenigde State voorkom, kan reisigers na lande waar dit endemies is, dit opdoen. Die Wêreldgesondheidsorganisasie (WGO) beraam dat ongeveer 200 miljoen mense regoor die wêreld die parasiet in hul liggame dra, en 20 miljoen het ernstige siektes.

Simptome

Benewens die kenmerkende bloedige en/of waterige diarree en abdominale krampe van disenterie, het die verskillende tipes ietwat verskillende simptoomprofiele:

  • Basillêre dysenterie. Die simptome van shigellose kan wissel van die klassieke bloedige diarree en tenesmus wat kenmerkend is van disenterie tot die verloop van niebloedige diarree wat lyk soos die los stoelgang wat veroorsaak word deur ander dermversteurings. Die hoë koors wat verband hou met shigellose begin binne een tot drie dae na blootstelling aan die organisme. Die pasiënt kan ook pyn in die rektum sowel as buikkrampe hê. Die akute simptome duur drie tot sewe dae, soms so lank as 'n maand. Basillêre dysenterie kan tot twee moontlik dodelike komplikasies buite die spysverteringskanaal lei: bakteremie (bakterieë in die bloedstroom), wat die waarskynlikste voorkom by ondervoedde kinders en hemolitiese uremiese sindroom, 'n tipe nierversaking met 'n sterftesyfer van meer as 50 persent.
  • Amebiese disenterie. Amebiese disenterie kom dikwels stadig en geleidelik voor, maar die meeste pasiënte met amebiasis besoek die dokter na 'n paar weke van diarree en bloedige ontlasting. Koors is ongewoon met amebiasis, tensy die pasiënt 'n lewer ontwikkel het abses as 'n komplikasie van die infeksie. Die ernstigste komplikasie van amebiese disenterie is egter fulminante of nekrotiserende kolitis, wat 'n ernstige ontsteking van die kolon is wat gekenmerk word deur dehidrasie, erge buikpyn en die risiko van perforasie (breuk) van die kolon.
  • Disenterie veroorsaak deur ander protosoë. Dysenterie wat verband hou met giardiasis begin ongeveer 1-3 weke na infeksie met die organisme. Dit word gekenmerk deur opgeblase en stinkende flatus, naarheid en opgooi, hoofpyn en lae graad koors. Hierdie akute simptome duur gewoonlik drie of vier dae. Die simptome van kriptosporidiose is lig by die meeste pasiënte, maar is gewoonlik ernstig by pasiënte met VIGS. Diarree begin gewoonlik tussen sewe en 10 dae na blootstelling aan die organisme en kan baie wees. Die pasiënt kan pyn in die regter boonste buik hê, naarheid, en braking, maar koors is ongewoon.
  • Virale disenterie. Virale disenterie het 'n relatief vinnige aanvang, en die simptome kan binne enkele ure na infeksie begin. Die pasiënt kan ernstig dehidreer van die diarree, maar het gewoonlik slegs 'n lae koors. Die diarree self kan voorafgegaan word deur een tot drie dae van naarheid en braking. Die buik van die pasiënt kan effens sag wees, maar is gewoonlik nie erg pynlik nie.
  • Disenterie veroorsaak deur parasitiese wurms. Pasiënte met intestinale skistosomose het gewoonlik geleidelik simptome. Benewens bloedige diarree en buikpyn, het hierdie pasiënte gewoonlik moegheid. 'N Ondersoek van die dikderm van die pasiënt sal gewoonlik gebiede van ulkusweefsel openbaar, wat die bron van bloedige diarree is.

King John: Dysentery en die dood wat die geskiedenis verander het

Dit is 800 jaar sedert een van Engeland se mees beledigde monarge, koning John, aan dysenterie gesterf het. BBC News ondersoek hoe hierdie ingewikkelde toestand die lewe van verskeie Engelse konings geëis het, wat die verloop van die geskiedenis verander het.

Hoe kwaad dit ook al is, word die hel self deur die teenwoordigheid van Johannes verwoes. & quot

Kroniekskrywer Matthew Paris se grafskrif weerspieël die minagting waarmee John wyd gehou is - maar kan ook 'n knik wees op sy onaangename afsterwe.

Sy chaotiese en rampspoedige heerskappy kom tot 'n hewige einde op, of naby die toilet. Of wat ook al in Oktober 1216 as 'n toilet in Newark Castle gedien het.

Deur John te voltooi, kan dysenterie - in wese diarree so gewelddadig dat dit bloeding en dood veroorsaak - die verloop van die Engelse geskiedenis skouspelagtig verander het.

En dit was nie die enigste keer dat dit daarin kon slaag om 'n koning dood te maak of die land 'n nuwe koers te gee nie.

"Hy was 'n totale ruk," sê Marc Morris, skrywer van King John: Treachery, Tyranny and the Road to Magna Carta.

Hy was deur tydgenote verafsku as wreed en lafhartig.

Baie mense dink aan die Middeleeuse Europa as 'n plek waar alles gaan, soos Game of Thrones.

Maar daar was reëls, veral oor hoe u edeles behandel het. John het hierdie taboes verbreek.

Hy het nie net doodgemaak nie, hy was sadisties. Hy het mense uitgehonger. En nie net vyandelike ridders nie, maar eens 'n mededinger se vrou en seun. & Quot

Deur onderdane van die geërfde gebied in Frankryk te verloor en belasting te verhoog om ydele pogings om dit terug te kry, te befonds, het sy onderdane in Engeland vervreem.

Die reputasie dat hy 'n seksuele roofdier was saam met die vroue en dogters van edeles, tesame met die willekeurige behandeling van bondgenote en teenstanders, het die elite kwaad gemaak.

Hy het pous Innocentius III so erg gemaak dat die pous John uit die ban gesit het en gelas het dat Engeland se kerke gesluit moet word.

Dit alles het daartoe gelei dat die burgeroorlog Magna Carta en 'n Franse prins, Louis, die troon aangebied is.

