Wash Your Hands!

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Margaret Bourke‑White, [Nurse Clara Stull prepares typhoid inoculation for flood victims at refugee aid station at Hikes Grade School, Louisville], 1937 (1648.2005)

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W. Eugene Smith, [Nurse‑midwife Maude Callen giving inoculation to little boy], 1951 (993.2005)

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John Vachon, Irwinville Farms, Georgia. Inoculation for typhoid in the clinic, 1938 (2009.59.14)

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Burton A. Beal, [Letter from Burton Beal in Waterford, Virginia, to Albert Beal in Augusta, Maine], December 2, 1866 (2010.15.8)

In a letter to his father dated December 2, 1866, Burton A. Beal writes about his lengthy sickness and slow recovery from typhoid fever in the small town of Waterford, Virginia, where an outbreak had already claimed more than a dozen lives. He laments the loss of a lucrative job and complains bitterly of a medical bill for $79.50, by which he implies that he is being gouged.

The disease can leave one bedridden anywhere from three to six weeks depending on availability and method of treatment. Early symptoms include fever and abdominal pain. A high fever (typically over 103) and severe and “green” diarrhea occur as the disease gets worse. Some people develop a rash called “rose spots,” which are small red spots on the abdomen and chest. Other symptoms that occur include: abdominal tenderness; agitation; bloody stools; chills; confusion; difficulty paying attention; delirium; fluctuating mood; hallucinations; nosebleeds; severe fatigue; slow, sluggish, lethargic feeling; weakness.

Typhoid fever had a mortality rate of 31.3 per 100,000 up and into the beginning of the 1900s was nearly annihilated by the mid-twentieth century. Increase in medical knowledge, improvements in environmental sanitation, and the implementation of public health programs all contributed to this dramatic shift. Although vaccines against the disease are available and recommended for visitors to developing countries, the most effective prevention method in North America is proper hygiene and sanitation. In other words, wash your hands.

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