what do you use to clean water?

[chiefdaddy]

I can't bring myself to go one direction on this topic, what do you guys think is best?
dunno if I can afford the sweatwater filter cost and or the cost of the doctor once sick if I leave it home.... Bleach drops? Iodine? all of the above lol Just boil it? I am no newbie and this just bugs me, short trips are a whole other world even up to 2 weeks compaired to thru hiking and what to carry. I have met TOOOOOO MANY HIKERS WITH GIARDIA!!!!! UGH!!!

[Dr O]

I can't bring myself to go one direction on this topic, what do you guys think is best?
dunno if I can afford the sweatwater filter cost and or the cost of the doctor once sick if I leave it home.... Bleach drops? Iodine? all of the above lol Just boil it? I am no newbie and this just bugs me, short trips are a whole other world even up to 2 weeks compaired to thru hiking and what to carry. I have met TOOOOOO MANY HIKERS WITH GIARDIA!!!!! UGH!!!

Hmmm... sweat water shouldn't need filtering ;)

[chiefdaddy]

the sweatwater does not catch everything! and then there is the cost and weight of it. I like it and have had two over the past 12 years.

[Dr O]

I use chlorine, but don't completely trust it. If the water is cold and/or the PH is just slightly basic, it may not be effective. If I'm cooking, it gets boiled anyway, but drinking water I feel like I'm taking a chance. :eek:

[chiefdaddy]

yeah this is why I can't figure out what to do lol!!! heavy filter....or take a chance.... ugh

[refreeman]

The First Need Deluxe Portable Purifier, as the name states is a water purifier. Many other products are just water filters, removing only some of the contaminants in the water. However, The First Need Deluxe removes EVERYTHING, the water comes out 99.9% pure. the First Need Deluxe removes all the bacteria, viruses and chemicals.

Here is a link to the US Military’s analysis and comparison of water filter/purification products.
http://chppm-www.apgea.army.mil/wpd/CompareDevices.aspx

I've used the First Need Deluxe for years and love the taste of its purified water. It works perfectly. I also use Sigg bottles, a very healthy solution to water storage and transportation (no leeching into the beverage as Lexan does). Be sure to buy some neoprene covers for the Sigg bottles. They will keep your water cool longer and protect the bottles from being dented or scratched. Sigg charges to much for their neoprene, so have a look on eBay or go to a dollar store. eBay was the best place for a 1 liter neoprene cover for Sigg, about $4 shipped if you bought 3. Do an ebay search for - Neoprene BYO. BYO is the brand of Neoprene covers, actually made for wine bottles, but work perfectly for Sigg bottles.

[chiefdaddy]

that's great but seems too heavy! that is also an issue these knees and back are not getting any younger!

[Cannibal]

Have you looked at the SteriPen? They make a small version now that is pretty lightweight. I've been using the standard one for about a year now in Florida and have not had any problems. I even had to pull water from a canal; not pretty.

[Seeker]

Aqua Mira.

[Cuffs]

I started with AquaMira (for the weight savings) and after just a couple of weekend hikes switched to the heavier filter. The difference for me was having "instant" water versus "sit and wait" water... When youre thirsty, you'll want the instant water!

[Jack Tarlin]

Someone mentioned they've met too many hikers with Giardia....

I dunno where they've been travelling, but in around 13 years of long-distance backpacking on or near the A.T., the number of backpackers I've met who were diagnosed correctly and treated for Giardia can be counted on on hand.

There are plenty of folks every year on the Trail who have stomach or intestinal problems, or a day or two of the trots, or bad cramps, or whatever. 99% of them don't have Giardia. The giardia threat is greatly and ridiculously exaggerated. One has a better chance of getting sick from using poorly washed dishes in one's own home than one does from getting sick on the A.T.