Maar terwyl hy baklei het, het John swak en siek geword. Hy reis van Norfolk na die Midlands en stop by Newark en sterf kort daarna.

Gerugte veroorsaak dat hy onryp perskes eet, te veel soetbier drink of selfs met gif van 'n padda gedoseer word.

Dr Iona McCleery, 'n kenner van die Middeleeuse geneeskunde aan die Universiteit van Leeds, sê: "Om te sê dat John aan oormatige dood gesterf het, was 'n manier om sy persoonlikheid te kritiseer. Dit impliseer onbeskaamdheid, vraatsug en onbedagsaamheid.

Om te sê dat hy vergiftig is, het getoon dat hy gehaat is. Wat die waarheid ook al was, diegene wat die geskiedenis neerskryf, het niks goeds oor John te sê nie. & Quot

Disenterie word veroorsaak deur parasiete in die ingewande, maar kan ook maklik verwar word met ander virale en bakteriële infeksies.

Dit word meestal versprei deur vuil water of voedsel wat met menslike afval besmet is.

Dr McCleery sê: "Disentery was nie noodwendig 'n toestand van die gewone nie. Baie groente is verbou in grond wat met menslike afval bemes is.

John was op 'n optog en het 'n oorlog gevoer, onder baie spanning.

Hy was waarskynlik fisies en emosioneel uitgeput en lewensomstandighede op die optog kan primitief wees, maak nie saak wie jy is nie. & quot

Na die dood van John het die brand uit die burgeroorlog gegaan en prins Louis is uit Engeland verjaag. Die stabiliteit het teruggekeer, die Magna Carta het wortel geskiet.

Maar disenterie was nie klaar met die lot van Engeland of sy konings nie.

Edward I, die Hamer van die Skotte, sterf daaraan op pad om oorlog te hernu met Robert the Bruce in 1307. Sy seun Edward II verloor die gevolglike gevegte en Skotland behou sy onafhanklikheid.

Dit was moontlik verantwoordelik vir Edward, die Swart Prins. Bekende vegter en staatsman, sy dood in 1376, die jaar voor sy pa Edward III, beteken dat die Swart Prins se seun, Richard II, koning sou word op 10 -jarige leeftyd.

Dysentery vermoor ook Henry V, held van Agincourt, terwyl hy in 1422 veldtog in Frankryk voer. Henry VI word op nege maande oud koning.

Die volwasse Henry VI was heeltemal ongeskik vir die middeleeuse koningskap en was onderworpe aan katatoniese aanvalle. Frankryk het verlore gegaan en rebellies het die oorloë van die rose veroorsaak, wat Engeland tot 1485 verwoes het.

Maar toe John sy lewe beëindig het, het disenterie moontlik die grootste impak gehad.

Dr Morris sê: & quot Baie konings kan volgens ons standaarde wreed wees, maar John was wreed, lafhartig en 'n mislukking.

Maar deur te sterf, beteken dit dat Magna Carta, wat hy verwerp het, weer uitgegee sal word.

& quot Standaard, sy nalatenskap was dat so 'n reël nie herhaal sou word nie, deur 'n dokument wat steeds die regte van die subjek teen die mag van 'n tiran simboliseer. & quot

En hoewel disenterie vir baie van ons soos 'n siekte van die verlede kan klink, is dit steeds 'n groot moordenaar in ontwikkelende lande.

Volgens die Wêreldgesondheidsorganisasie sterf daar jaarliks ​​byna 900 000 mense aan dysenterie of soortgelyke siektes, die oorgrote meerderheid jong kinders.


Sally oorlede aan dysenterie: 'n geskiedenis van Die Oregon -roete

Die agtste leerlinge sit en kyk hoe Don Rawitsch 'n enorme toestel in hul klaskamer insleep. Dit was 3 Desember 1971, en Rawitsch - 'n onderwyseres aan die Carleton College buite Minneapolis wat geskiedenis by 'n plaaslike skool geleer het - was gereed om te wys wat sy kamermaats, Paul Dillenberger en Bill Heinemann, in slegs twee weke van programmering en met beperkte, amateur -koderingvaardighede: 'n speletjie genaamd Die Oregon -roete.

Daar was geen skerm om op te fokus nie. Die rekenaar se koppelvlak was 'n teletipe masjien wat instruksies en die gevolge van 'n speler se optrede op velle papier uitgespoeg het. Die studente het die goed gedra skoene van setlaars aangeneem wat in 1848 van Missouri na Oregon migreer, en bespreek hoe hulle hul geld die beste kan bestee, wanneer om te stop en te rus, en hoe om te gaan met die skielike en onverwagte siektes wat hul spelgenote teister. Rawitsch het selfs 'n kaart van die reis aan hulle verskaf, sodat hulle die gevare wat voorlê, kon visualiseer.

Die studente was mal daaroor: Die Oregon -roete sou uiteindelik verander van 'n deeltydse eksperiment in begeleide leer na 'n stapelvoedsel van klaskamers regoor die land. Kinders wat nog nooit van difterie of cholera gehoor het nie, sou betreur oor sulke wrede lotgevalle dat tienduisende mense (feitlik) sou verdrink om meer as 65 miljoen eksemplare te probeer oorsteek.

Maar Rawitsch was onbewus van die kulturele toetssteen Die Oregon Roete sou word. Hy het nie verwag dat die eenvoudige spel 'n lang rakleeftyd na die semester sou hê nie, so aan die einde van die jaar het hy dit verwyder.

So laagtegnologies as wat dit was, die eerste weergawe van Die Oregon -roete was nog kilometers ver enigiets wat Rawitsch kon voorstel toe hy probeer om sy studente te betrek. As 21-jarige hoofvak in die geskiedenis was Rawitsch jonk genoeg om te besef dat sy tienerstudente iets meer uitdagend as droë handboeke nodig gehad het. In die herfs van 1971 besluit hy om 'n bordspel te skep wat gebaseer is op die gevaarlike beweging van 19de-eeuse reisigers wat weswaarts wil gaan om hul lewensomstandighede te verbeter.

