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Some of my readers have asked, "what did gold rush miners die from?" There were many dangers that they faced, but the biggest threat to gold rush miners didn't come from outside elements - it was from a preventable disease called scurvy.

Overland parties were especially susceptible to the disease because they packed flour, meat and other staples which they felt would last but the only food they brought which contained vitamin C was in the form of dried fruit such as apples which were then further cooked - depleting whatever vitamin C was left.

The symptoms of scurvy started to show themselves after the miners had been completely deprived of ascorbic acid for 40 days. Fatigue and depression set in and after several more weeks, gums got sore and began to bleed. Night blindness and vision trouble occurred. Cuts and wounds would scab over but never heal. In a few more weeks, scorbutics would get debilitating pain and swelling in their legs and feet and eventually become too lame to move. The skin would blacken and death was imminent.

It is not known how many gold rush miners suffered and died from scurvy, because the deaths were usually attributed to exposure to the elements or starvation, but it was probably fairly significant. It is believed that several thousand gold rush miners died from scurvy in the California gold rush.

At Fort Laramie, Wyoming, a scurvy outbreak was documented in 1859. Although the post surgeon attributed this problem to "want of cleanliness" and "defective cooking" he solved the problem by concocting a drink from cactus, which he learned from the local Indians.

Harry Jones and his fellow miners in the Cariboo were fortunate to encounter " Dr. Spruce " who helped to cure them of scurvy.

The story of the Rennie brothers, a group of Overlanders who travelled across the prairies to the Cariboo goldfields in 1862, is a possible example of scurvy. After travelling overland from St. Paul with stops at Red River, Edmonton, Jasper, and Tête Jaune Cache, the group was in a very weakened state. William Rennie and his brother Gilbert left the others near the grand canyon of the Fraser River with the intention of getting help at Fort George. William and Gilbert had to be carried in and out of canoes by helpful natives on their way there. Meanwhile, the rest of the party which had stayed behind languished and suffered - too lame to carry on with the others. They resorted to cannabilism as a last means of survival.

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Some of my readers have asked, "what did gold rush miners die from?" There were many dangers that they faced, but the biggest threat to gold rush miners didn't come from outside elements - it was from a preventable disease called scurvy.

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Welcome back to Caterpickles!

As we learned last week, miners during the Klondike Gold Rush valued the scurvy-fighting power of the humble potato so highly they were willing to pay $25 per bushel for them. After politely listening to my explanation of why miners were willing to part with 1.21 oz of gold dust for a mere 50 lbs of potatoes, Daddyo calmly pointed out that the cure for scurvy would have been known for almost a century by that time. "The first medical trial ever was on scurvy back in the mid-1700s. Wouldn't the folks in the California Gold Rush of 1848-55 also have known how to prevent it?"
Why didn't the miners during the California Gold Rush realize eating potatoes could prevent scurvy?
Scurvy decimated the mining camps during the California Gold Rush. By some estimates, as many as 10,000 miners died of a disease for which the cure should have been well-known. After all, the British Navy had been giving their sailors lemon juice to prevent scurvy since the mid-1700s.

Oddly, relatively few people connected the lack of fresh fruits and vegetables in their diet with the scurvy outbreaks. In a 1857 letter to the editor which he wrote to a New Orleans journal - the only medical article written about scurvy at the time - Dr. Thomas Logan, who had gone to seek his fortune in the gold fields, speculated that miners got scurvy from eating spoiled food.
So what happened?
Although scurvy itself has remained a fairly constant and severe problem throughout the centuries, the knowledge of how to cure it somehow didn't stick. Turns out that the mid-1800s when the California Gold Rush took place was one of those times when the cure for scurvy was in dispute.

Scottish physician James Lind proved back in 1747 that citrus fruits effectively cured scurvy, but his findings had come into question by the mid-19th century.
While Lind's experiment showed that fresh citrus prevented and even cured scurvy, no one really understood why.
There's a great explanation of the history of scurvy treatment and why Lind's citrus cure came under such suspicion at the blog Idle Words. I encourage you to read it.

