infections and itises

So last time, I wrote about disease versus infection following the phrase sexually transmitted, and I started thinking (again) about how we talk about medical things--technical or non-technical? In the book I'm writing (for you!), I've touched on it a little with respect to bodily functions:

Sitting in my doctor’s waiting room, I’m amused and a bit astonished to find posters about what to do if there is blood in your pee or poo.* The equivalent American public-service advertisements say urine and stool. In the medical context, America avoids being crude by sounding more scientific, and Britain uses baby-talk.
* Make an appointment with your doctor immediately!
The discussion hits on things like BrE waterworks ('urinary tract') and back passage ('rectum') and  classes given to foreign nurses in the NHS on British slang--aka British euphemism. (It's a bit of the book that looks at the stereotype of Americans as euphemists, so yes, there's a lot of attention in the other direction.)

The "Americans use overly technical terminology" aka "Americans like jargon" stereotype that I contribute to in the quote above is one worth taking apart as well. I've been encouraged in that stereotype when I hear friends talk about their chest infections where I tend to have bronchitis. But then they're also talking about having cystitis (my poor, unhealthy friends), which I hadn't heard of before moving here. An infected cyst? Ew... No, it's a bladder infection. In AmE I'd call it a UTI (urinary tract infection). (The NHS website tells us that cystitis is a common type of UTI, so the terms are slightly different--but that's the case with bronchitis and chest infection too.)

So far, we're tied: Itises: BrE 1, AmE 1. Infections: BrE 1, AmE 1.

So I thought I'd have a look at which things Americans and Brits call infections and which they use Medical Greek -itis names for.

 The tables below are the statistically "most American" (left) and "Most British" (right) nouns that come before infection in the GloWBE corpus. (If you click on the table, it should get bigger.)
"Most American" and "Most British" words preceding infection
What you can notice there (if you can read the small print) is that the "more British" preceding nouns include things that can get infected (wounds, chests, throats), whereas the "more American" ones tend to be the microbes that do the infecting. In AmE, I think I'd say someone has an infected wound rather than that they have a wound infection. And one kind of wound infection you can have is a staph infection (in the US list), which is a very familiar term from my AmE childhood (we were constantly being told that gym mats were very dangerous). I don't know that I've ever heard staph infection in the UK.

In the BrE column you can also see urine infection, another BrE way of saying urinary tract infection. This one names neither the pathogen nor the organ, and always strikes me as a bit odd. Urine might have germs in it, but can urine itself be infected?

BrE has more throat infections because Americans are more likely to say they have strep throat. In my experience, scarlet fever is heard more in BrE these days (which is not to say you never hear it in AmE). When my child was diagnosed with it (in the UK), I really felt like I'd been taken back to Victorian times. She wasn't all that sick. But when I looked it up and found that it's the strep germ, I thought: maybe you hear scarlet fever more often in UK because AmE has strep infection.

Some of the numbers up there, though, are art{e/i}ifacts of the corpus. AmE has 56 instances of HSV infection but all of them come from a single website (, so we shouldn't take too much from that. American, like British, English would typically call that herpes. HBV infection is found on a greater range of sites, but they are mostly medical journals and such. Laypeople would generally say Hepatitis B.

But that does seem to sum up the difference between the AmE table and the BrE table: a lot of the AmE infection cases are use of medical jargon in a medical context--staph infection was the only one I knew as a layperson. Whereas in BrE the body-part+infection cases are terms that non-medical people would use when talking about their maladies.

If we look at the infections that American and British English have in common, we can see  that Americans do talk about infections too, sometimes with body parts, even.

But what about -itises? Is it mostly Americans using the fancy words? No, but there again maybe some effects here of one source being over-sampled in the corpus. Here I'm showing what came up as 'most American' (left) and 'most British' (right), with a bit of the 'neither one nor the other' showing in white. This is going to be very hard to read on a phone (sorry!), but I'll write up the highlights below.

I've given a comment in red if (a) the things are not diseases, but just coincidentally spelled with -itis, or (b) if it's a spelling issue. Though oesophagitis shows up in the British list, it's not because Americans don't use an -itis name for the problem, but because we spell it esophagitis. (Click here for my old post on oe/e spellings.) The British list is lengthened by a misspelling of arthritis and having two spellings for tonsil(l)itis.