Op 'n groot stuk slagterspapier het hy 'n kaart geteken wat 'n ruwe uiteensetting gee van die reis van 2000 myl van Independence, Missouri na Willamette Valley, Oregon. Onderweg sou spelers met 'n morbiede reeks hindernisse te kampe gehad het: vuur, gure weer, gebrek aan voedsel, verouderde siektes en dikwels die dood. Elke besluit het 'n rol gespeel in die vraag of hulle tot die einde sou kom of nie.

MECC

Rawitsch het sy idee vir die bordspel aan Dillenberger en Heinemann, twee ander bejaardes van Carleton, gewys wat albei ondervinding het met die gebruik van die BASIC -rekenaartaal. Hulle het voorgestel dat die spel van Rawitsch perfek sou wees vir 'n teksgebaseerde avontuur met teletipe. 'N Speler kan byvoorbeeld' BANG 'tik om osse of takbokke te skiet, en die rekenaar sal identifiseer hoe vinnig en akkuraat die tikster die opdrag voltooi het - hoe vinniger hulle was, hoe groter was die kans om aandete te bekom.

Rawitsch het van die idee gehou, maar hy sou binne 'n paar weke begin om uitbreiding na die weste te leer, so daar was geen tyd om te mors nie. Heinemann en Dillenberger het twee weke na-ure gewerk om te kry Die Oregon -roete gereed. Toe dit sy debuut op daardie Desember -dag in 1971 maak, het Rawitsch geweet dat hy 'n treffer gehad het - hoewel 'n kortstondige. Soos 'n onderwyser wat toesig gehou het oor 'n spesiale handwerkprojek vir 'n spesifieke klaskamer, het Rawitsch geen behoefte gehad om dit te behou nie Die Oregon -roete vir die toekoms en het dit onmiddellik uit die skool se hoofraamstelsel verwyder.

Dillenberger en Heinemann het na die gradeplegtigheid permanente onderwysgeleenthede aangeneem. Hy het homself as 'n gewetensbeswaarder verklaar en het as deel daarvan werk by die nuutgestigte Minnesota Educational Computing Consortium (MECC), 'n staatsondersteunde program wat probeer het om openbare skole met rekenaarbenodigdhede te moderniseer. Dit was 1974, en Rawitsch het geglo dat hy die perfekte sagteware het om saam met hul inisiatief te gaan: Die Oregon -roete. Alhoewel hy die speletjie uitgevee het, het Rawitsch die kode gedruk.

Deur dit reël vir reël te tik, het Rawitsch die spel weer aan die gang gehad en was dit beskikbaar vir studente in Minnesota. Hierdie keer het hy die werklike joernaalinskrywings van setlaars geraadpleeg om te sien wanneer en waar gevaar kan ontstaan, en het hy die spel geprogrammeer om op die toepaslike plekke langs die pad in te gryp. As 'n ware reisiger 'n kans van 20 persent gehad het om water op te loop, sou die speler dit ook doen.

Rawitsch het toestemming van Dillenberger en Heinemann gekry om die spel vir MECC te hergebruik. Dit is onwaarskynlik dat een van die drie van hulle besef het hoeveel 'n instelling die spel sou word, of hoe MECC se sakevennoot, Apple - destyds 'n nuwerwetse rekenaarkorporasie - 'n omwenteling in die bedryf sou maak.

Teen 1978 werk MECC saam met die hardeware -onderneming om Apple II's en leerprogrammatuur aan skooldistrikte regoor die land te verkoop. In plaas daarvan om 'n plaaslike treffer te wees, Die Oregon -roete- nou 'n primitiewe skermgrafiek - het 'n nasionale toebehore in klaskamers geword.

Vir 'n groot deel van die 1980's en 1990's het skoolrekenaarklasse regoor Amerika het ten minste 'n deel van hul toegewese tyd aan die spel gewy. Die bedekte wa en sy ongelukke bied iets wat vaagweg lyk soos die hipnotiese, pittige wêrelde wat tuis op hul Nintendo -konsoles op studente wag. In daardie opsig, Die Oregon -roete het 'n bietjie minder gevoel vir leer en baie meer vir vermaak - hoewel die voltooiing van die reis in een stuk 'n ongewone gebeurtenis was. Spelers sou meer gereeld deur wanvoeding of verdrinking verslaan word in pogings om 'n rivier oor te steek. Hulle sou ook verwar word oor die idee dat hulle 'n dier van 2000 pond kon jag en doodmaak, maar kon slegs 'n fraksie daarvan na hul wa terugneem. (Hiermee gekonfronteer tydens 'n Reddit Ask Me Anything in 2016, het Rawitsch opgemerk dat 'die konsep wat daar verteenwoordig word, veronderstel is dat die maaltyd sal bederf, nie dat dit te swaar is nie', en stel voor dat 'n 'yskas met 'n verlenging van 2000 myl ingesluit word koord. ")

MECC

'N Opgedateerde weergawe, Oregon Trail II, debuteer op CD-ROM in 1995. MECC sou 'n paar keer van eienaar verander, deur die verkryging van waagkapitaliste en daarna deur die Learning Company, en is selfs vir 'n tydperk deur Mattel besit. Pogings om dit op te dateer met spoggerige grafika voel teenstrydig met die spelgees, soos die setlaars wat dit uitgebeeld het, Die Oregon -roete blykbaar aan 'n ander era te behoort.

Vandag is beide Dillenberger en Heinemann afgetree. Rawitsch is 'n tegniese konsultant. Nie een van hulle het winsdeelname vir die sagteware ontvang nie. Hul gesamentlike poging is in 2016 opgeneem in die World Video Game Hall of Fame en is dieselfde jaar in 'n kaartspel aangepas. Vandag, spelers van die gewilde rolspel Minecraft toegang tot 'n virtuele Oregon -roete ter wêreld is die oorspronklike spel ook in blaaiers speelbaar. Tegnologie het moontlik gevorder, maar u kan steeds sterf aan dysenterie so gereeld as wat u wil.