But for our purposes here, it's enough to know that no one even knew about Vitamin C yet, much less that the lack of it was what actually caused scurvy. All people really knew was that when sailors in the British Navy were served lemon juice in their grog they rarely got scurvy. For many years, that simple approach worked beautifully. But when the British Navy swapped in lime juice for lemon juice in 1860 on the grounds that all citrus fruits were more or less the same, the treatment started to fail.

This is where the lack of knowledge comes in. Because Vitamin C hadn't been discovered yet ( and wouldn't be until the 1930s), there was no way to know that Vitamin C occurs at different rates in different foods. Fresh lemon juice contains nearly four times the scurvy-fighting Vitamin C of fresh lime juice, for example.

Nor was there any way to know that Vitamin C breaks down quickly in foods that are cooked, preserved, or stored in containers exposed to light. As a result, the preserved lime juice sold as a countermeasure for scurvy often had no effect at all.

Finally, because the human body can store Vitamin C for up to six months at a time, it wasn't always clear that the change in diet from a more varied fruit and vegetable rich cuisine to the extremely limited beans, bacon, coffee, and flapjacks favored by miners was the reason miners eventually ended up developing scurvy.

If you had lived in a time when a tried and true measure for countering scurvy suddenly seemed to be failing for no discernible reason, would you have spent your hard-earned gold dust on it?
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About Shala Howell

I spent two decades helping companies like Bell Labs, Juniper Networks, and a genetic testing company that was later acquired by CVS translate some of the world's most complicated concepts into actionable, understandable English. Now I'm working on a much harder problem -- fostering children's curiosity and engagement in the scientific, artistic, and linguistic world that surrounds them. The first book in my Caterpickles Parenting Series, What's That, Mom?, focuses on how to use public art to nurture children's curiosity in the world around them. My next book, Did Dinosaurs Have Belly Buttons?, is currently planned for release in 2018. In the meantime, you can find me blogging about life with a very curious Ten-Year-Old at Caterpickles.com, chatting about books and the writing life at BostonWriters.blog, and tweeting about books, writing, science, & things that make me smile at @shalahowell.

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"Why didn't miners during the California Gold Rush realize eating potatoes could prevent scurvy?"

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Welcome back to Caterpickles! As we learned last week, miners during the Klondike Gold Rush valued the scurvy-fighting power of the humble potato so highly they were willing to pay $25 per bushel for them. After politely listening to my explanation of why miners were willing to part with 1.21 oz of gold dust for...

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The yellow fever virus is found in tropical and subtropical areas of Africa and South America. The virus is spread to people by the bite of an infected mosquito. Yellow fever is a very rare cause of illness in U.S. travelers. Illness ranges from a fever with aches and pains to severe liver disease with bleeding and yellowing skin (jaundice). Yellow fever infection is diagnosed based on laboratory testing, a person's symptoms, and travel history. There is no medicine to treat or cure infection. To prevent getting sick from yellow fever, use insect repellent, wear long-sleeved shirts and long pants, and get vaccinated.

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The yellow fever virus is found in tropical and subtropical areas of Africa and South America. The virus is spread to people by the bite of an infected mosquito. Yellow fever is a very rare cause of illness in U.S. travelers.

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Cholera - Vibrio cholerae infection | Cholera | CDC

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Cholera, caused by the bacteria Vibrio cholerae, is rare in the United States and other industrialized nations. However, globally, cholera cases have increased steadily since 2005 and the disease still occurs in many places including Africa, Southeast Asia, and Haiti.

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WHO fact sheet about yellow fever, an acute viral haemorrhagic disease transmitted by infected mosquitoes. It provides key facts and information on signs and symptoms, populations at risk, transmission, treatment, prevention, WHO response.

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Health. Immigrants who entered the Trans-Appalachian region in the early nineteenth century hoped to leave behind the disease and contamination that seemed so characteristic of Eastern cities. They expected to find in the West an environment of clean air and water, with limitless opportunities for health and material advancement. However, the process of settling the West changed the environment itself. Migrants brought more than their culture; they also transported bacteria and viruses, and with those came epidemics that wrought turmoil in both white and Native American communities. The fact that most people lived far from medical care in primitive, makeshift conditions added to the dangers of disease. When students think of the American West, they often think of gunfights and ambushes even though more persons died from illness than from violence. Thousands of anonymous, unmarked graves along the great trails and in small, deserted towns remain today as a testimony to the unhealthy nature of life in the era of westward expansion.