After discounting those, the British list is still a lot longer than the American one, but I'm very much suspecting some bad corpus effects here. Tonsillitis, colitis, dermatitis, gastroenteritis, appendicitis, pancreatitis--I or members of my family have had all of these and that's just what they were called in the US. The numbers for these diseases are greater than expected in the British part of the corpus--but they're hardly absent in the American part. For example, note that there are 756 AmE occurrences of meningitis--which is here counting as "rather British", while only 16 AmE hits for phlebitis make it "very American". Some of these cases are going to seem "more British" or "more American" to the software just because the corpus happened to hit on some websites that talked about these things a lot. But I think what we can say from this exercise is that we have no particular evidence for British English avoiding -itis words, despite its greater use of body-part+infection.

Still there are a few itises worth mentioning for BrE/AmE interest. One is labyrinthitis, which I had an unfortunate encounter with this spring. When I described my symptoms (the room going upside-down and inside-out every time I turned my head left), lots of British friends said "Oh, that's labyrinthitis. I've had it. It's horrible!" But it was not a word that my American friends seemed to have at their fingertips--to them it was an inner-ear infection. (Why do Brits seem to get it more often, though?)

Conjunctivitis shows up on the British list, though it is a word that Americans use too. But Americans have another informal term for the problem: pink-eye. That will push the US conjunctivitis numbers down. (There are a few UK hits for pink-eye--with or without the hyphen, but a lot of US hits.)

In the white part of the table--where the numbers are similar for AmE and BrE -- are the two itises that are earlier in this post: cystitis, which I've experienced as more British, and bronchitis, which I've experienced as more American. Because the corpus is imperfect, I'm not going to totally discount my experience on these. But it would be interesting to hear if others (particularly transatlantic others who can compare) think I'm off my rocker...

I was surprised to see only one made-up disease in the list: boomeritis on the AmE side. (It was the name of a book--click on the word to learn more.) I would have bet that (AmE) senioritis would appear. (As it happens, there were only two US examples of it in the corpus--most are Canadian.) To quote Wikipedia:

Senioritis is a colloquial term mainly used in the United States and Canada to describe the decreased motivation toward studies displayed by students who are nearing the end of their high school, college, and graduate school careers.
For a minute there, I was worried that I expected senioritis to be there because I am OLD and UNCOOL. But I'm happy to report that in both the Corpus of Historical American English and in Google Books, the rate of senioritis use has only gone up in the decades since I was a high-school/college senior. Not happy for the teachers who have to teach these seniors, but happy that my vocabulary is not a complete dinosaur--yet.

If you're interested in other disease names, do have a look at the medicine/disease tag--thanks to (a) having a small child and (b) being a complete hypochondriac, quite a few have come up over the years--but there are still many more to cover in future.


  1. "Still there are a few itises worth mentioning for BrE/AmE interest. One is labyrinthitis, which I had an unfortunate encounter with this spring. When I described my symptoms (the room going upside-down and inside-out every time I turned my head left), lots of British friends said "Oh, that's labyrinthitis. I've had it. It's horrible!" But it was not a word that my American friends seemed to have at their fingertips--to them it was an inner-ear infection. (Why do Brits seem to get it more often, though?)"

    I think because most Americans tend to call it "Vertigo" rather than labyrinthitis or an inner ear infection...

    I've only ever heard of labyrinthitis (which is a TYPE of inner ear infection in the same way that cystitis is a UTI) called vertigo, and I've had it. So I think the American term for it is actually vertigo (which may or may not be Alfred Hitchcock's fault).

  2. Yes the absence of made-up names is surprising.

    I clearly recall comma-itis, the punctuational disease. I have a vague sense that I used to know lots of others, but this may well be a false memory.

  3. The OED records fiscalitis, Suffragitis, testiitis (a disease of cricket), bushrangeritis and electionitis.

    Several quotes appear to be from the politicians Asquith and Churchill, which raises the speculation that they personally invented them.

  4. abyaday:

    Brits will say 'vertigo' too, but it's a symptom, rather than a diagnosis--and there are many things that can cause it. So I say "I've got vertigo", and my British friends say "It's probably labyrinthitis", whereas I think my American friends would say "You might have an inner-ear infection".