Hou in gedagte dat daar ook 'n projek vir diarree is.

  • Disenterie is anders as diarree Dit is die voorwaarde dat u drie of meer los of vloeibare stoelgang per dag het.

Disenterie is 'n dermontsteking, veral in die kolon, wat kan lei tot ernstige diarree met slym of bloed in die ontlasting.

Dit word veroorsaak deur 'n aantal tipes infeksies, soos bakterieë, virusse, parasitiese wurms of protosoë. Dit is 'n tipe gastro -enteritis. Die meganisme is 'n inflammatoriese afwyking van die ingewande, veral van die kolon.

Pasiënte ondervind gewoonlik ligte tot erge buikpyn of maagkrampe. In sommige gevalle kan onbehandelde disenterie lewensgevaarlik wees, veral as die besmette persoon nie vinnig genoeg verlore vloeistowwe kan vervang nie.

Net soos cholera, word dysenterie versprei deur fekale besmetting van voedsel en water, gewoonlik in verarmde gebiede waar oorbevolking en swak sanitasie die oordrag vergemaklik. Epidemies, 'n groot probleem onder vlugtelinge, kom gereeld in hierdie gebiede voor. As mense in geïndustrialiseerde lande disenterie het, is tekens en simptome geneig om lig te wees. Baie sal nie eers hul dokter sien nie, en die probleem is binne 'n paar dae opgelos. Tog, as 'n dokter in Wes -Europa, Noord -Amerika en baie ander lande 'n geval van disenterie ondervind, moet die plaaslike owerhede ingelig word - dit is 'n aanmeldbare siekte.

Die Wêreldgesondheidsorganisasie sê daar is twee hooftipes disenterie:

  • Basillêre dysenterie, veroorsaak deur Shigella, 'n bakterie. In Wes -Europa en die VSA is dit die algemeenste tipe disenterie onder mense wat nie onlangs in die trope was nie.
  • Amoebiese disenterie (amoebiasis) veroorsaak deur Entamoeba histolytica, 'n tipe amoeba, en kom meer gereeld in die trope voor. 'N Amoeba is 'n protosoïese (eensellige) organisme wat voortdurend van vorm verander.

Die Wêreldgesondheidsorganisasie skat dat shigellose verantwoordelik is vir ongeveer 120 miljoen gevalle van ernstige disenterie met bloed en slym in die stoelgang wêreldwyd. Die oorgrote meerderheid gevalle kom voor in ontwikkelende lande onder kinders jonger as vyf jaar. Daar word vermoed dat ongeveer 1,1 miljoen mense jaarliks ​​wêreldwyd aan Shigella -infeksie sterf. Sestig persent van hierdie sterftes is onder baie jong kinders.

Verskil tussen diarree en dysenterie:

  • Diarree Dit is 'n toestand wat lei tot die gereelde afloop van los of waterige stoelgang sonder bloed en slym, al dan nie vergesel van krampe of pynskoors nie, kom minder gereeld voor, en die uitdroging van die dunderm is groot, dit benodig NIE antibiotika nie, maar het mondelinge of binneaarse vloeistowwe nodig om te hidreer.
  • Disenterie is 'n dermontsteking, veral in die dikderm, wat kan lei tot ernstige diarree met slym of bloed in die ontlasting, veroorsaak gewoonlik krampe en laer buikpyn veroorsaak gewoonlik 'n koors wat die kolon beïnvloed, behandeling bevat byna altyd antibiotika of ander maniere om die patogeen uit te roei sonder behandeling kan baie komplikasies veroorsaak.

Die saad, blare en bas van die kapokboom is in tradisionele medisyne gebruik deur inheemse mense in die reënwoudstreke in Amerika, Wes-Sentraal-Afrika en Suidoos-Asië om hierdie siekte te behandel. Bacillus subtilis word sedert 1946 in Amerika en Europa bemark as 'n immuunstimulerende hulpmiddel vir die behandeling van siektes van die ingewande en urienweg, soos Rotavirus en Shigella, maar het in gewildheid afgeneem na die bekendstelling van goedkoop antibiotika vir verbruikers, ondanks die verminderde kans op allergiese reaksies en aansienlike laer toksisiteit vir normale dermflora.