Indian Depopulation. Disease took its greatest toll on Native Americans. As contact with whites grew more frequent, Indians became exposed to germs and pathogens for which they had no immunity, and as a result they suffered sickness and mortality rates much higher than whites. Scholars estimate that the American Indian population (within contemporary U.S. boundaries) declined from about 600,000 in 1800 to a mere 250,000 by 1900. Besides leaving tribes numerically ill prepared to resist white encroachment, imported diseases struck hardest at elders who filled important leadership roles in Indian societies. Native Americans increasingly blamed these losses on white intrusion while many whites believed that Indians were a dying race destined for extinction. Thus disease exacerbated tensions between whites and natives and made peaceful co-existence far more difficult.

Smallpox. No other disease ravaged Indian peoples more than the dreaded smallpox. The first major pandemic in the nineteenth-century West occurred in 1801-1802 among tribes in the Central and Northwestern regions of the continent. This epidemic devastated people along the Missouri River with particular ferocity. Between 1836 and 1840 another epidemic swept the Northern plains, killing many, including thousands of Blackfeet, Pawnees, and Mandans. The artist George Catlin described a tragic scene among the Mandans in 1837: Chief Four Bears, who always had advocated peace with outside traders, witnessed the deaths of his family and tribal members to smallpox. Surviving the disease himself, Four Bears denounced the White Dogs who brought disease to his people and rather than witness their further destruction, starved himself to death over a period of nine days. Smallpox continued its widespread devastation until the late nineteenth century though not with the same intensity as before 1840. Government officials from both the United States and Mexico attempted to vaccinate certain Indian groups, yet such actions had little effect because of sporadic implementation and many Indians' suspicion that vaccination was another white plan to kill them.

Cholera. Medical science had no vaccination for the other great scourge of the nineteenth century: cholera. Merchants and sailors transported the disease, believed to have emanated from India, to the United States in 1832, where the poor sanitary facilities of Eastern cities allowed it to thrive. During the 1849 California Gold Rush, travelers carried the bacterium along the Santa Fe Trail and other overland routes. Migrants' notoriously filthy hygienic habits caused them to eat spoiled meat and to drink and bathe in waste water. These conditions proved ideal for the spread of cholera. Yet unlike the contagious smallpox virus, cholera's danger lay less in its actual spread than in how it struck at undernourished populations. Prospective gold seekers often suffered from overwork and poor diet, leaving their bodies susceptible to cholera infection. Nomadic Indian tribes suffered the same conditions; as many as one-half of the Pawnees and two-thirds of the Southern Cheyennes died of cholera between 1849 and 1852. Reports among the Comanches state that survivors lacked the strength to bury their hundreds of dead while Arapaho legends tell of several people who committed suicide rather than face the dreaded sickness. Medical practitioners could do little for cholera patients other than administer tinctures such as laudanum, which relieved the horrifying abdominal cramps suffered by the afflicted.

Cholera in the West

The sudden, explosive nature of cholera epidemics horrified white physicians and native healers alike in their respective attempts to combat the disease. During the 1849-1852 epidemics a frontier doctor named Andrew Still commented on local treatments at a Shawnee Indian mission in Kansas:

The Indian's treatment for cholera was not much more ridiculous than are some of the treatments of some of the so-called doctors of medicine. They dug two holes in the ground, about twenty inches apart. The patient lay stretched over the two,-vomit in one hole and purge in the other, and died stretched over the two, thus prepared, with a blanket thrown over him. Here I witnessed cramps which go with cholera dislocate hips and turn legs out from the body. I sometimes had to force the hips back to get the corpse in the coffin.

In the 1880s doctors discovered the microscopic Vibrio cholerae bacillus, which causes the disease. With subsequent emphases on sanitation and quarantine, medical practitioners managed to lessen cholera's destructive power.

Source: A.T. Still, Autobiography of Andrew T. Still, with a History of the Discovery and Development of the Science of Osteopathy (Kirks-ville, Missouri: The author, 1897), p. 61.

