Talk:Endemic (epidemiology)

Article should compare several definitions of the word endemic

The article should be rewritten to compare several definitions of the word endemic

• A disease is endemic if R*S=1 (Endemic steady state)
• A disease is endemic to an area if it survives within the area without relying on receiving new infected people (and variants) from the outside.
• A disease is endemic if it has regular outbreaks

Note that influenza is not endemic according to the first two definitions, but it is still often described as an endemic disease. Therefore the third definition is needed

Note that a disease in the endemic steady state cannot have seasonal variations, so this requirement is very strict.

enzootic

The article Strangles links this page for the word enzootic, apparently meaning "endemic" but for people. This word/meaning should be noted.Wakablogger2 (talk) 22:34, 21 August 2009 (UTC)

Wikidata list of endemic diseases and subclasses of them

Most forms of turberculoses are currently included in the following list - but are all of them endemic?

Please enter correct data in these Wikidata items. Some columns of the following auto-generated list can be useful in various language versions of this article. The content may also affect the content of a future Wikidata based infoboxes. Tomastvivlaren (talk) 16:41, 22 March 2020 (UTC)

Hidden wikidata list - updates inactivated. Click here for a new Wikidata database query, and click on the arrow button

{{Wikidata list}}

Wikidata item	Pandemic	Start date	End date	Number of deaths	Number of infected	Description	Medical state	Cause	Direct cause	Part of	Instance of	Subclass of	Symptoms	Country of origin	Map
Q548165	Ghon focus											primary tuberculosis pulmonary tuberculosis
Q1040214	Extensively drug-resistant tuberculosis											multidrug-resistant tuberculosis
Q1166500	intestinal tuberculosis											gastrointestinal tuberculosis intestinal disease	gastrointestinal bleeding nausea bleeding vomiting
Q3267710	Lupus vulgaris											cutaneous tuberculosis
Q3604586	papulonecrotic tuberculid											cutaneous tuberculosis Tuberculid
Q3624458	tuberculous arthritis											septic arthritis osteoarticular tuberculosis
Q3851642	breast tuberculosis											extrapulmonary tuberculosis breast disease
Q4000120	post-primary tuberculosis											tuberculosis relapse
Q4000121	tonsillar tuberculosis											tonsillitis extrapulmonary tuberculosis
Q4254929	Latent tuberculosis											tuberculosis latent infection
Q6137194	Netter and Musset syndrome											female genital tuberculosis
Q6153637	osteoarticular tuberculosis											extrapulmonary tuberculosis bone disease
Q6543213	Lichen scrofulosorum											cutaneous tuberculosis Tuberculid
Q7243141	Primary inoculation tuberculosis											cutaneous tuberculosis
Q7250563	Prosector's wart											occupational disease cutaneous tuberculosis
Q7323489	Rich focus											tuberculoma central nervous system tuberculosis
Q7439268	scrofuloderma											lymph node tuberculosis cutaneous tuberculosis
Q7828253	Totally drug-resistant tuberculosis											Extensively drug-resistant tuberculosis
Q7850836	Tuberculid											skin disease cutaneous tuberculosis
Q7850844	tuberculosis cutis orificialis											cutaneous tuberculosis
Q7850852	Tuberculous gumma											cutaneous tuberculosis
Q7850854	tuberculous lymphadenitis											lymphadenopathy extrapulmonary tuberculosis lymphadenitis
Q12074859	infiltrative tuberculosis											pulmonary tuberculosis
Q12090031	focal tuberculosis											tuberculosis
