Well, I was going to paint just
a couple of seadogs, but now it seems I have caught pirate fever.
I thought that I'd find out more about this ailment. The most comprehensive article on pirate fever I could find was published in the
Port Royal Journal Of Infectious Disease, which I have copied below:
"Pirate Fever, Uncharted Waters? - A Systematic Literature Review
Introduction
Most clinicians coming to contact with seafaring patients, especially between the tropics of Cancer and Capricorn, have had to at least consider pirate fever as a differential diagnostic option. But this condition is not unheard-of even hundreds of kilometers inland. However, there exist no commonly accepted guidelines for diagnosis and treatment of pirate fever and what is known about this disease seems to be mostly based on hear-say and educated guesswork.
To rectify the situation, the authors set out to gather the existing body of scientific work on pirate fever into this article. The method was to review existing studies and reports gathered by presenting the search-term "pirate fever" to the library database of the University of Port Royal, PubMed, the Cochrane library, two independent voodoo priestesses and one witch doctor (see appendix 1).
The search results were reviewed and assessed for relevance and cogency, with emphasis placed on works published in peer-reviewed journals and papers written in human blood.
Symptoms, Signs and Diagnosis
Pirate fever is a form of chronic encephalitis. Common symptoms include dysarthria (dys-ARRR!-thria) and a form of gait know as sea legs (thalassoskelia). (Morgan, H. 1667.)
Pathognomonic clinical signs are eyepatches, nautically themed tattoos and amputation (Vane, C. 1716).
Pirate fever is a clinical diagnosis. There are no know radiological or clinical laboratory findings that are specific for pirate fever. Patients with pirate fever are more likely to have elevated blood serum levels of cardiolipin antibodies, but the high prevalence of syphilis among these patients is a confounding variable in this respect. (Teach, E."B." 1718.) Those afflicted by pirate fever are also more likely to draw "The Devil" (odds ratio 12.1), "The Hanged Man" (OR 18.6) or "Death" (OR 33.2) from the tarot Major Arcana (Laveau, M. 1821).
Pathogenesis
Pirate fever is thought to be commutable, but as of yet, the pathogen and it's vector(s) remain unidentified. The most commonly accepted method of contagion is believed to be exposure to tropical miasma. (Worley, R. 1717, Hornigold, B. et Teach, E."B." 1717.) Other suggested causes include smell of rum, promise of gold, betrayal at love and prolonged exposure to dull autumns and winters of temperate to sub-arctic climates. (Gathenhielm, I. et Gathenhielm, L. 1715, Bellamy, S."B.S." 1716.)
Since the cause of pirate fever is unclear, the incubation period is also unknown. Case studies in literature suggest that the latency of the disease can range from nigh non-existent to several decades, during which prodromal symptoms, such as wistful sighs when the infected has been presented with pictures of sail ships, have been reported in retrospective studies. (Swann, E., Turner, W. et al. 1732, Kidd, W. 1697.)
Epidemiology
The estimates of the prevalence of pirate fever vary from 1/100 000 to 4/10, with higher prevalence associated with closeness to large bodies of water and weak navies (Coxon, J. et al. 1681). The incidence varies in accordance with the form of government and the tides with figures as high as 0.67/person/month at sea reported (Low, E. 1721).
Known associated co-morbidities of pirate fever are scurvy (OR 141.3, 95% confidence interval 75.7 - 206.9) (Toothrot, H. 1698) and psittacosis (OR 32.1, CI95% 21.2 - 43.0) (Silver, L-J. 1745).
Prognosis
The prognosis of pirate fever is also uncertain. The severity of the symptoms can range from severe, e.g. full-blown attempts at commandeering near-by vehicles, to mild, e.g. the sudden urge to bury one's loose change and mark the spot with an "X". (Roberts, B."B.B." 1722.) A full, spontaneous recovery is possible (Every, H. 1696), but in some epidemics, mortality rates as high as 99% have been reported (LeChuck, G.P. 1789).
Treatment
Conventional treatments involve high-dose courses of grog and booty, but studies into their effectiveness have yielded contradictory results (Rackham, J."C.J." 1718, Rackham, J."C.J." et Bonny, A. 1719, Bonny, A, Rackham, J."C.J." et Read, M. 1720, Rackham, J."C.J.", Read, M. et al. 1720, Bonny, A. et Read, M. 1721, Bonny, A. 1767).
Clinical experience suggests that these treatments are effective at alleviating the symptoms in the short term, but relapses are common (Teach, E."B." 1718, personal communication by seance, see appendix 1).
Other treatments, commonly thought more likely to be curative, include repeated keel-hauling, love of a good man/woman/other as applicable and hanging from the neck until dead (Rosvo-Roope, R. 1733).
Of the last mentioned method of treatment, there exist a rare placebo-controlled trial (hanging from the neck until dead vs. hanging from the legs until red) (Rogers, W. 1718). But this study has been widely criticized for methodological shortcomings (Morris, T. 1719, Kidd, W. 1721). According to case reports, even hanging is not a definitive cure (Kidd, W. 2011).
The treatment of pirate fever with voodoo curses has been shown to be effective (number-needed-to-treat 3.5). But serious side effects, such as zombi-outbreaks, are common and limit the usefulness of this method (number-needed-to-harm 0.4) (Lady, V., LeChuck, G.P. et Threepwood, G. 1697).
Conclusion
In conclusion, very little is know for certain about pirate fever. This is unfortunate considering the burden caused by this chronic and often fatal illness and more research is needed. To this end, the authors of this article propose to raise funds to outfit a fast ship with a crew of 30-50 able seamen and/or scholars (post-doc and under-graduate) and sufficient provisions, grain, salted pork, stockfish, fresh water, grog, tobacco, coffee, chewing tobacco, grog, pens, paper, ink, powder and shot, microscopes, and other laboratory equipment, grog, chemical reagents, beads (for trading with natives), medical supplies, picks and spades, grog, etc. for an exploratory voyage to increase the scientific community's understanding of pirate fever."
Not much is known, so spread the word and help raise awareness!