Opmerklike gevalle

  1. Sien ook:Bekende mense wat gesterf het aan dysenterie – 45 gelys
  • 򑈖 – John I & quotLackland & quot, koning van EngelandJohn Plantagenet, koning van Engeland (1166-1216)] is op 18 Oktober 1216 dood aan dysenterie in Newark Castle.
  • 򑐢 – Koning Henry V Lancaster, koning van Engeland (1387-1422) sterf skielik aan dysenterie in 1422. Hy was vyf en dertig jaar oud.
  • 򑖖 – Sir Francis Drake, vise -admiraal, (1540-1596) sterf aan dysenterie op 27 Januarie 1596 terwyl hy San Juan, Puerto Rico, aanval. Hy is op see begrawe in 'n loodkis, naby Portobelo.
  • 򑘅 – Akbar die Grote, heerser van die Mughal -ryk van Suid -Asië, is aan dysenterie dood. Op 3 Oktober 1605 word hy siek met 'n aanval van disenterie, waaruit hy nooit herstel het nie. Hy is vermoedelik op 27 Oktober 1605 dood, waarna sy lyk begrawe is by 'n mausoleum in Agra, die huidige Indië.
  • 򑙵 – Jacques Marquette died of dysentery on his way north from what is today Chicago, traveling to the mission where he intended to spend the rest of his life.
  • 򑙶 – Nathaniel Bacon died of dysentery after taking control of Virginia following Bacon's Rebellion. He is believed to have died in October, 1676, allowing Virginia's ruling elite to regain control.
  • In the 1700s-1800s, dysentery was a disease causing many deaths. In fact, in some areas in Sweden 90 percent of all deaths were due to dysentery during the worst outbreaks. The pattern of transmission for the three most severe outbreaks in 1773, 1808 and 1857 shows that although the disease spread across almost the entire county, there were some clusters with extremely high mortality. However, the hardest hit parts of the county varied.
  • ङth century – As late as the nineteenth century, the 'bloody flux,' it is estimated, killed more soldiers and sailors than did combat. Typhus and dysentery decimated Napoleon's Grande Armພ in Russia. More than 80,000 Union soldiers died of dysentery during the American Civil War.
  • 򑢖 – Phan Đình Phùng, a Vietnamese revolutionary who led rebel armies against French colonial forces in Vietnam, died of dysentery as the French surrounded his forces on January 21, 1896.
  • During the Mexican War (1846-48), a staggering 88% of deaths were due to infectious disease, most of those overwhelmingly dysentery. For every man killed in battle, seven died of disease.
  • Pioneers traveling the Oregon Trail wouldn’t have faired much better than soldiers fighting in war. Dysentery would have been one of the leading causes of death amongst these pioneers, although it is difficult to determine just how many died from it as medical records were typically not kept.
  • 򑤰 – The French explorer and writer, Michel Vieuchange, died of dysentery in Agadir on 30 November 1930, on his return from the "forbidden city" of Smara. He was nursed by his brother, Doctor Jean Vieuchange, who was unable to save him. The notebooks and photographs, edited by Jean Vieuchange, went on to become bestsellers.
  • 򑥂 – The Selarang Barracks Incident in the summer of 1942 during World War II involved the forced crowding of 17,000 Anglo-Australian prisoners-of-war (POWs) by their Japanese captors in the areas around the barracks square for nearly five days with little water and no sanitation after the Selarang Barracks POWs refused to sign a pledge not to escape. The incident ended with the capitulation of the Australian commanders due to the spreading of dysentery among their men.
  • š four-year epidemic in Sentraal Amerika, starting in 1968, resulted in more than 500,000 cases and more than 20,000 deaths.
  • Since 1991, dysentery epidemics have occurred in eight countries in southern Africa (Angola, Burundi, Malawi, Mozambique, Rwanda, Tanzania, Zaire, and Zambia).
  • Worldwide, approximately 140 million people develop dysentery each year, and about 600,000 die. Most of these deaths occur in developing countries among children under age five.
  • In the United States, only about 25,000 to 30,000 cases occur each year.

Deaths from dysentery during civil war.

  • The disease dysentery was the most common disease during the Civil war.
  • špproximately 57,265 Yankee soldiers died from dysentery and around 130 men from a prison in Georgia died from dysentery also.
  • špproximately 45,000 people in the Union died from dysentery.
  • ॐ,000 people in the confederacy had died from the disease.
  • It was very rare for someone to survive dysentery at that time.

Cure for Dysentery

  • The treatement and cure for dysentery now is to have rehydration therapy. You could also take antibiotics and amoevidal drugs or an antirheumatic drug ridaura.

Bibliografie:


The clinical manifestations of dysentery have been described for centuries, and the prototypic bacterial agent, Shigella dysenteriae, was identified 100 years ago. In the English language there has been remarkably little written about Dr. Kiyoshi Shiga, discoverer of the dysentery bacillus. We submit a brief biography of Dr. Shiga and the circumstances leading to his discovery, which proved the bacterial etiology of nonamebic dysentery.

In 1936, as a senior scientist and honored guest at the tercentenary celebration at Harvard University, Dr. Kiyoshi Shiga began his address as follows: “The discovery of the dysentery bacillus stirred my young heart with hopes of eradicating the disease…Many thousands still suffer from this disease every year, and the light of hope that once burned so brightly has faded as a dream of a summer night. This sacred fire must not burn out [ 1].”

Today, 100 years after Shiga's landmark discovery, shigellosis kills hundreds of thousands a year, primarily children in developing countries [ 2]. The disease occurs endemically worldwide, but certain populations such as refugees, institutionalized persons, and military units under field conditions are especially at risk [ 3–5]. Large-scale epidemics have also occurred [ 6]. Shigella species commonly exhibit broad antibiotic resistance, and a safe, effective vaccine against Shigella remains elusive [ 7–10].

Dr. Shiga ( figure 1) was an internationally recognized authority in microbiology in the early part of this century, but there is little English-language information on his life. He was born the fifth child of Shin and Chiyo Sato on 5 February 1871 in Sendai, in northern Japan. His early years were difficult and mirrored the turbulent times as Japan entered the Industrial Age. From 1600 until the mid-19th century Japan was an isolated, agricultural nation under feudal rule. Western nations, motivated by aggressive military and economic policies, forced Japan to open its ports when Matthew Perry sailed American warships into Tokyo harbor in 1853. The Mejii Restoration (1868–1877), initiated by former feudal lords, created radical changes in the social and political structure of Japan.

Dr. Kiyoshi Shiga, 1871–1957.

Dr. Kiyoshi Shiga, 1871–1957.

Shiga's father, a successful administrator of the samurai class under the old regime, lost his position during the Restoration, an event that forced economic hardship on his family. Young Kiyoshi was raised in his maternal family and later adopted his mother's maiden name, Shiga, as his surname. In 1886 his family moved to Tokyo, where Shiga attended high school and studied mathematics and German, among other subjects. He entered the Tokyo Imperial University School of Medicine in 1892.

During medical school Shiga attended a lecture by Dr. Shibasaburo Kitasato, the most prestigious Japanese scientist of the day and a protégé of Robert Koch. Kitasato had achieved international recognition in 1889 with his successful pure cultivation of Clostridium tetani and his discovery of tetanusantitoxin, with the promise of immunotherapy [ 11]. In 1894 Kitasato had investigated a bubonic plague epidemic in Hong Kong and reported his findings in the Lancet [ 12]. Kitasato's confident and charismatic personality impressed young Shiga. After graduation Shiga entered the Institute for Infectious Diseases, established and directed by Kitasato, as a research assistant.