Q12794230	cutaneous tuberculosis											extrapulmonary tuberculosis bacterial skin disease
Q16360163	osseous tuberculosis											osteoarticular tuberculosis bone inflammation disease
Q17014545	Tuberculosis in relation to HIV											AIDS related disease tuberculosis
Q17632129	ocular tuberculosis											extrapulmonary tuberculosis eye disease tuberculosis
Q18467212	Infantile tuberculosis											tuberculosis
Q18553225	tuberculous salpingitis											urogenital tuberculosis fallopian tube disease female genital tuberculosis
Q18553245	Alkhurma hemorrhagic fever							infection				Kyasanur forest disease	thrombocytopenia arthralgia vomiting
Q18554175	phthisical cornea											corneal degeneration tuberculosis
Q18554329	tuberculous epididymitis											urogenital tuberculosis male genital tuberculosis epididymis disease
Q18555012	tuberculous oophoritis											urogenital tuberculosis oophoritis ovarian disease female genital tuberculosis
Q18558155	tuberculous pneumothorax											tuberculosis pneumothorax
Q18924570	cervix tuberculosis											female genital tuberculosis cervix disease
Q18928085	tuberculous encephalitis											central nervous system tuberculosis
Q18928327	obsolete bronchial tuberculosis											tuberculosis
Q18928343	tuberculous mesenteric gland											abdominal tuberculosis
Q18928387	yellow fever hepatitis											yellow fever
Q18966239	Trypanosoma brucei rhodesiense infectious disease							Trypanosoma brucei rhodesiense				African trypanosomiasis
Q18966240	Trypanosoma brucei gambiense infectious disease							Trypanosoma brucei				African trypanosomiasis
Q18966256	primary tuberculosis											tuberculosis primary affect
Q18966257	tuberculous myelitis											central nervous system tuberculosis myelitis
Q18966491	nodular lung tuberculosis											pulmonary tuberculosis
Q18966880	intrathoracic lymph node tuberculosis											lymph node tuberculosis
Q18967082	infiltrative lung tuberculosis											interstitial lung disease pulmonary tuberculosis
Q18967303	thyroid gland tuberculosis											thyroid gland disease endocrine tuberculosis
Q18967464	tuberculous lung fibrosis											tuberculosis pulmonary fibrosis
Q18967471	female genital tuberculosis											female reproductive system disease urogenital tuberculosis
Q18967769	endocrine tuberculosis											extrapulmonary tuberculosis endocrine infection
Q18968227	tracheal tuberculosis											obsolete bronchial tuberculosis tracheal disease
Q18975183	ear tuberculosis											extrapulmonary tuberculosis ear disease
Q18975729	tuberculous ascites											abdominal tuberculosis ascites
Q18975749	cardiovascular tuberculosis											extrapulmonary tuberculosis cardiovascular disease
Q19000641	tuberculous lung cavity											pulmonary tuberculosis cavitary pneumonia
Q19001042	male genital tuberculosis											urogenital tuberculosis male reproductive system disease
Q19001181	tuberculous pneumonia											pulmonary tuberculosis bacterial pneumonia
Q19001209	tuberculous erythema nodosum											erythema nodosum cutaneous tuberculosis
Q19001246	peripheral lymph node tuberculosis											lymph node tuberculosis
Q19001346	tuberculous bronchiectasis											bronchiectasis tuberculosis
Q19001376	urinary tuberculosis											urogenital tuberculosis urinary system disease
Q26695325	cardiac tuberculosis											tuberculosis cardiovascular tuberculosis heart disease
Q55009294	tracheobronchial tuberculosis											obsolete bronchial tuberculosis
Q68882216	King's Evil											lymph node tuberculosis