    I wish I could do a 'match case' search for it in the online corpus software I've used, but I can't, so any search for 'vertigo' is going to be overrun with references to the film. I'm not in a place where I can use other pseudo-parallel BrE/AmE corpora at the moment. Searching for just the phrase "have/has/had vertigo" there are 14 hits in the US data, 16 in the UK data--indicating no real difference in usage. (I checked and none of those are 'have Vertigo on DVD' or any such thing!)

  5. I suspect the UK's use of cystitis is a diagnosis thing. People will use "a problem with my waterworks" or whatever but cystitis doesn't sound like that and it's a specific thing rather than a NSUTI so they give it the technical name. It usually requires different treatment too because drugs to reach the bladder (which is anatomically a cyst) are a pain because they have to get through the kidneys which are really efficient at filtering drug molecules out. Why it's NOT used in the US is more interesting to me. Perhaps because UTI is so commonly used they use that for the specific too.

    I couldn't see some -itises I'd expect to like plantar fasciitis in your list (or maybe it's too small to read). It's an inflammation of the foot, the plantar fascia to be precise with roughly speaking forms the arches and gives shape to the sole of your foot. It's quite common in joggers and runner and athletes. But maybe running shoes have got a lot better so it's not common enough now.

  6. British doctors still use terms like stool and urine, in my experience.

    Over sixties in the UK get free bowel cancer screening kits through the post every two years. The how-to leaflet that came with mind refer to samples of "bowel motions". (You're asked to scrape bits of turds three days in a row and put them on a special card and post them, presumably one of the few occasions it's OK to send human faeces through the post.)

  7. Eloise: fasciitis is the first one in the white section, indicating no difference between AmE/BrE usage. The 'plantar' won't show up because it's a one-word search. I've had it in both countries--same term.

  8. Bad eyesight then, sorry.

  9. Why are Brits so much more likely to write about Kuwaitis?

  10. Speaking of scarlet fever and being taken back to Victorian times, in Alcott's Little Women (yes, I've now managed to refer to this novel on Separated by a Common Language twice in the last month) young Beth actually dies of a heart condition she develops as a result of a bout of scarlet fever. So I'm wondering whether such fatal results from strep throat are rare today simply because of antibiotics or whether scarlet fever just isn't what it used to be.

    For the record, apparently Alcott had a sister, Elizabeth, who did actually die from complications of scarlet fever.

    Lastly, just to muddy the waters, I Googled scarlet fever and in its search results Google helpfully provides in the right nav a summary of the condition (complete with illustration) that includes a caption that reads A bacterial illness that develops in some people who have strep throat. Which suggests scarlet fever and strep throat are somehow not one and the same.

  11. I didn't know that strep throat was the same as scarlet fever. In my experience, I'd say that I have a bit of a sore throat, and Americans I know would say they have strep and head to the doctor pronto.

    I've not heard people in the US use gastroenteritis much - more likely is "stomach flu" which irritates me almost as much as people who say they have flu when they have a cold.

    (Brit living in the US for 7 years)

  12. I'd have to dig out the text books, and I will if people are interested. Basically, depending on the plasmid-encoded toxins produced Streptococcus pneumoniae, when it causes a nasopharyngeal infection (aka Strep throat) can give you the common cold, a nastier fever (URTI with pyrexia), scarletina or scarlet fever. If you've ever had the either of the last two you wouldn't be calling them Strep throat.

    Modern health care - things like clean water and hygiene standards - even without antibiotics, make scarlet fever a lot more survivable in the developed world than it was 100+ years ago, but it certainly was when I was a child (so 40-odd years ago) a reportable disease in the UK and I think it still is. Most community acquired streptococcal infections have variable resistance to penicillin these days but succumb to other standard antibiotics (erythromycin, tetracycline etc.) although it obviously varies from strain to strain. So scarlet fever still has the potential to be really nasty but it's pretty treatable and it's less devastating than it used to be if you don't live in a slum, you have a good standard of living and good basic health care.

  13. When my wife and I first got involved, I learned more about cystitis than I wanted to (drinking cranberry juice helps as both preventive and cure), and always by that name. Also, the bladder is not usually called a cyst, but it does meet the technical definition of an empty space within the body sometimes filled with fluid, and bladder can be used for things like a fish's swim bladder or even the gas-filled things that keep kelp afloat.

  14. Clarification: Scarlet fever is *a strep infection*. Strep throat is a strep infection that just affects the throat, but if you have scarlet fever, then you have a rash over your body. My kid had the rash, but I do wonder if we were in the States whether we'd have been told she had a strep infection, instead of being told she had a scarier sounding disease. (The kid also has a penicillin allergy, so these things are always fun. The stuff one has to take instead is the vilest concoction I've ever seen or smelled.)