Shiga was initially assigned to the tuberculosis and diphtheria wards, but in late 1897 Kitasato directed his attention to the microbiological investigation of a sekiri (dysentery) outbreak. In the older medical literature, the term dysentery was somewhat vague and had been used to “signify violent diarrheal disturbances of almost any cause” [ 13]. The meaning of the Japanese word sekiri, derived from Chinese characters that indicate “red diarrhea,” is closer to the contemporary definition, which implies frequent, small bowel movements accompanied by blood and mucus, with tenesmus or pain on defecation [ 14].

Lösch had described intestinal amebiasis in 1875, and although European, Japanese, and American researchers had postulated that the cause of nonamebic dysentery was bacterial, no one had demonstrated an etiologic agent [ 13]. Dysentery epidemics, affecting tens of thousands with high mortality, occurred periodically in Japan during the last decades of the 19th century [ 15]. Shiga described the fear engendered by these seasonal outbreaks as follows: “It [dysentery] has been regarded as the most dreaded disease of children from its fulminating course and high mortality [ 1].” The 1897 sekiri epidemic affected >91,000, with a mortality rate of >20%.

Shiga studied 36 dysentery patients at the Institute for Infectious Diseases. Acutely aware of his mentor's regard for Koch's postulates, Shiga employed simple but exacting methods to identify the organism that had eluded so many previous investigators. He isolated a bacillus from stool that was negative by gram-staining, fermented dextrose, was negative in the indole reaction, and did not form acid from mannitol. Subcultures of the organism caused diarrhea when fed to dogs.

The key to his remarkable discovery, however, was a simple agglutination technique. Shiga demonstrated that the organism repeatedly coalesced when exposed to the serumofconvalescent dysentery patients. He published his findings with a gracious acknowledgment of Dr. Kitasato's guidance [ 16].

Shiga continued to characterize the organism, initially termed simply Bacillus dysenterie [ 15, 17]. In particular, he described the production of toxic factors by the organism. One of these factors, now known as Shiga toxin, was recently reviewed in a historical context [ 18]. In the years immediately following Shiga's discovery of the dysentery bacillus, similar organisms were described by other investigators. Several revisions in nomenclature followed. The genus was first termed Shigella in the 1930 edition of Bergey's Manual of Determinative Bacteriology [ 19].

Vandag Shigella is classified as follows: S. dysenteriae (group A), the original organism described by Shiga S. flexneri (group B) S. boydii (group C) and S. sonnei (group D). They exist as nonmotile, gram-negative rods that do not ferment lactose (except for group D) and fail to produce H2S in triple-sugar-iron agar. Unlike the other species, S. dysenteriae does not ferment mannitol. The genus is well-characterized antigenically, with multiple serovars within each species except S. sonnei [ 20].

In addition to work on the pathogenesis of bacillary dysentery, Shiga focused his efforts on the development of a Shigella vaccine. In his autobiography he describes how he initially prepared a heat-killed whole-cell vaccine and injected himself as the first study subject. The resulting local reaction was severe and required incision and drainage [ 21]. He then developed a serum-based passive immunization and later an oral vaccine, which was administered to thousands of Japanese citizens. These experiments were conducted before the advent of controlled clinical trials, and his observations were published primarily in German- and Japanese-language journals. Shiga later expressed reservations about the efficacy of vaccines for the control of enteric diseases and emphasized the importance of public health practices [ 1].

Shigellosis is the most communicable of the bacterial enteric diseases, and experiments with volunteers have demonstrated that as few as 10–100 organisms can cause symptoms [ 22, 23]. The low inoculum dose and highly contagious nature of shigellosis present a public health challenge. Recent advances have characterized many of the virulence factors of Shigella species [ 24–26]. Insight into the pathogenesis of shigellosis has led to novel approaches in vaccine design, and vaccine development efforts continue worldwide [ 27–33].

In 1900 Shiga married, and he and his wife, Ichiko, had the first of their eight children the next year. He was soon on his way to Germany, where he entered Paul Ehrlich's laboratory as a research assistant at the Institut für Experimental Therapie in Frankfurt. During his time with Ehrlich, Shiga worked on various projects, including early studies of chemotherapy for trypanosomiasis. He returned to Japan to work in Kitasato's laboratory in 1905. By this time Shiga had developed an international reputation, and in 1906 he presented his research on epidemic shigellosis at the first Congress for Asian Tropical Medicine in Manila, the Philippines [ 15].

In 1914 the Japanese government undertook an organizational restructuring of the Institute for Infectious Diseases. Kitasato resigned in protest, and Shiga followed him to establish the Kitasato Institute, an institution that continues today. Shiga was named a division director of the Institute.

Shiga was appointed professor in the medical faculty of Keio University in Tokyo in April 1920. Later that same year, at the request of the Japanese government, Shiga left for Korea, a Japanese colony at the time, to serve as the director of the National Hospital of Seoul. He held an additional post in the Seoul Technical College of Medicine. From May to November 1924 he visited medical schools and lectured in Europe and the United States.

In 1926 Keijo University (Seoul University) was founded, and Shiga was named the Dean of the School of Medicine. He became President of the University in 1929 and served until 1931, when he resigned and returned to Japan to pursue his main interest, research, at the Kitasato Institute. His long-time mentor and colleague, Dr. Kitasato, died that same year. Shiga continued active laboratory investigations, with interests ranging from dysentery to tuberculosis, until 1945.

The war years brought personal tragedy to Shiga. His wife died of stomach cancer in 1944. His oldest son, Naoshi, a university professor in Taipei, was killed at sea while returning home to attend his mother's funeral. Another son, Akira, contracted tuberculosis during the fighting in China and died after the war. Shiga's Tokyo house was destroyed during a bombing attack, and he returned to Sendai to live with his son, Makoto. In retirement Shiga received guests, corresponded with friends overseas, and continued to write. He completed his autobiography as well as a Japanese-language biography of his friend and mentor, Paul Ehrlich.