Q69090928	intracranial tuberculoma											tuberculoma central nervous system tuberculosis
Q2086658	Ghon's complex										clinical sign	Ghon focus
Q733616	Erythema induratum										disease	panniculitis cutaneous tuberculosis
Q3541798	Tuberculosis of the adrenal glands							infection			disease	adrenal gland disease endocrine tuberculosis
Q3542008	osteoarticular tuberculosis of the knee										disease	osteoarticular tuberculosis knee disorder
Q7520132	Simon focus										disease	pulmonary tuberculosis
Q7850851	Tuberculous cellulitis										disease	cutaneous tuberculosis cellulitis
Q13046587	pulmonary tuberculosis										disease infectious disease	lung disease tuberculosis	pleural effusion
Q18553330	extrapulmonary tuberculosis										disease	tuberculosis
Q18553331	abdominal tuberculosis										disease	extrapulmonary tuberculosis
Q18556156	oral tuberculosis										disease infectious disease	gastrointestinal tuberculosis mouth disease
Q18558100	splenic tuberculosis										disease infectious disease	splenic disease abdominal tuberculosis	abscess
Q24975389	Tuberculous dactylitis										disease	osteoarticular tuberculosis
Q55093324	silicotuberculosis										disease	tuberculosis silicosis
Q7850846	tuberculosis in India										disease by country or region	tuberculosis
Q12156	malaria							Plasmodium falciparum Plasmodium vivax Plasmodium malariae Plasmodium ovale Plasmodium Plasmodium knowlesi			endemic disease	parasitic protozoa infectious disease vector-borne disease	intermittent fever periodic fever hepatomegaly anemia splenomegaly jaundice coma chills
Q12199	HIV/AIDS	1959						HIV			endemic disease syndrome pandemic	human immunodeficiency virus infectious disease acquired immunodeficiency	fever lymphadenopathy diarrhea lethargy weight loss
Q331283	leishmaniasis							Leishmania Leishmania donovani Leishmania infantum Leishmania braziliensis Leishmania mexicana Leishmania major Leishmania tropica			endemic disease	parasitic protozoa infectious disease vector-borne disease	ulcer mouth ulcer fever splenomegaly anemia hepatomegaly
Q17583	miliary tuberculosis										infectious disease	extrapulmonary tuberculosis
Q154874	yellow fever							yellow fever virus			infectious disease endemic disease	rare skin disease arbovirosis skin infection flavivirus infectious disease viral infectious disease endemic disease	fever bradycardia fatigue headache vomiting cyanosis jaundice Faget sign chills arthralgia anorexia hyperaemia swelling tachycardia Ferrari sign melena hypotension hepatomegaly splenomegaly oliguria anuria encephalitis bleeding
Q160649	typhus							Rickettsia			infectious disease endemic disease	primary bacterial infectious disease rickettsiosis
Q203133	African trypanosomiasis							Trypanosoma brucei Trypanosoma brucei gambiense Trypanosoma brucei rhodesiense			infectious disease	trypanosomiasis neglected tropical disease endemic disease vector-borne disease	Winterbottom's sign periodic fever headache malaise anemia arthralgia sleep disorder dizziness primary affect tachycardia swelling cachexia sopor
Q649558	Chagas disease							Trypanosoma cruzi			infectious disease	trypanosomiasis neglected tropical disease endemic disease	Chagoma Romana's sign cardiomyopathy myocarditis hepatomegaly splenomegaly megacolon
Q782898	Murray Valley encephalitis							Murray Valley encephalitis virus			infectious disease	viral infectious disease viral encephalitis arbovirosis endemic disease mosquito-borne disease brain diseases	malaise prodrome irritability somnolence headache fever delusion altération de l'état de conscience sopor coma tremor meningism signs muscle weakness mental confusion nausea vomiting