    In AmE one can just say that people 'have strep', though I think in that case you'd usually assume 'strep throat'.

  15. I've heard cystitis used quite a bit here in Michigan, especially as 'honeymoom cystitis'. When I was a child i the 50's and 60's you quite often heard of scarlet fever. People were very nervous about strep throat, because it could lead to scarlet fever, which could then lead to rheumatic heart disease which was extremely serious. Strep throat was taken far more seriously then than it is now. As a teacher I come across a lot of childhood diseases and I hadn't heard about scarlet fever in many years but it has come up in my school over the past one or two years. I haven't heard anyone talk about rheumatic heart disease in ages.

  16. True Scarlet Fever (with the rash) is pretty rare, especially when compared to the rate of common strep throat. The rash is caused by the bacteria in the throat producing a toxin (not all strains of strep produce the toxin). Except for med school exams, I've never seen a case in real life, although I don't practice primary care. And Scarlet Fever should be distinguished from Rheumatic Fever which can be caused by both improperly treated strep throat and Scarlet Fever

  17. In my experience this use of baby terms like "pee and poo" in British public service communications is recent (10-15 years?). I suppose it comes from attempts to make such communications more user-friendly.
    A friend of mine has been complaining recently of frequent UTIs, but she's a former nurse and I would not previously have been familiar with the expression.

  18. A few years back, I became aware of (AAVE?) "the itis", meaning a general lethargy, particularly after eating a large meal. The main source for this on the Internet appears to be Urban Dictionary; proper dictionaries don't seem to have it yet.

    As a WNYer USAian, I don't think I've ever heard the term "strep infection" before today, but I have been told I once had scarlet fever as a small child.

  19. I'm old enough to think I remember that "-itis" as a semi-comical reference to something topical (and usually ephemeral) wasn't uncommon - the "-gate" of its day, perhaps. And I certainly remember Ena Sharples in Coronation Street deriding the new-fangled launderette as a symptom of "pure lazyitis" - something you could clearly never be accused of!

  20. I think some of it is generational, too - I would say my grandsons had pink-eye, but my daughter says they have conjunctivitis.

    I would probably say I had tonsillitis (even though my tonsils were removed nearly 60 years ago), or a throat infection - certainly "strep throat" is not something I would ever have. Nor would I have "intestinal flu" (unlike my poor boss, yesterday); I'd have a tummy upset, or more recently, noro (virus) (or, if speaking French, une gastrite).

  21. I'm an American who has been living in London for the past several years, and it was there that I first encountered several of the words you mention, specifically: conjunctivitis, labyrithitis, and cystitis. So those are all seem particularly British to me! On the other hand, the first time I told a British nurse that I felt like I had a strep infection she appeared to have no idea what I meant.

  22. Lynne, I can tell you that here on Staten Island, we were told outright when the girls had scarlet fever. (Of course, the doctor hastened to explain that that was "just strep with a rash". I knew that. What I couldn't get over was the fact that nothing was scarlet!)

    As I understand it, while antibiotics and hygiene have played their part, scarlet fever has simply gotten less dangerous since the middle of the last century (that's the 1900s) for reasons that are unclear - perhaps a new strain, or milk pasteurization? At any rate, it started to become less dangerous before widespread use of antibiotics.

    Pro tip: You can actually purchase rapid strep tests, the same sort doctors use, for your own home use. Then if you think your kid might be streppy or they might just have a cold, you can give the rapid strep test rather than schlepping out to the doctor with a sniffly kid. They're pretty simple to use, and if you have a copay it's definitely cheaper. (Or, in our case, we have two kids who present atypically whenever they get strep. I still remember the time I went to the doctor and went "She shows no symptoms whatsoever, but I'm convinced she has strep" and I was right. It really boosts your credibility when you can show them the strep test.)

  23. @ conuly - don't think we could do such things here in the UK! And of course we don't have "copays" - medical services are free at the point of use, having been paid for out of National Insurance.

  24. >Why are Brits so much more likely to write about Kuwaitis?

    Perhaps because they're so much more likely to write about Nottingham Forest?


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AmE = American English
BrE = British English
OED = Oxford English Dictionary (online)