Instead of obsessing about the water, here are 3 quick ways to stay healthy:

1. Clean or replace your water bottles, hydration bags, tubes, etc. regularly. It's amazing
how many people will hike for 6 months and NOT do this. Here's the news: Your
drinking water is most likely FINE. What you're carrying it in is diseased.
2. Clean your cook pots as often as possible with real soap and hot water. Wash and
replace pot scrubbies often, or don't use them at all. Most of the folks going nuts worry-
ing about giardia clean their cookpot with something that looks like it's been up
someone's ass.
3. Carry soap or hand sanitizer and use it after performing intimate personal functions.
The vast majority of gut illness on the Trail is due to poor personal hygeine and not bad
drinking water.

Oh, and don't be so quick to share food, or handfuls of gorp, or spoonfuls of food from someone's pot, or swigs from their water bottle. Think a minute about the nasty level of your OWN personal hygeine out there; I assure you, other people's is probably worse. Most of the people on the A.T. who have gotten "giardia" probably contracted it from reaching into a handful of their hiking partner's ass-besmirched peanuts or beef jerky rather than from ingesting bad water. The simple truth is that most of the water out there is just fine.

[shoe]

I am a filter girl. I use the Katadyn Hiker. A bit heavy I suppose but I don't like to wait for my water and I don't like floaties in my water. And when it is dry and all you have is a small trickle, it's earier to get water.

But, alot of times I don't use my filter. I just stick my cup under the water and take may chances. I have yet to get any of the nasties.

And I wholly agree with Jack. I don't share open food with other people, period.

[Appalachian Tater]

1. Clean or replace your water bottles, hydration bags, tubes, etc. regularly. It's amazing
how many people will hike for 6 months and NOT do this. Here's the news: Your
drinking water is most likely FINE. What you're carrying it in is diseased.

All of these things, plus any filter system components, need to be cleaned regularly and then soaked in a mild bleach solution.

[chiefdaddy]

haha best reply yet!!! I agree 100% and just to clear things up i have met 5 people or so that have gotten it in the past two years and that was too many for me. I learned from my vet that Dogs can get it also so I filtered all of Chief's water the last trip.....he still got sick the last day and I am sure it was from something else.

hey Jack what do you use? Like I said I have had a sweetwater for ever and I keep a few tabs of aqua just in case it breaks.

[hopefulhiker]

Aqua Mira, two or more bottles and a dipper is all I used...

[Jack Tarlin]

ChiefD: In recent years, I've used Polar Pure (i.e a simple iodine solution) or I drink my water straight.

I also make every attempt to use and drink tap water (i.e. from fountains, spigots, bathrooms, stores, etc.) If one makes an attempt to do this religiously, one can probably end up using tap water 10-15% of the whole Trail, greatly reducing your chances of gettting "bad" water." But really, there isn't a whole lot of bad water out there. Most of the problems come from filth, i.e. hand-to-mouth contamination, usually fecal. Yeah, I know that's yucky to say or read, but it's the truth. Wash your water bottles and your cook pots; don't scrub your pot with a piece of asswipe; keep people's filthy mitts away from your foor or drink, and be careful what you eat yourself. Most of all, try and wash your hands more than once a week, which is actually pretty high for a lot of thru hikers. The problem is NOT in the streams or springs.

[CoyoteWhips]

I am fine with iodine.

I also think that Purell is the greatest invention since wood matches. Got a little bottle hanging from the front of my shoulder strap.

[Mags]

Iodine tabs and hand sanitzier. I also use a bandana for floaties..

[brotheral]

Do you think Hoss and Little Joe filtered water b-4 filling their canteens on those awesome adventures they shared with us on Bonanza ????? Heck, they drank out of their hats !!!!!!!!!!!!!!!!!!

[prozac]

I have to agree with Jack on this one. The couple of times I've seen an outbreak of the dreaded G-funk it usually struck multiple hikers who had been traveling off and on together. Fiquring a couple of day incubation period I fiqure one person contracted something either in town or on the trail and infected his mates through personal contact before they even realize they are sick. I've met hikers who make little to no effort to practice even the most basic hygiene skills when it really doesn't take much effort. Some even wear their funk like a badge of honor. The worst part isn't even being sick, its the fact that even people you have just hiked for months with will treat you like a pariah. No one wants to jeopardize their hike by getting too close to a sick hiker. Giradia is the Boogey Man of the trail, all hype.