Other Diseases. Westerners contended with many other ailments as well. Malaria, tuberculosis, measles, scarlet fever, mumps, influenza, and whooping cough were common. If settlers had the luck of living in the vicinity of a military base, they could seek help from the post surgeon. Military doctors frequently prescribed mercury and calomel (a laxative) in the hope of purging infectious matter. Yet since trained physicians rarely traveled to remote areas (and since many of these diseases were untreatable at the time), pioneers learned to fashion home remedies. In mining camps or wagon crews any person with a meager knowledge of animal birthing or bone setting could be called on to render medical advice. Many Western diseases conferred long-term immunity to survivors, an advantage that Native Americans did not share. The transfer of dangerous organisms from one people to another became a decidedly one-way process that worked against Indians. Venereal disease also appeared common. Miners, fur trappers, and traders engaged frequently in sexual relations with natives, increasing the possibility of both sides becoming infected with syphilis and gonorrhea. Nearly every man on Meriwether Lewis and William Clark 's famous expedition received treatment for syphilis, which at the time consisted of a heavy dose of mercury.

Ramon Powers and James N. Leiker, "Cholera among the Plains Indians: Perceptions, Causes, Consequences," Western Historical Quarterly, 29 (Autumn 1998): 317-340;

Powers and Gene Younger, "Cholera on the Overland Trails, 1832-1869," Kansas Historical Quarterly, 5 (Spring 1973): 32-49;

Russell Thornton, American Indian Holocaust and Survival: A Population History Since 1492 (Norman: University of Oklahoma Press, 1987).

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Health. Immigrants who entered the Trans-Appalachian region in the early nineteenth century hoped to leave behind the disease and contamination that seemed so characteristic of Eastern cities. They expected to find in the West an environment of clean air and water, with limitless opportunities for health and material advancement.

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Scurvy is the name for a vitamin C deficiency. It can lead to anemia, debility, exhaustion, spontaneous bleeding, pain in the limbs, and especially the legs, swelling in some parts of the body, and sometimes ulceration of the gums and loss of teeth.

Scurvy has been known since ancient Greek and Egyptian times. It is often associated with sailors in the 15th to 18th centuries, when long sea voyages made it hard to get a steady supply of fresh produce. Many died from the effects.

It also occurred during the Irish potato famine in 1845 and the American Civil War. The most recent documented outbreak was in Afghanistan in 2002, following war and a drought.

Modern cases of scurvy are rare, especially in places where enriched breads and cereals are available, but it can still affect people who do not consume enough vitamin C.

Fast facts about scurvy:

Here are some key points about scurvy. More detail is in the main article.

Symptoms of scurvy result from severe vitamin C deficiency.

They include bleeding sores, tooth loss, anemia, and a reduced rate of healing for injuries.

It can be fatal if left untreated.

Scurvy is treatable with oral or intravenous vitamin C supplements.

What is scurvy?

Scurvy happens when there is a lack of vitamin C, or ascorbic acid. The deficiency leads to symptoms of weakness, anemia, gum disease, and skin problems.

This is because vitamin C is needed for making collagen, an important component in connective tissues. Connective tissues are essential for structure and support in the body, including the structure of blood vessels.

A lack of vitamin C will also affect the immune system, absorption of iron, metabolism of cholesterol and other functions.

Symptoms

One of the more notable symptoms of scurvy is the loss of and damage to teeth

Vitamin C is a necessary nutrient that helps the body absorb iron and produce collagen.

If the body does not produce enough collagen, tissues will start to break down.

It is also needed for synthesizing dopamine, norepinephrine, epinephrine, and carnitine, needed for energy production.

Symptoms of vitamin C deficiency can start to appear after 8 to 12 weeks. Early signs include a loss of appetite, weight loss, fatigue, irritability, and lethargy.

Within 1 to 3 months, there may be signs of:

anemia

myalgia, or pain, including bone pain

swelling, or edema

petechiae, or small red spots resulting from bleeding under the skin

corkscrew hairs

gum disease and loss of teeth

poor wound healing

shortness of breath

mood changes, and depression

In time, the person will show signs of generalized edema, severe jaundice, destruction of red blood cells, known as hemolysis, sudden and spontaneous bleeding, neuropathy, fever, and convulsions. It can be fatal.

Infants with scurvy will become anxious and irritable. They may experience pain that causes them to assume a frog-leg posture for comfort.

