“You have died of dysentery,” and what the Oregon Trail video game still teaches us about health

Tech has come a long way since Oregon Trail. Can the same be said about today’s sanitation challenges?

If you grew up with Apple IIs in the classroom in the 1990s, few tech events stir up nostalgia more than the computer game Oregon Trail.

Go on and have a field day playing Oregon Trail online at the Internet Archive. Because in doing so, you can learn a few still-valuable health lessons.

Did you know of the diseases that plagued the pioneers — cholera, dysentery, and typhoid fever, among others — at least the first three are caused by a lack of proper sanitation and are still relevant today?

The Public Health LabLog has a great post from its archives about the diseases and their effects, but here are the highlights:


Cholera is a diarrheal illness caused by a toxic bacteria, usually transmitted in food or water contaminated with infected feces. A cholera outbreak hit Cleveland in 1832.


Dysentery is similar to cholera in its symptoms and transmission.

Typhoid fever

Contracted through infected food and drink, typhoid causes those infected to shed the bacteria in their stool and urine for days and weeks after the infection. Our archive uncovered a graph of typhoid fever cases near Sandusky, Ohio in the early 1900s with a huge spike in 1908.

Wastewater treatment and proper sanitation have made these diseases rare in the developed world but they have not been eradicated by any means.

Cholera is still considered a global pandemic. Dysentery in many strains is resistant to antibiotics. Typhoid fever still affects more than 5,000 Americans per year, primarily those who travel abroad.

Sewer districts and wastewater treatment agencies play a critical role in water quality and infrastructure that keep these diseases at bay. And around the world, causes like World Water Day and World Toilet Day raise awareness of the realities of poor sanitation and offer opportunities to support or advocate for change.

So next time you saddle up in front of your 8-bit Conestoga wagon stocked with supplies, remember the clean-water systems that exist to protect your family today.

Updated December 3, 2021, the 50th anniversary of The Oregon Trail computer game.



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