Rick Curtis
Princeton University Outdoor Action Program
We hope
that you had an exciting and enjoyable time in the wilderness
on your latest trip. After you've gotten a shower and washed
your clothes, there are a few important pieces of information
you need to be aware of. All outdoor travelers may come in
contact with things during the trip that can lead to illnesses
later on. Typically, the signs and symptoms of these illnesses
don't become apparent until after your trip is over, so it
is important that you be able to recognize them. Should you
experience some of the symptoms noted below after a wilderness
trip, see your physician and describe your symptoms. Be sure
to inform him or her about your backcountry trip since s/he
may not initially identify the proper cause of the disease
without knowing about your wilderness trip. Most of these
illnesses can be treated effectively using antibiotics, as
long as you go for treatment.
Giardiasis:
Giardiasis
refers to a syndrome of diarrhea, excess gas, and abdominal
cramping. It is caused by Giardia lamblia, a water-borne
parasite that is worldwide in distribution. The symptoms usually
occur one to two weeks after exposure to the parasite. Symptoms
initially include diarrhea, bloating, nausea, abdominal cramping,
and malaise. Weight loss is also a frequent finding. Backcountry
travelers usually contract giardiasis by drinking water from
untreated or improperly treated sources Chemical treatment
of the water and commercial water filtration systems, used
properly, eradicate the parasite. The diagnosis of giardiasis
can be confirmed by inspecting a stool sample for the presence
of the parasite. Because this test may not always identify
the organism even if it is present, a physician may elect
to treat you empirically for the infection. The use of an
appropriate antibiotic for seven days is usually highly effective
in relieving symptoms and curing the disease.
Cryptosporidium:
Cryptosporidium
is a protozoan that causes a diarrhea illness similar to
Giardia. Symptoms include watery diarrhea, headache, abdominal
cramps, nausea, vomiting, and low-grade fever that may appear
2 to 10 days after infection. Some infected people will be
asymptomatic. Currently, there is no effective treatment for
Cryptosporidium. Symptoms usually last 1 to 2 weeks,
at which time the body's immune system is able to stop the
infection. People with normal immune systems are generally
not at risk and improve without taking antibiotics or antiparasitic
medications. For people with compromised immune systems this
can be a dangerous disease. Please see your physician.
Cyclospora:
Cyclospora
is a recently discovered cause of diarrhea. It can cause a
prolonged illness (average 6 weeks) with profound fatigue,
loss of appetite, and intermittent diarrhea. Cyclospora can
be treated with antibiotics. If you develop these symptoms,
consult your physician.
Lyme
Disease:
Lyme
disease is an infection caused by a spiral shaped bacterium
called a spirochete. This bacterium is carried in the gut
of the deer tick Ixodes dammini. The tick becomes infected
after feeding on the blood of an infected animal. Once infected,
the tick can transmit the disease to its next host. Deer ticks
are extremely small, with tick nymphs being about the size
of the period at the end of this sentence. This means that
you may have been bitten without realizing it. The tick need
to feed for an extended period of time (8-12 hours) before
infection can occur. So just because you have found a tick
does not mean that you have been infected. It is also possible
that the tick was not carrying the disease.
Detecting
Lyme Disease can be difficult as the symptoms associated with
the early stages--fever, headache, stiffness, lethargy, and
a myriad of other mild complaints, are often dismissed as
the flu. In some cases (25%), there is a red, ring-like rash
that occurs at the site of the bite. The rash is often referred
to as a "bull's eye" rash because it has a white center surrounded
by a red ring. Most typically, the rash expands and then fades
within a few weeks after the bite. There is a blood test for
Lyme Disease, but it is not perfect. The test generally produces
positive results in the later stages of the disease but often
turns up false negative results in the early stages of infection.
Therefore, diagnosis in the early phase is frequently based
on symptoms and the likelihood of a deer tick bite. Early
detection means early treatment when the disease is most effectively
controlled with antibiotics. Lyme disease can result in more
serious symptoms if left untreated.
Rocky Mountain
Spotted Fever:
Rocky
Mountain Spotted Fever is carried by a bacterium and can be
transmitted by the bites of dog or wood ticks. Contrary to
what the name of the disease suggests, it can be found throughout
the U.S. Watch for mild chills, appetite loss, and a general
run-down feeling. These symptoms may worsen to sever chills,
fever, headaches, muscle and bone pain, and sensitivity to
light. Also, a spotty red rash may appear (hence the name)
usually starting at the wrists and ankles and spreading over
the rest of the body. Normal onset of these symptoms is anywhere
between 3 and 14 days, so anyone bitten by a tick should be
aware of the disease, as it may not present itself until the
trip is over. Untreated, the mortality rate is 20 to 30%.
Anyone who shows these signs should seek medical attention
as soon as possible.
The
information provided here is designed for educational use
only and is not a substitute for specific training or experience.
Princeton University and the author assume no liability for
any individual's use of or reliance upon any material contained
or referenced herein. When going into outdoors it is your
responsibility to have the proper knowledge, experience, and
equipment to travel safely. The material contained at the
Web Site may not be the most current. This material may b
freely distributed for nonprofit educational use. However,
if included in publications, written or electronic, attributions
must be made to the author. Commercial use of this material
is prohibited without express written permission from the
author. Copyright © 1997, all rights reserved, Rick Curtis,
Outdoor Action Program, Princeton University.
Disclaimer and Reproduction Information: Information in NASD
does not represent NIOSH policy. Information included in NASD
appears by permission of the author and/or copyright holder.
More
NASD Review: 04/2002
|