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HomeNL-2018-04 Safety Minute

Safety Minute: The Runs on the Water
April 2018
by Harmon Everett

This isn’t a laughing matter. The CDC (Center for Disease Control) estimates that almost half a million children worldwide die from diarrhea every year. It is the second most common cause of death for children younger than 5. For all age groups, it was the NINTH LEADING cause of all deaths.

In the Vietnamese war, diarrhea exceeded malaria as the most common cause of hospitalization for US soldiers.

Historically, dysentery and diarrhea have been more fatal to armies than battles. David lamented in Psalms 22: “I am poured out like water, and all my bones are out of joint; my heart is like wax; it is melted in the midst of my bowels.” Haven’t we all been there.

According to findings in the Annals of Emergency Medicine (July 1992), "Viral syndromes and diarrhea account for 60 percent of the illnesses and 45 percent of the illness evacuations [from wilderness programs]."

Water and food contamination and lack of hand washing are the major means of contracting this result, and heaven knows that usually on a paddle, much of the water is not particularly sanitary, and normal sanitary handling of food and snacks are relaxed.

Whatever the cause or causes, the effect is loss of hydration and electrolytes. Sometimes diarrhea can cause the loss of up to 25 liters of water in 24 hours. Unless this water and electrolytes are replaced, loss of life can be imminent.

The most important treatment for this, is to replace the lost water. Diarrhea is a body’s response to some agent that it wants to get out of the body, and it is attempting to rid itself as fast and as efficiently as possible. Support it by replenishing the lost water. If you take Imodium or other anti-diarrheal drugs, it may relieve the symptoms, but make the problem worse and the effects longer lasting. It probably needs to be said to not use alcohol, caffeine, or fruit juices as the liquids to use to rehydrate. Use water. Water is good.

If the diarrhea has gone on for a while, add a pinch of salt and 8 teaspoons of sugar (less than a quarter of a cup) to each liter of water to help replenish lost nutrients. Some electrolyte supplements such as NUUNs, Lyteshow, Propel, or others are helpful. The use of plain salt tablets is discouraged, as it doesn’t replenish many of the other needed electrolytes and can overwhelm your body’s sodium processing.

If your stool is bloody, attempt to exit the trip as soon as possible, and find a doctor.

As with most other diseases, prevention is way better than treatment after you are sick.

Wash your hands. Wash your hands. Wash your hands. Especially after going to the bathroom, or using a cat hole. Properly dispose or contain human waste. And then wash your hands again. It doesn’t necessarily require an anti-bacteria soap. Plain soap and water is just as effective. Wash up away from water sources, rivers or lakes.

Filter and clean your drinking water. Oh, and boiling water is also good, and does NOT have to boil for 15 minutes (unlike I learned in the Boy Scouts). It only needs to come to a boil momentarily for it to be effective. Pasteurization actually only brings milk to a temperature of 162 degrees for 15 seconds to be effective.

A recent change in group behavior to control diarrhea while camping has been the move to NOT SHARE bagged snacks and GORP. If you do share your GORP or snacks, shake them out of YOUR bag into THEIR hands. Do not let them put their hands into your bag. There have been studies that indicate that many of the trail epidemics of diarrhea and stomach ailments have been much more correlated to occasions of sharing food among groups of campers, than can be correlated with drinking unfiltered water from lakes and streams. Hmmm. So, also, do not share cups, water bottles, or eating utensils.

So. Practice cleanliness while out paddling and camping. Clean up your waste and yourself after going to the bathroom. Keep washing your hands. Don’t share GORP or snacks unless you can do it cleanly.

And if you do get the runs while out paddling. Keep everything extra clean. And drink lots of water, with some electrolytes.

With proper care and lots of water, this too, shall pass.

References:
Backcountry Diarrhea: Treating The Runs
Buck Tilton, Backpacker Contributing Editor Sep 30, 1997
Travelers Diarrhea, By Charles D. Ericsson, Herbert L. duPont, Robert Steffen




The author, Harmon Everett