Near the end of his life Dr. Shiga composed the following calligraphy: “Follow the mentor's spirit, not the mentor's footsteps” ( figure 2). As the protégé and contemporary of giants in the field of microbiology, Shiga could easily have been obscured by their imposing shadows. However, he earned a place in the milestones of microbiology by his creative thinking and contributions to research in the etiology, pathogenesis, and immunization of enteric diseases.


Voorkoming

Shigellosis is an extremely contagious disease good hand washing techniques and proper precautions in food handling will help in avoiding spread of infection. Children in day care centers need to be reminded about hand washing during an outbreak to minimize spread. Shigellosis in schools or day care settings almost always disappears when holiday breaks occur, which sever the chain of transmission.

Traveler's diarrhea (TD)

Shigella accounts for about 10% of diarrhea illness in travelers to Mexico, South America, and the tropics. Most cases of TD are more of a nuisance than a life-threatening disease. However, bloody diarrhea is an indication that Shigella may be responsible.

In some cases though, aside from ruining a well deserved vacation, these infections can interrupt business conference schedules and, in the worst instances, lead to a life-threatening illness. Therefore, researchers have tried to find a safe, yet effective, way of preventing TD. Of course the best prevention is to follow closely the rules outlined by the WHO and other groups regarding eating fresh fruits, vegetables, and other foods.

One safe and effective method of preventing TD is the use of large doses of Pepto Bismol. Tablets are now available which are easier for travel usage must start a few days before departure. Patients should be aware that Bismuth will turn bowel movements black.

Antibiotics have also proven to be highly effective in preventing TD. They can also produce significant side effects, and therefore a physician should be consulted before use. Like Pepto Bismol, antibiotics need to be started before beginning travel.


“You have died of dysentery” – History According to Video Games

Right now millions of people worldwide are reliving the American Revolution through a new historical fiction. This fictionalized revolution, however, is not televised on PBS, nor is it directed by Steven Spielberg or written by Assassin’s Creed III. Developed and published by the French gaming company Ubisoft, Assassin’s Creed III follows the story of Connor Kenway, a half-English and half-Mohawk assassin battling the British and the Knights Templar (don’t worry, I’ll explain later) during the period of the US Revolution. From Connor’s perspective, players are able to interact with famous historical figures such as George Washington and Benjamin Franklin, and explore virtual recreations of colonial cities such as Boston, New York and Philadelphia. The game, released on October 30, has already met with critical acclaim from gaming journalists and it promises to become the most consumed and financially successful historical fiction, in any medium, this year.

The video game is a relatively new medium, but it has a long record of using history to tell stories like the one found in Assassin's Creed. Given the mass popularity of video games and gaming culture, it seems appropriate that we begin to analyze the history portrayed in this medium in the same way we consider a historical novel or period film. Why and how is history used in video games? How has this use of history changed over time? How does the use of history in video games compare to the use of history in other media? Finally, are these uses of history merely a pretense for entertainment or do they offer a real opportunity to learn about the past?

Early examples of history in video games came from titles designed explicitly for classroom use. Probably the best and most famous of these is The Oregon Trail. Developed by a group of teachers and released by the Minnesota Educational Company Consortium (MECC) in 1974, The Oregon Trail positions players as American settlers leading their families from Independence, Missouri to Oregon in 1848. While on the trail, players are required to manage their provisions as well as a number of impromptu crises, including broken wagon wheels, spoiled food, overworked oxen, and the sudden death of caravan members (usually from dysentery).Success is not guaranteed and the player’s expedition will end in failure without careful planning. Despite its rudimentary visuals and gameplay, The Oregon Trail gives players a rather accurate sense of the difficulty of transcontinental travel in the nineteenth century. It also provides players with something they cannot get from a book or film: an understanding of the past introduced through direct interaction. This interaction, however, is limited to the journey on the trail, and leaves the surrounding historical context (e.g. motivations for the journey, relations with Native Americans, etc.) up to the players, or their teacher, to fill in.

Soos The Oregon Trail and its imitators proliferated in classrooms during the 1980s and 90s, commercial games also began to adopt historical settings and topics. Early ventures in this genre included adaptations of historically themed board games, such as Axis and Allies, Diplomasie en Risiko, as well as digital versions of turn-based, tactical military games focused on the campaigns of the Second World War. These games were joined later by a large number of real-time strategy games (RTSs), including The Ancient Art of War, as well as games from the Totale oorlog en Age of Empires reeks. Like the vast majority of historical novels and films, these games focus on high politics and military history. Unlike these media, however, video games often range across long historical time periods and allow players to engage with a wide variety of subjects and events.

A key example of this type of work is the Civilization series, which debuted in 1991. Developed by the legendary Sid Meier, Civilization puts the player in charge of one of the world’s civilizations in 4000 B.C.E., with the objective of establishing and maintaining an empire until they reach either the game’s time limit (the game usually ends in the early 21 st century) or one of several victory conditions (conquer all other civilizations by force, establish a colony on Alpha Centauri, be elected leader of the United Nations, or establish cultural hegemony).Players determine nearly every facet of their civilizations: agriculture, construction, demographics, diplomacy, economic policy, religion, and scientific research. The player’s civilization faces challenges from not only computer controlled competitors, but also from unhappy citizens and random natural disasters.

Die Civilization series, in many respects, reflects a triumphalist, neoliberal conception of world history. Playable civilizations include crude stereotypes of current nation states, with many civilizations being completely out of place at the beginning of the game in 4000 B.C.E. For example, gamers can choose to play as the United States “civilization,” complete with an Abraham Lincoln avatar, dressed in a bearskin toga. Players often find that the game’s victory conditions are easier to achieve if they maintain a civilization that is democratic, culturally liberal, and secular. Play at all difficulty levels rewards aggressive foreign policy and the military conquest of neighboring civilizations is often a simpler path to victory than diplomatic or financial incentives. An aggressive foreign policy, however, can end in disaster if competing nations have nuclear weapons.