Q866602	multidrug-resistant tuberculosis										infectious disease	tuberculosis MDR bacteria
Q1432397	Kyasanur forest disease							Kyasanur Forest disease virus			infectious disease	viral infectious disease tick-borne disease viral hemorrhagic fever arbovirosis hospital-acquired infection endemic disease	fever chills headache myalgia lymphadenopathy conjunctivitis photophobia internal bleeding bleeding cough abdominal pain hyperesthesia nausea vomiting diarrhea tremor meningism signs dehydration
Q1737838	laryngeal tuberculosis										infectious disease	laryngitis obsolete bronchial tuberculosis rare respiratory disease	Granulomatous inflammation hoarse voice dysphagia
Q2500965	urogenital tuberculosis										infectious disease	extrapulmonary tuberculosis genitourinary system disease rare urogenital disease
Q3392410	pleural tuberculosis							infection			infectious disease	pleurisy extrapulmonary tuberculosis pleural disease rare respiratory disease allergy	pleural effusion allergic response
Q3854687	tuberculous meningitis										infectious disease	central nervous system tuberculosis bacterial meningitis
Q4678337	lymph node tuberculosis										infectious disease	extrapulmonary tuberculosis tuberculous lymphadenitis lymph node disease immune disorder	enlargement of lymph nodes lymphadenopathy
Q7850856	pericardial tuberculosis							tuberculosis			infectious disease	pericarditis cardiovascular tuberculosis rare cardiac disease extrapulmonary tuberculosis pericardium disease	pericardial effusion
Q18554739	tuberculous empyema										infectious disease	pleural empyema empyema pleural tuberculosis
Q18554860	central nervous system tuberculosis										infectious disease	extrapulmonary tuberculosis infection of the central nervous system central nervous system disease
Q18556166	gastrointestinal tuberculosis										infectious disease	abdominal tuberculosis gastrointestinal system disease	weight loss nausea vomiting
Q18556185	hepatic tuberculosis										infectious disease	gastrointestinal tuberculosis liver disease	jaundice
Q18557555	esophageal tuberculosis										infectious disease	gastrointestinal tuberculosis esophageal disease	dysphagia
Q18557641	bladder tuberculosis										infectious disease	urogenital tuberculosis bladder disease urinary tract infection male infertility due to obstructive azoospermia of genetic origin rare genetic urogenital disease
Q18557889	ureter tuberculosis										infectious disease	urogenital tuberculosis ureteral disease urinary tract infection
Q18558204	renal tuberculosis										infectious disease	urinary tract infection rare genetic renal disease male infertility due to obstructive azoospermia of genetic origin rare genetic urogenital disease urogenital tuberculosis kidney disease
Q18558227	tuberculous peritonitis										infectious disease	gastrointestinal tuberculosis peritonitis	abdominal discomfort abdominal distention
Q18924547	Rocio virus encephalitis							Rocio virus			infectious disease	arbovirosis viral encephalitis zoonosis flavivirus infectious disease mosquito-borne disease endemic disease	prodrome fever headache nausea vomiting conjunctivitis meningism signs coma
Q18967247	Chagas cardiomyopathy										infectious disease	Chagas disease extrinsic cardiomyopathy cardiomyopathy
Q12204	tuberculosis							Mycobacterium tuberculosis			notifiable disease endemic disease	primary bacterial infectious disease mycobacterium infectious disease endemic disease infectious disease	cough hemoptysis weight loss fever