There may also be subperiosteal hemorrhage, a type of bleeding that occurs at the ends of the long bones.

Animal studies have shown that vitamin C deficiency in a woman during pregnancy can lead to problems with fetal brain development.

Causes

The main cause is an insufficient intake of vitamin C, or ascorbic acid.

Risk factors

Not getting enough vitamin C is a cause of scurvy. To prevent this, get a healthy amount of vitamin C from sources such as oranges and fresh fruit.

Humans cannot synthesize vitamin C. It needs to come from external sources, especially fruits and vegetables, or fortified foods.

A deficiency may result from:

a poor diet lacking in fresh fruits and vegetables, possibly due to low income or famine

illnesses such as anorexia and other mental health issues

restrictive diets, due to allergies, difficulty orally ingesting foods, or other reasons

older age

excessive consumption of alcohol or use of illegal drugs

Late or unsuccessful weaning of infants can also lead to scurvy.

Conditions, treatments, or habits that reduce the body's ability to absorb nutrients, such as Crohn's disease, ulcerative colitis, chemotherapy, and smoking, increase the risk.

Treatment

Treatment involves administering vitamin C supplements by mouth or by injection.

The recommended dosage is:

1 to 2 grams (g) per day for 2 to 3 days

500 milligrams (mg) for the next 7 days

100 mg for 1 to 3 months

Within 24 hours, patients can expect to see an improvement in fatigue, lethargy, pain, anorexia, and confusion. Bruising, bleeding, and weakness start to resolve within 1 to 2 weeks.

After 3 months, a complete recovery is possible. Long-term effects are unlikely, except in the case of severe dental damage.

Diagnosis

A physician will conduct a physical exam, and request lab tests to assess vitamin C levels in the blood.

Imaging tests can reveal internal damage resulting from scurvy.

Prevention

Scurvy can be prevented by consuming enough vitamin C, preferably in the diet, but sometimes as a supplement.

The United States (U.S.) Office of Dietary Supplements (ODS) advise the following intake of vitamin C:

Up to 6 months: 40 mg, as normally supplied though breastfeeding

7 to 12 months: 50 mg

1 to 3 years: 15 mg

4 to 8 years: 25 mg

9 to 13 years: 45 mg

14 to 18 years: 75 mg for men and 65 mg for women

19 years and above: 90 mg for men, 75 mg and women

During pregnancy, women should consume 85 mg of vitamin C, rising to 120 mg while breastfeeding.

Smokers need 35 mg more than nonsmokers every day.

Food sources

Foods that contain vitamin C include:

fruits, such as oranges, lemons, strawberries, blackberries, guava, kiwi fruit, and papaya

vegetables, especially tomatoes, carrots, bell peppers, broccoli, potatoes, cabbage, and spinach

Other good sources are paprika, liver, and oysters

One medium orange contains 70 mg of vitamin C, and a green bell pepper contains 60 mg.

Ascorbic acid can be destroyed by heat and during storage, so fresh, raw fruit and vegetables offer the best supply.

Vitamin C supplements are also available to purchase in health food stores or online.

We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link(s) above.

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University of Illinois-Chicago, School of Medicine

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Scurvy: Symptoms, causes, treatment, and prevention

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Scurvy is the name for a vitamin C deficiency. It can lead to anemia, debility, exhaustion, spontaneous bleeding, pain in the limbs, and especially the legs, swelling in some parts of the body, and sometimes ulceration of the gums and loss of teeth. Scurvy has been known since ancient Greek and Egyptian times.

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Cholera is a bacterial disease usually spread through contaminated water. Cholera causes severe diarrhea and dehydration. Left untreated, cholera can be fatal within hours, even in previously healthy people.

Modern sewage and water treatment have virtually eliminated cholera in industrialized countries. But cholera still exists in Africa, Southeast Asia and Haiti. The risk of a cholera epidemic is highest when poverty, war or natural disasters force people to live in crowded conditions without adequate sanitation.

Cholera is easily treated. Death from severe dehydration can be prevented with a simple and inexpensive rehydration solution.

Most people exposed to the cholera bacterium (Vibrio cholerae) don't become ill and don't know they've been infected. But because they shed cholera bacteria in their stool for seven to 14 days, they can still infect others through contaminated water.