These problems aside, the Civilization series has much to recommend it from a historian’s perspective. It is the only history game that offers a global perspective on the past as well as an appreciation of contingency in history. The game does not follow the historical record – a player could successfully lead the Carthaginian Empire past Rome and begin the Industrial Revolution in Africa in the seventeenth century. Moreover, players can use a custom map or other modifications to create counterfactual situations in order to test variables. How different would European history be if the British Isles were connected to the continent? What if societies in the Americas had access to horses before contact with Europe? Civilization encourages players to consider the longue durée of cultural, economic, and ecological structures. And for players who seek a deeper knowledge of the game’s concepts, each edition of Civilization provides a “Civilopedia” with encyclopedia-size synopses of historical events and figures.

Alhoewel die Civilization series remains popular today, the most popular and profitable history video games of recent years come from the first-person shooter (FPS) genre. Beginning with 1992’s Wolfenstein 3D and continuing with the Call of Duty series in the 2000s, FPS games use the history of the Second World War as window dressing for what are essentially action movie simulators. Players take the role of a soldier from one of the Allied powers and shoot their way through levels filled with either German or Japanese enemy soldiers. These games make no effort to contextualize the player’s actions or to consider the moral implications of those actions. Moreover, the Second World War portrayed in these games remains firmly entrenched in the “Good War” narrative: Allied soldiers in these shooters are always heroic and righteous.

Other recent games, including the FPS series BioShock and the strategy series Command and Conquer: Red Alert, use history as the basis for adventures in counterfactuals. Die eerste BioShock places the player in the city of Rapture, a submerged metropolis under the Atlantic Ocean built in the 1940s by a Howard Hughes-esque industrialist who hoped to create a utopian society based on Randian, or Objectivist philosophy (spoiler: it didn’t turn out so well). BioShock: Infinite, scheduled for release next year, is set in the floating city of Columbus in 1912, and will see the player engaging with Progressive Era ideas of American empire, eugenics, and exceptionalism. Command and Conquer: Red Alert begins with Albert Einstein using time travel to murder Adolf Hitler in 1924 in order to prevent the Second World War. Unfortunately, this event creates a parallel timeline in which the Soviet Union embarks on world domination during the 1950s.

Die Assassin's Creed series, which debuted in 2007, also revels in counterfactual fantasies, but attempts to place these stories in realistic historical settings. In Assassin's Creed, players take the role of Desmond Miles, a modern day bartender who is kidnapped by a shadowy multinational corporation called Abstergo Industries. Abstergo forces Desmond to use a virtual reality machine called the Animus, which allows the user to relive the lives of their ancestors using their DNA (hold on, it gets crazier). During the first game of the series, Desmond relives the life of his ancestor Altaïr ibn-La’Ahad, a Syrian assassin who lived during the third Crusade. The second installment of the series finds Desmond reliving the life of Ezio Auditore da Firenze, a fifteenth-century Italian assassin. Eventually, Desmond learns that Abstergo is the modern incarnation of the Knights Templar and that the organization is using Desmond’s ancestral memories to search for the “Pieces of Eden,” objects of immense supernatural power (think the Ark of the Covenant in Raiders of the Lost Ark). Famous historical figures make appearances throughout the series. Assassin’s Creed II, for instance, sees Leonardo Da Vinci, act as an early modern Q to the player’s James Bond, providing the protagonist with an assortment of gadgets, including his famous tank and flying machine models.

Die storie in Assassin's Creed – the Illuminati meets Ancestry.com – has much in common with the conspiratorial history seen in the fiction of Dan Brown and Neal Stephenson. This fantastical story, however, is couched in a largely accurate and detailed historical setting. The first installment of the series, set in Palestine, features period recreations of Acre, Damascus, and Jerusalem. Assassin’s Creed II, set in Italy, provides recreations of Florence, Monteriggioni, Venice, and Rome.

This game also adds historical descriptions to the buildings players encounter (and climb) while playing, including St. Mark’s Basilica, Santa Maria del Fiore, Santa Croce, and the Ponte Vecchio. A direct sequel to Assassin’s Creed II, gebel Assassin’s Creed: Revelations, takes place in Istanbul and provides a similar level of detail. Developer Ubisoft’s effort at recreation also extends to the human characters who populate the game world. Careful attention is paid to clothing, demeanor, and language. In pre-release coverage for the third game, creative director Alexander Hutchinson described the process of research and consulting that went into creating a Native American protagonist. Hutchison boasts of reading Wikipedia entries and watching documentaries, but his company also relies on a multinational group of professional historians and in-house researchers.

Of course, Ubisoft’s recreations are far from perfect and not always completely accurate. Yet their work demonstrates the potential for video games to provide consumers with history that is both interactive and instructive. To be sure, this history continues to focus on blood and guts, but a desire for different stories is emerging. For instance, Xav de Matos of Joystiq.com suggested last month that developers create a game focused on Harriet Tubman and the abolitionist movement . The recent growth in the popularity of video games has forced the industry and traditional gamers to begin to confront some of their biggest demons regarding racism, violence, and, most importantly, sexism . Ubisoft, for its part, published a portable game called Assassin’s Creed III: Liberation , which follows the life of a female African-French Assassin in eighteenth century New Orleans. If this trend continues, there is little doubt that new and different video game histories will emerge, and it will be exciting to see if those narratives lead to better opportunities for learning about the past.

The author would like to thank Dr. John Harney for his comments on an earlier draft of this essay.

You might also like:

A free version of the original Civilization is available here

For ideas on using video games in the classroom, see Jeremiah McCall’s Gaming the Past: Using Video Games to Teach Secondary History (2011)

More by Bob Whitaker on gaming can be found on twitter @whitakeralmanac and his Playstation, Steam, and Xbox gamertag is hookem1883.


Kyk die video: dysenteries (Mei 2022).