Endemic! Week: Introduction

Vibrio cholerae, the bacterium that causes cho...
Vibrio cholerae, the bacterium that causes cholera. (Photo credit: Wikipedia)

I’m very excited to announce our first-ever theme week here at Medical Microfiction!

Endemic! Week: an entire week of microfiction revolving around the word endemic.

The word endemic has two meanings. The first meaning is ecological and refers to a state of being defined by a unique location. It’s sort of a synonym for “native”. Endemic plants and animals are the ones native to an area and not found elsewhere. Pandas are endemic to China. Goth teens are endemic to Hot Topic. Your brain is endemic to your skull.

The second meaning comes from disease pathology. Endemic in this sense refers to diseases that have a low mortality rate, but are widespread in a specific population or region. In parts of the world, endemic diseases and conditions include malaria, rickets, measles, and intestinal worms.

"Pandemic" is also one of my favorite board games!
“Pandemic” is also one of my favorite board games! (Photo credit: Wikipedia)

Endemic diseases are not the same thing as pandemic diseases. Pandemics tend to spread quickly over a very large area and leave a lot of death in their wake.

Sometimes the same disease can be either endemic or pandemic, depending on the conditions. Cholera, a bacterial intestinal disease, is such a disease. In endemic mode, cholera won’t kill you. The bacteria will multiply conservatively, making the host sick enough to pass it on but not sick enough to kill many people. This means you’ll have a village or town where at any given time, someone’s got cholera. It plays musical host, jumping from person to person. Human and disease reach a sort of equilibrium. Everyone’s miserable but no one dies.

In pandemic mode, the bacteria mutate so that they multiply extremely rapidly the moment they reach your intestines. The cholera induces such intense diarrhea that you can’t drink enough water to keep your body hydrated. Untreated, this leads to a very quick death, often within a day of falling ill. The bacteria has chosen an aggressive survival strategy in this case, infecting as many people as possible regardless of whether they’ll survive in the long run.

(I could talk all day about cholera. If I’ve piqued your interest, go read this book right now. It’s about how a cholera outbreak led to new discoveries about disease transmission. It’s amazing. I promise.)

Imagine this, but with intestinal worms.
Imagine this, but with intestinal worms. (Photo credit: Wikipedia)

Compared to pandemics, endemics sound pretty tame. Jerry Bruckheimer’s never going to make an exciting thriller about the CDC’s race to cure an outbreak of head lice or intestinal worms (although the actual CDC is quite concerned with these less flashy health issues). Therefore, I’m stepping up to the plate.

This week, prepare yourselves for exciting tales of things that’ll destroy you — very, very slowly.

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