Most cases of cholera that cause symptoms cause mild or moderate diarrhea that's often hard to tell apart from diarrhea caused by other problems. Others develop more-serious signs and symptoms of cholera, usually within a few days of infection.

Symptoms of cholera infection can include:

Diarrhea. Cholera-related diarrhea comes on suddenly and can quickly cause dangerous fluid loss - as much as a quart (about 1 liter) an hour. Diarrhea due to cholera often has a pale, milky appearance that resembles water in which rice has been rinsed.

Nausea and vomiting. Vomiting occurs especially in the early stages of cholera and can last for hours.

Dehydration. Dehydration can develop within hours after cholera symptoms start and range from mild to severe. A loss of 10% or more of body weight indicates severe dehydration.

Signs and symptoms of cholera dehydration include irritability, fatigue, sunken eyes, a dry mouth, extreme thirst, dry and shriveled skin that's slow to bounce back when pinched into a fold, little or no urinating, low blood pressure, and an irregular heartbeat.

Dehydration can lead to a rapid loss of minerals in your blood that maintain the balance of fluids in your body. This is called an electrolyte imbalance.

Electrolyte imbalance

An electrolyte imbalance can lead to serious signs and symptoms such as:

Muscle cramps. These result from the rapid loss of salts such as sodium, chloride and potassium.

Shock. This is one of the most serious complications of dehydration. It occurs when low blood volume causes a drop in blood pressure and a drop in the amount of oxygen in your body. If untreated, severe hypovolemic shock can cause death in minutes.

The risk of cholera is slight in industrialized nations. Even in areas where it exists you're not likely to become infected if you follow food safety recommendations. Still, cases of cholera occur throughout the world. If you develop severe diarrhea after visiting an area with active cholera, see your doctor.

If you have diarrhea, especially severe diarrhea, and think you might have been exposed to cholera, seek treatment right away. Severe dehydration is a medical emergency that requires immediate care.

A bacterium called Vibrio cholerae causes cholera infection. The deadly effects of the disease are the result of a toxin the bacteria produces in the small intestine. The toxin causes the body to secrete enormous amounts of water, leading to diarrhea and a rapid loss of fluids and salts (electrolytes).

Cholera bacteria might not cause illness in all people who are exposed to them, but they still pass the bacteria in their stool, which can contaminate food and water supplies.

Contaminated water supplies are the main source of cholera infection. The bacterium can be found in:

Surface or well water. Contaminated public wells are frequent sources of large-scale cholera outbreaks. People living in crowded conditions without adequate sanitation are especially at risk.

Seafood. Eating raw or undercooked seafood, especially shellfish, that comes from certain places can expose you to cholera bacteria. Most recent cases of cholera in the United States have been traced to seafood from the Gulf of Mexico.

Raw fruits and vegetables. Raw, unpeeled fruits and vegetables are a frequent source of cholera infection in areas where there's cholera. In developing countries, uncomposted manure fertilizers or irrigation water containing raw sewage can contaminate produce in the field.

Grains. In regions where cholera is widespread, grains such as rice and millet that are contaminated after cooking and kept at room temperature for several hours can grow cholera bacteria.

Everyone is susceptible to cholera, with the exception of infants who get immunity from nursing mothers who have previously had cholera. Still, certain factors can make you more vulnerable to the disease or more likely to have severe signs and symptoms.

Risk factors for cholera include:

Poor sanitary conditions. Cholera is more likely to flourish in situations where a sanitary environment - including a safe water supply - is difficult to maintain. Such conditions are common to refugee camps, impoverished countries, and areas afflicted by famine, war or natural disasters.

Reduced or nonexistent stomach acid. Cholera bacteria can't survive in an acidic environment, and ordinary stomach acid often serves as a defense against infection. But people with low levels of stomach acid - such as children, older adults, and people who take antacids, H-2 blockers or proton pump inhibitors - lack this protection, so they're at greater risk of cholera.

Household exposure. You're at increased risk of cholera if you live with someone who has the disease.

Type O blood. For reasons that aren't entirely clear, people with type O blood are twice as likely to develop cholera compared with people with other blood types.