[elray]

Katadyn Hiker, hands down. Worth its weight in gold, dependable and fast. I usually section hike with a partner and one filter is very sufficient for the both of us. The hiker that carries the filter gets to lounge in the shelter while the non carrier makes the trek to the water source. Pretty good trade off. I've used this style of filter since it was introduced by the Pur company 10 years ago and hope it will always be available.

[Tennessee Viking]

I am using cheesecloth and coffee filters to get the dirt and mud out. I got my hands on some heavy duty grease filters, like coffee filters but more like cloth. Works wonders.

Then I am starting to use Aqua Mira. Everybody I know raves about it.

I tried Iodine tablets a couple times but it ended up being on he salty side. And after each sip, it seemed I was increasingly more thirsty.

[Dr O]

I tried Iodine tablets a couple times but it ended up being on he salty side. And after each sip, it seemed I was increasingly more thirsty.

Heh, same here. I believe the salty taste is only because we associate the taste of iodine with iodised tablesalt though, use of uniodised salt our whole lives probably wouldn't have left us with that association.

I haven't had iodised salt in years since I discovered the taste of Kosher salt. It'd be interesting to try iodine treated water now to see if that association is still there.

[CoyoteWhips]

I am using cheesecloth and coffee filters to get the dirt and mud out. I got my hands on some heavy duty grease filters, like coffee filters but more like cloth. Works wonders.

Paint strainer bags are good for that.

[Lone Wolf]

I have met TOOOOOO MANY HIKERS WITH GIARDIA!!!!! UGH!!!

really. i've hiked for 21 years on the AT and thousands of miles. never met one with G.

[Dr O]

really. i've hiked for 21 years on the AT and thousands of miles. never met one with G.

Maybe they've just kept it to themselves, like herpes :p

[Lone Wolf]

diagnosed geeardeea is very rare on the AT

[JAK]

I started with AquaMira (for the weight savings) and after just a couple of weekend hikes switched to the heavier filter. The difference for me was having "instant" water versus "sit and wait" water... When youre thirsty, you'll want the instant water!I use Aqua Mira. I never have to sit and wait, but perhaps that is only because I know where the water stops are where I hike. I mix the stuff before I hit the water stop, and start grabbing scraps for my Kelly Kettle along the way, a handful of birch bark off the ground and snap off a few spruce sticks. When I hit the water stop I dump my wedding bottle of mixed aqua mira into my water bottle or water bottles and make my tea and in less than 10 minutes of stopping I am off with a bottle full of tea and a bottle full of cold water with stuff in it. What goes into the Kelly Kettle probably doesn't need the aqua-mira as it goes to a full boil, so I don't worry about wait time on that one. If for some reason I don't want tea, or I come to the water stop my chance, I grab the water and just keep going, and start the mix at that point and have my stop later, perhaps the top of the next hill that always seems to follow water stops where I hike. I don't see the waiting. For me it seems way faster and less fuss than any of the more expensive rigs I've seen. I don't do it to save weight or money or time though. It's mostly the simplicity, but perhaps mostly just because that's the way I do it. It works for me. But I don't get any of the lame excuses people use for not doing it my way. ;)

[Dr O]

diagnosed geeardeea is very rare on the AT

I would imagine you're right. Most diagnosed cases probably happen near doctors.:p

The Journal of Family Medicine did a study in 1993 where 63% of AT hikers surveyed reported at least one incidence of diarhria. Few sought treatment.

[Lone Wolf]

diarhea ain't giardia

[Dr O]

diarhea ain't giardia

Nope, it's not, it's just a major cause of it.

[Lone Wolf]

Nope, it's not, it's just a major cause of it.

no. poor hygiene is.

[JAK]

Can you give yourself diarrhea? I'm guessing perhaps yes, I'm just not sure how. Is it that you might move certain bad bacteria that might always be present in some numbers from the latter stages of the large intestines up to the earlier stages of digestion where they might cause more trouble and have an opportunity to increase greatly in population, and perhaps at the expense of many good bacteria. Is that part of it, or close.