---

∑ 109 items.

End of auto-generated list.

• Why not list the diseases alphabetically? I resorted them for myself, but you say that any changes will be deleted in the next update.
• What countries are these diseases currently endemic within?
• Surely there are other endemic diseases afoot in the world. What does a disease have to do to make the cut for this list?
• Why all the columns that you don't use?
• Will this chart ever be added to the Endemic article itself after these kinks are ironed out?

Thank you for you help, Wordreader (talk) 23:59, 26 April 2020 (UTC)

@Tomastvivlaren:. What is the point of this table? This seems like an improper usage of the talk pages. I am tempted to remove it. Jason Quinn (talk) 14:27, 26 October 2021 (UTC)

Jason Quinn:The aim was to encourage people to fact-check and improve endemic related items at Wikidata, since infoboxes in some Wikipedia versions (not yet English Wikipedia, but for example a few articles on the Swedish version), many pages at Wikimedia commons, etc, automatically take that information from Wikidata and show it in the local language. I have now hidden the list and inactivated the neverending updates for this page. I realize it is better to refer people to the above wikidata database query.

Wordreader: Thanks for good questions. My code sorted the list based on "Instance of", i.e. type of endemic, but that can be changed. The columns correspond to proporties that potentially may be entered in the endemic pages at Wikidata, and may be shown automatically in infoboxes on some wikis. I do not think an automatically updated chart should be added to the endemic article for many years, it is still dangerous to rely on Wikidata, but perhaps the chart may inspire someone to compile a manually updated list. I have stopped working on the topic of endemics. Tomastvivlaren (talk) 22:17, 26 October 2021 (UTC)

What people say is not biomedical information

Here's what I wrote:

• Hopes for COVID-19 to become endemic make a similar mistake; generally, the speaker expresses a wish that COVID-19 will become relatively harmless and non-disruptive to society, whereas endemicity promises only that there will be a steady, predictable number of sick people.

Here's what @Crossroads has turned it into:

• Hopes for COVID-19 to become endemic may make a similar mistake; endemic COVID-19 could be mild if immunity from infection against pathology is lifelong or lasts longer than immunity against infection, but endemicity in itself promises only that there will be a steady, predictable number of sick people.

First of all, I think that the "could be mild" idea is POVish. Sure, it "could be mild", but it also "could be not-mild", and with an additional year-plus of data behind us, it seems like "not-mild" is unfortunately possible. There is no lifelong immunity. Some people get extremely sick, some of them stay sick for many months, perhaps the rest of their lives, and some of them die. Or perhaps it's just in line with the definition of "mild COVID" from the early days, when "moderate" meant that you had to be admitted to the hospital for supplemental oxygen, and "mild" just meant you couldn't get out of your own bed without help, which is not how most people normally use those words.

Compare that the hopeful statement about COVID-19 becoming "mild" against the tone struck in newer sources:

• "Endemic is not equal to harmless. Commonly, endemic is falsely interpreted as the end of COVID-19, bringing to a false complacency. Endemic "label" on an infectious disease, such as malaria, HIV infection, tuberculosis in certain regions of the world, means the overall rates of infection are static - neither rising nor falling. Endemic "label" defines nothing about time duration to reach disease end or how many populations will still be susceptible to the disease." [1]
• "But reframing COVID-19 as an endemic disease right now is a premature notion at best, representing more of what we want COVID-19 to become than the epidemiological reality...But the evolutionary trajectory of COVID-19 does not at this time suggest a clear path toward endemicity, and epidemiologists and evolutionary biologists warn against impulsively applying this notion to the disease." [2]
• "While the “boat has sailed” on eliminating SARS-CoV-2, it’s still unclear what kind of endemicity the virus will establish, said Kaushic. Endemic means that a virus is continually present and somewhat predictable — not that it’s harmless or that precautions to prevent infections are unnecessary." [3]
• "An endemic disease can still have serious consequences. Take the examples of malaria, HIV, tuberculosis and other infectious diseases that are endemic worldwide. In 2020, there were an estimated 241 million cases of malaria worldwide and around 627,000 deaths.3 Outbreaks and sporadic infections will continue to occur" [4]

Second, I deliberately constructed this sentence to talk about how people use this word, and how people use a word is not Wikipedia:Biomedical information. This is a statement about linguistics, not about science. The Atlantic is a reliable source for what I wrote.

As for what you wrote, the source you cite does not say that COVID-19 will become endemic. They write, in fact, that "Epidemics can fade or transition to an endemic phase", which means that there are two options for the end of an epidemic, and only one of them is endemicity. The source also says that "infection does not generate life-long immunity", so that zero-likelihood prospect should probably not be mentioned anywhere.