Raw or undercooked shellfish. Although industrialized nations no longer have large-scale cholera outbreaks, eating shellfish from waters known to harbor the bacteria greatly increases your risk.

Cholera can quickly become fatal. In the most severe cases, the rapid loss of large amounts of fluids and electrolytes can lead to death within hours. In less extreme situations, people who don't receive treatment can die of dehydration and shock hours to days after cholera symptoms first appear.

Although shock and severe dehydration are the worst complications of cholera, other problems can occur, such as:

Low blood sugar (hypoglycemia). Dangerously low levels of blood sugar (glucose) - the body's main energy source - can occur when people become too ill to eat. Children are at greatest risk of this complication, which can cause seizures, unconsciousness and even death.

Low potassium levels. People with cholera lose large quantities of minerals, including potassium, in their stools. Very low potassium levels interfere with heart and nerve function and are life-threatening.

Kidney failure. When the kidneys lose their filtering ability, excess amounts of fluids, some electrolytes and wastes build up in the body - a potentially life-threatening condition. In people with cholera, kidney failure often accompanies shock.

Cholera is rare in the United States with the few cases related to travel outside the U.S. or to contaminated and improperly cooked seafood from the Gulf Coast waters.

If you're traveling to areas known to have cholera, your risk of contracting the disease is extremely low if you follow these precautions:

Wash your hands with soap and water frequently, especially after using the toilet and before handling food. Rub soapy, wet hands together for at least 15 seconds before rinsing. If soap and water aren't available, use an alcohol-based hand sanitizer.

Drink only safe water, including bottled water or water you've boiled or disinfected yourself. Use bottled water even to brush your teeth.

Hot beverages are generally safe, as are canned or bottled drinks, but wipe the outside before you open them. Don't add ice to your drinks unless you made it yourself using safe water.

Eat food that's completely cooked and hot and avoid street vendor food, if possible. If you do buy a meal from a street vendor, make sure it's cooked in your presence and served hot.

Avoid sushi, as well as raw or improperly cooked fish and seafood of any kind.

Stick to fruits and vegetables that you can peel yourself, such as bananas, oranges and avocados. Stay away from salads and fruits that can't be peeled, such as grapes and berries.

Cholera vaccine

People traveling from the United States to areas affected by cholera can get a cholera vaccine called Vaxchora. It's suggested for people between ages 2 and 64 who plan to travel where cholera is being spread or regularly spreads. It is a liquid dose taken by mouth at least 10 days before travel.

Several other countries offer oral vaccines as well. Contact your doctor or local office of public health for more information about these vaccines. Even with the vaccine, it's important to take the above precautions to prevent cholera.

1. Kliegman RM, et al. Cholera. In: Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Dec. 12, 2019.

2. Ferri FF. Cholera. In: Ferri's Clinical Advisor 2020. Elsevier; 2020. https://www.clinicalkey.com. Accessed Dec. 12, 2019.

3. Cholera. Centers for Disease Control and Prevention. http://www.cdc.gov/cholera/index.html. Accessed Dec. 12, 2019.

4. Cholera. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/cholera. Accessed Dec. 12, 2019.

5. LaRocque R, et al. Cholera: Clinical features, diagnosis, treatment, and prevention. https://www.uptodate.com/contents/search. Accessed Dec. 12, 2019.

6. WHO position paper on oral rehydration salts to reduce mortality from cholera. World Health Organization. https://www.who.int/cholera/technical/en/. Accessed Dec. 12, 2019.

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Cholera-Cholera - Symptoms & causes - Mayo Clinic

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Cholera is a treatable - yet potentially fatal - bacterial disease that causes diarrhea and dehydration. Learn how to lower your risk.

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With 270+ travel clinics nationwide, Passport Health is your local leading provider of travel vaccinations and medications. Prepare your health for travel, visit us before you go.

According to the CDC, yellow fever is a mosquito-borne viral disease present in Africa and South America. The infection can range from mild to severe. Vaccination is the best protection against this virus.

Mild symptoms of yellow fever include: fever, nausea, vomiting, headache, abdominal and muscle pains. More severe symptoms include hepatitis and hemorrhagic fever.

While yellow fever is not present throughout the globe, yellow fever vaccination is important because of the virus's high mortality rate.