If so, what are the various bacteria that might always be present in some numbers in the latter stages of the large intestines that might give you serious trouble if re-injested?

[JAK]

Also, what are the most common mistakes regarding bad hygiene in the field? I hike solo, so I am less concerned than when I am around other people. I have sense when to wash my hands. If I think I've compromised my hands after relieving myself I first wash them with forest litter, then with water downstream. I don't carry soap when hiking solo. I do use lots of water. Usually in the morning I use hot water from my Kelly Kettle to wash my face and hands and pits before breakfast, and dishes after breakfast. The rest of me and my boxers and perhaps some other clothing might wait until closer to noon on a sunny day, which might get the hot water treatment after a good long swim or soak. Depends on how long the hike is, but even on a short hike I would like to do this at least once, if only for the fun if not the practice.

If I'm not mistaken though, when hiking solo in low traffic areas you are less likely to get sick in the field than you would be at home. Is this not so?

[JAK]

Thought I would bump this because I think L.Wolf raised an interesting point,
and I think I followed it up with an interesting question.

Can you give yourself diarrhea?

I don't mean by eating too much fruit, or from the environment, but from your own intestinal parasites? I'm not saying personal hygene isn't still important when you hike alone. I'm just curious what all the mechanisms might be. I might be wrong, but when alone in the woods in low traffic areas I think I can actually be less concerned than when I am in town and around other people. I view the woods as a cleaner place for people, because there are fewer people. I'm not saying I don't take precautions, I just think its important to understand all the mechanisms, and I see clean water and common sense as generally being sufficient when hiking alone in low traffic areas.

Still curious about the question, not that I intend to poop on my own hands or anything. Does anyone know the answer? I'm guessing we have most of these parasites all the time. It's just a matter of population and where they are in our system. Is that more or less true?

[SGT Rock]

Nope, it's not, it's just a major cause of it.

I doubt that. The literature I have read tends to tag this more on some viruses and a few germs. I'm going to use some simple logic. Most people get diarrhea take some tums and stuff and it goes away in a few days on it's own. Giardia is treated with Flagyl for 5-10 days to kill it. Since most diarrhea sufferers on the trail never take this drug, and it goes away that quickly, then chances are it is not a major cause of it.

Giadria on the AT is a bogeyman to sell filters. The largest outbreaks of disease that could be traced to a cause was a Hep A outbreak. Filters do not stop Hep A - hand washing and chemical treatments do.

[JAK]

I wonder if part of the reason that people show diarrhea symptoms, either from giardia or some other cause, is because they might be so very run down at that point in their thru-hike. Sometimes being run down can go hand in hand with poor hygene, but I'm more likely to think they might show symptoms even if they practice the same good hygene and come into contact with various things at normal rates. So maybe it has more to do with a state of weight loss and fatigue and overtraining. If so, then perhaps another reason to pump up the personal hygene and water treatment once you start getting run down, and of course stay as healthy as possible throughout the hike especially towards the end, and know when to conserve your energy like when your feeling less than great or bad weather is closing in. I'm not suggesting water treatment is less neccessary. I'm really saying it is not the only thing, If anything I'm saying you might need to pump water treatment and personal hygene up when your feeling down. Full boil along with usual treatment. That sort of thing.

Where do most people think most people get diarrhea from on the AT?
- from inadequate water treatment ?
- from contact with other people on the trail ?
- from contact with other people in the towns ?
- from dogs on or near trails, licking face etc. ?
- from some foods, such as fresh produce ?
- from one self, and insufficient personal hygene ?
- from some or all of above plus being run down after many days/miles?

Is it really any more or less common when hiking than in the general population?

[JAK]

I agree with the Rock that there is too much hype and not enough honest information and common sense.