(As a side note, the bit that runs "if immunity from infection against pathology...lasts longer than immunity against infection" is garbled and needs to be re-written. Perhaps you meant "if previously acquired immunity reduces the risk of death and disability during future infections"? Another approach would be to shorten it substantially: "It is possible that COVID-19 could become endemic, i.e., that it would produce a steady and predictable number of infections.") WhatamIdoing (talk) 07:34, 1 December 2022 (UTC)

Agree the re-write is not an improvement. The Atlantic article is good for non-WP:BMI. Bon courage (talk) 07:53, 1 December 2022 (UTC)

The assertions found in that article and cited to it about viral endemicity are all biomedical information. Crossroads ^-talk- 20:10, 1 December 2022 (UTC)

I agree both that comments about society's "hopes" vs what "endemicity" is does not require a MEDRS source. The cited paper that got added discusses scenarios concerning the severity of an endemic covid, but does not address "what people/society think/say/hope". While it does have some sentences using the "it could be mild if..." they could equally have been written "it could be severe if...". It is clear the journal article writers hope for a mild outcome, but we aren't here to document their hope. There is also a persistent myth that diseases become mild as they evolve in a host population, which is nonsense (think of rabies and smallpox), and if you are thinking of myxomatosis, I don't know how a case fatality rate of 50-95% sounds to you, and we don't breed like rabbits. I don't think this article needs to get bogged down in details of how covid might become mild or might not. What matters is that people (in the West anyway) wrongly thing endemicity is a good thing and associate it with a harmless disease. I'm not sure that folk in central Africa think endemic disease is a harmless thing. Do we have any sources indicating this is a wealthy nation's fallacy? -- Colin°^Talk 12:37, 1 December 2022 (UTC)

WhatamIdoing, I don't mind adjusting the text I wrote, but your version is POV toward the idea that endemic Covid could be not mild. "Could be mild" is a fact, not POV. Both possibilities should be mentioned here. And the fact is that this article is a medical article, and this aspect of the topic is implying or making medical claims, so we should be relying on medical sources when possible.

The four "newer" sources you cite have a total of 7 citations on Google Scholar (5 of them in just the 2nd one), and are mostly rather short articles. The 3rd one especially is written very much like a news report, not a full-on review article. The article I cited has 61 citations. It is from late 2021, well after there were new variants after vaccination and such.

I strongly encourage people here to read it. It addresses many of the objections made here. For instance, "no lifelong immunity" against infection doesn't mean that it can't be mild when endemic, because immunity to severe disease could be lifelong or could last significantly longer than immunity to infection, leading to regular 'boosting' from infections (or from yearly vaccine boosters, presumably). Evolving to be more intrinsically more mild is also not necessary at all, though entirely possible and may have happened already with existing human coronaviruses, including one that likely caused the 1890 pandemic - this is all in the article too. Comparisons to smallpox and rabies are irrelevant because these are very different species with very different means of spread - we already have endemic coronaviruses. Regarding the claim the authors "hope for a mild outcome, but we aren't here to document their hope" - actually they explain why and how that would happen like any academic paper rather than mere "hope", they acknowledge it is not a given, and in fact we are here to document the views of experts with WP:DUE weight. Endemicity is a good thing compared to a pandemic when eradication is impossible, as is true for all coronaviruses due to the inability to create lifelong immunity to infection.

I think at minimum, as a simplification, we could agree that some experts expect that endemic COVID will be mild and some think it will not. So why only present one view and call the other a "mistake"? Is this not misleading readers? We can't use what basically amounts to 'this is about society so we don't need MEDRS' as a reason to present just the possibility that society doesn't want as though the other one isn't possible. Some in the media like to write articles and thinkpieces debunking people's hope for normalcy or whatever - negativity gets more views and always has - but we should not think that MEDRS mostly think this is the most likely possibility.

We should probably also cut the "similar mistake" bit since it's not clear what is "similar", and COVID is very different from AIDS anyway - HIV infections are permanent but COVID infections are not, just for starters. Something like this, integrating a suggestion from WhatamIdoing earlier: "Some in the public wrongly assume that endemic COVID-19 means the disease would necessarily be mild. Endemic COVID-19 could be mild if previously acquired immunity reduces the risk of death and disability during future infections, but in itself endemicity only means that there will be a steady, predictable number of sick people." Crossroads ^-talk- 19:37, 1 December 2022 (UTC)

References