Some countries like Ghana and Brazil require all or some travelers receive the immunization to enter the country.

In addition to receiving a yellow fever vaccine, travelers should be sure to use appropriate mosquito repellents or netting. These are also available through Passport Health.

What Is the Yellow Fever Vaccine?

The yellow fever vaccine provides protection against the virus for travelers and those living in areas where the disease is present. The vaccine is only available in an injectable form.

Because the yellow fever vaccine is very safe and the disease risk is high, the CDC recommends this vaccine for adults and children over 9 months who will be traveling to high-risk areas.

Some countries require proof of yellow fever immunization for entry. Because of this, all individuals who receive a yellow fever vaccination at Passport Health also receive an International Certificate of Vaccination (or 'yellow card') to certify they have been immunized. This card is what will be presented at an international entry point in most cases.

Where Can I Get The Yellow Fever Vaccine?

Only registered Yellow Fever Vaccination Centers like Passport Health can give the yellow fever vaccine and provide the International Certificate of Vaccination ("yellow card") to travelers and other individuals. After receiving the vaccine at Passport Health you will receive an International Certificate of Vaccination (ICV) completed, signed and validated with the official stamp. Find a Passport Health location near you to get vaccinated against yellow fever.

How To Prevent Yellow Fever

The best way to prevent yellow fever is through vaccination. But, you should take extra precautions if you are in an area with the virus. The CDC recommends travelers do the following to prevent mosquito bites in these regions:

Use Insect Repellent- Be sure to use an EPA-registered insect repellent. These include repellents containing DEET, picaridin, IR3535 or oil of lemon eucalyptus.

Wear Proper Clothing- When possible, wear long-sleeves, long pants and socks when engaging in outdoor activities. Consider using a spray-on clothing repellent like permethrin for extra protection.

Be Aware of Peak Hours- Mosquitoes bite the most at dusk and dawn. Be sure to take extra precautions during this time.

Schedule a yellow fever vaccination today at a local Passport Health clinic by calling or book online now.

Where does Yellow Fever occur?

Yellow fever is common in sub-Saharan Africa (where it is endemic), countries in South America and a few other parts of the world.

Many countries that do not require yellow fever vaccination for entry, do require proof of the yellow fever vaccine if coming from an infected region. The vaccine is recommended for travel outside urban areas especially in yellow fever endemic zones.

Fatal cases of yellow fever have occurred in unvaccinated tourists visiting areas within the yellow fever endemic zone. Some countries require a traveler, even if only in transit, to have a valid international certificate of yellow fever vaccination if he or she has been in a country either known or thought to harbor yellow fever.

Countries with risk of Yellow Fever Transmission

¹ Countries/areas where "a risk of yellow fever transmission is present," as defined by the World Health Organization, are countries or areas where "yellow fever has been reported currently or in the past, plus vectors and animal reservoirs currently exist."

² These countries are not holoendemic (i.e., only a portion of the country has risk of yellow fever transmission). Please see above map for details.

¹ Country requirements for yellow fever vaccination are subject to change at any time; therefore, CDC encourages travelers to check with the destination country's embassy or consulate before departure.

Will I Need A Yellow Fever Booster Shot?

Recent studies show one dose of yellow fever vaccine may be effective for a patient's entire life. Previous evidence recommended a booster every 10 years. However, many countries still require evidence of a yellow fever vaccination within the last five to ten years in order to be allowed entry. This may mean you will need to get a yellow fever booster shot. Be sure to check with your Passport Health travel specialist regarding whether you need a yellow fever booster.

So, if you are asking yourself, " What travel shots and vaccinations do I need?" or " Where do I get the yellow fever Vaccine?" schedule an appointment with your local Passport Health travel medicine clinic.

Customer Reviews

Passport Health - Yellow Fever Vaccine

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Yellow Fever Vaccine | Passport Health Travel Clinics

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Yellow fever is a mosquito-borne virus found in many regions. Many countries like Brazil, South Africa or India may require proof of vaccination to enter the country. Be sure to consult with a travel health specialist to learn if you need the vaccine for your specific trip. Tap or click to learn more.

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Yal git da cholera from drinkin dirty water.

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In da Haiti, Southeast Asia, and Africa, yal gittin da cholera.