[Lone Wolf]

stay out of shelters, hostels and other places where hikers pack in and risks go way down

[Footslogger]

Plus ...many "reported" cases of giardiasis infection are NOT confirmed by lab tests. They are inferred from symptoms. Not all labs across the country are set up to test "definitively" for Giardiasis. In the absence of a definitive diagnosis, many medical practioners simply prescribe the Metronidazole (http://www.emedicinehealth.com/script/main/art.asp?articlekey=751) (Flagyl).

A lot of people who travel a lot and have altered diets and water/fluid intake end up with gastrointestinal distress.

Not suggesting that giardiasis isn't a problem. Just that it is sometimes over-reported and not clinically confirmed. The definitive tests for Giardiasis infection are expensive and time consuming to run.

Carry chewable Peptobismal tablets and if you start to experience gastrointestinal symptoms start chewing a couple a day. Your stool will temporarily turn a dark/black color but in many cases this will effectively treat the symptoms and shorten the course/cause of the distress.

'Slogger

[weary]

I can't bring myself to go one direction on this topic, what do you guys think is best?
dunno if I can afford the sweatwater filter cost and or the cost of the doctor once sick if I leave it home.... Bleach drops? Iodine? all of the above lol Just boil it? I am no newbie and this just bugs me, short trips are a whole other world even up to 2 weeks compaired to thru hiking and what to carry. I have met TOOOOOO MANY HIKERS WITH GIARDIA!!!!! UGH!!!
I usually just leave dirty water where I find it. I only drink the clean cold water I find along trails. If trail water looks a bit questionable, however, I fire up my Zip Stove and boil it.

[SGT Rock]

Carry chewable Peptobismal tablets and if you start to experience gastrointestinal symptoms start chewing a couple a day. Your stool will temporarily turn a dark/black color but in many cases this will effectively treat the symptoms and shorten the course/cause of the distress.

'Slogger
Your tongue will also turn black.

[JAK]

Even online medical information like this, while it might not be to sell filters, is it really of any practical use? What does it really tell us? Nothing really. Academic research often has a bent to it also, or it might be just as shallow or pointless as the online medical information, even if it is published and peer reviewed. I'm not saying their cheating. I'm just saying the bar isn't always raised all that high.

Here is a very good article on giardia
www.brianjford.com/Giardia-14-06.pdf

It was written by a Brian D. Ford.
www.brianjford.com

What I like about it is that it is current, but it also covers the history, and the dude and the article seems way to preoccuppied with microscopes and history and other interesting stuff to get too caught up in selling filters or anything like that.

What I picked up from the article is that it seems to be pretty darned common, even here in the developed world, not just in the woods. It is less common due to water treatment, though still common. As a side effect of this when we do get its symptoms can be more severe.

My point is sure, you drink out of a place like a beaver pond you are likely to get beaver fever, so try and get better water and treat it with something or boil it, but its all around us all the time, not just in the woods. Generally speaking, the woods are cleaner than most places. We should stop using expensive products like filters and UV crap to maintain this mythical bubble around civilization, when common sense and cheaper methods are often better. Generally speaking, civilization is a dirty place because it has higher population densities. Get away from it when you can, and don't take too much of it with you.

[Footslogger]

Your tongue will also turn black.

===================================

Rock ...that's a different disease all together.

Just kiddin. Yeah more than 2 - 3 tabs a day will tend to darken the tongue surface.

'Slogger

[JAK]

Meant to say...

Even online medical information like this...
http://www.cdc.gov/Ncidod/dpd/parasites/giardiasis/factsht_giardia.htm
... while it might not be to sell filters, is it really of any practical use?

It's one of the better ones, but does it teach us anything?

How many people have it in their systems now but are not showing symptoms.
That's what I would like to know.

From something like that we might get a better feel for what the real mechanisms are for people getting sick when backpacking, or at home, or at work, and what the most practical means are for staying healthy. We should not be trying to stop every cyst from entering our mythical bubbles. We should simply adopt a practical layered defense, based largely on knowledge and healthy practices and less on expensive consumer products and medical cures.

[weary]

....The definitive tests for Giardiasis infection are expensive and time consuming to run......
The last time I checked, there was no "definitive" test. If they find the Giardia cysts, you have the disease or are a carrier of the disease and can infect others. But the cysts are hard to find and easily missed.

However, it is truly a rare disease. and even rarer is trailside water the cause.

Weary

[JAK]

Does anyone have any figures on that? How many North Americans are carrying the giardia cysts in there systems at any given moment, but are not showing symptoms for one reason or another?

[JAK]

The last time I checked, there was no "definitive" test. If they find the Giardia cysts, you have the disease or are a carrier of the disease and can infect others. But the cysts are hard to find and easily missed.

However, it is truly a rare disease. and even rarer is trailside water the cause.

WearyOr perhaps it is extremely common. Perhaps it is only relativelty rare to find in large enough concentrations to be easy to detect. In situations were fecal matter is recycled, like beaver ponds, and day cares, then the populations might build up and make people sick. Is that not more likely?

[Footslogger]

[quote=JAK;399222]

How many people have it in their systems now but are not showing symptoms.
That's what I would like to know.

======================================

...and THAT's the $64,000,000 question !!

"Tolerance" to bacteria, especially gastrointestinal ones, is all over the map. People without symptoms aren't very likely to show up and have their stool tested for the presence of Giardia.

In general though, if over your life you've had what some call a "sensitive system" then you are more likely to show symptoms earlier than those with the so-called "cast iron stomachs". But not all gastrointestinal distress encountered during or after time in the woods is giardia related.

Case in point. I have a fairly sturdy GI system but about 4 - 6 weeks after coming home from hiking the 100 mile wilderness in 2001 with my wife I had all the "classic symptoms" of giardiasis infection. Went to the doctor for diagnosis and relief. Based on my symtoms and history he immediately placed me on a course of Flagyl. After the first dosing of the antibiotic the symptoms persisted and he placed me on yet a second dose of that vile medicine - - NO HELP. When all was said and done, my symptoms turned out to be transferred pain with accompanying cramping and nausea from renal colic, secondary to kidney stone disease.

Chew the Pepto !!

'Slogger

[JAK]

From Brian Ford's Paper on the discovery of giardia:
http://64.233.169.104/search?q=cache:w0UIaNhS6mgJ:www.brianjford.com/Giardia-14-06.pdf+brian+j+ford+giardia&hl=en&ct=clnk&cd=1

"Giardia is the most commonly detected intestinal protozoanparasite in the world, and the prevalence of giardiasis in developing countries is approximately 20% compared to about 5% in the developed world (3) Between100,000 to 2.5 million Giardia infections occur annually in the United States (4)"

What does he mean by prevalence of 5%? Does that mean 5% of of have it, or 5% of us get it every year, whether we know it or not. My guess is the latter, but that is still very common. That is not rare.

Here are those references that Brian Ford used above:
3. WHO, 2002, Protozoan parasites(Cryptosporidium, Giardia, Cyclospora). Addendum: Micro-biological agents in drinking water, 2ndedition.
4. Furness, B.W., Beach, M.J. & Roberts, J.M., 2000,Giardiasis Surveillance - United States, 1992 - 1997.Morbidity & Mortality Weekly Report, 49 (SS07): 1-13.

[The Old Fhart]

It basically comes down to this: is the unprotected water you find and drink while on the trail less safe than tap water and how much of a risk taker are you? The obvious answer is untreated and unprotected sources are less safe but how unsafe are they? The chances of having a problem from drinking unprotected water go up as the frequency of drinking water from random sources increases. As Dirty Harry says: "you've got to ask yourself a question: 'Do I feel lucky?' Well, do ya, punk?":-?

I always get a chuckle when I hear someone make the claim that they only drink from ‘clear’ sources. You can dissolve large amounts of sugar, acid, poison, or Metamucil in water and it can still be clear. Also I have yet to meet a person whose eyesight is keen enough to see the microbes that can cause you so much grief. Clarity of the water is not an indication of purity.

This doesn’t mean that you will get giardia lamblia (http://www.cfsan.fda.gov/~mow/chap22.html) (check out this reference if you think giardia is rare) by drinking untreated water but it does mean your chances go up. What you want to do is a risk-cost analysis before you make a decision to treat or not. Although the chances are small that you might get giardia, the consequences are great and could abruptly end your thru hike. Some people can be carriers of the parasite and show no effects (Lone Wolf? ;) ), just like some people are not prone to get poison ivy while others seem to get it if they just walk close to it.

Whether the water source if covered or piped doesn’t mean that it is ‘pure.’ I remember on my thru hike in 1998 getting to a pump by a ball field near the edge of a town and there was a warning posted on the pump that the water had been tested and was contaminated with giardia. One woman I met on the trail in 2000 didn’t treat her water and reportedly caught giardia twice, it can happen.

Soap and water, Purell, and good hygiene will go a long way to making sure you stay healthy on the trail but an attitude that “it won’t happen to me” doesn’t do squat if you aren’t careful with how you treat yourself and the water you drink.

One problem that filter users have is they are very careless with storing their pump, filter, and hoses. I have seen many wind the inlet and output hoses together after filtering water thereby creating the chance of cross-contamination. In the 1980s I used iodine and was careful to invert my water bottle with the treated water inside and let some of it leak out over the threads and the cap to make sure they were treated as well. Since then I have used a pump and when I had one with two hoses I would store the output hose separately in a ziplock bag as well as flush some filtered water through it before I sent any of the filtered water to my water bottle. I also gave the bottles a good cleaning every so often.

I have never got sick from water while hiking and have treated water for about 30 years. There is a possibility that I might have survived just as well without treating all that water but I don’t see treating as wasted weight and effort. The peace of mind I get from treating makes it worth it for me. YMMV.

[JAK]

Slogger,
Interesting story. Even a medical diagnosis is no proof.

But then why was it so easy for Antony vanLeeuwenhoek to find these little guys in his own diarrhea under a microscope back in 1681?

[Footslogger]

[quote=JAK;399232]

What does he mean by prevalence of 5%? Does that mean 5% of of have it, or 5% of us get it every year, whether we know it or not. My guess is the latter, but that is still very common. That is not rare.

======================================

Epidemiologists use 2 terms to predict disease: Prevalence and Incidence

The "prevalence" of a condition means the number of people who currently have the condition

The "incidence" refers to the annual number of people who have a case of the condition.

'Slogger

[jaiden]

REI has the Katadyn Hiker on sale for $39.99 and the Steri Pen for $79.99.

Other thoughts:
Sure everyone has ideas about giardia, but E. Coli is potentially fatal and probably carried in most of our butts. Salmonella is nasty too. As stated before, hygene is generally reported to be the cause of most bacterial problems.

Please don't wash your hands in a stream... Carry water away from the stream and wash hands there. We don't need your butt germs or soap downstream either!

[JAK]

Old Ffart,
I'm not suggesting we don't need to treat our water. Read the thread.

I'm suggesting that staying healthy on the trail is about more than just preventing every single cyst from contaminating the purity and essence of our natural... fluids.

As I see it these cysts are everywhere. A better way to think of it is to keep their numbers down by a practical layered defense, based on knowledge and common sense. This includes:
1) Staying in good general health while hiking.
2) Good hygene. Extreme measures when neccessary, but not neccessarily exteme measures.
3) Clean water. Extreme measures when neccessary, but not neccessarily exteme measures.

People need a layered defense. There is too much focus on the last items, and too much of a myth that these cysts are rare but deadly. Such fear might promote water filters, but it doesn't promote a more common sense knowledge based approach, which is far more effective.

[JAK]

REI has the Katadyn Hiker on sale for $39.99 and the Steri Pen for $79.99.

Other thoughts:
Sure everyone has ideas about giardia, but E. Coli is potentially fatal and probably carried in most of our butts. Salmonella is nasty too. As stated before, hygene is generally reported to be the cause of most bacterial problems.

Please don't wash your hands in a stream... Carry water away from the stream and wash hands there. We don't need your butt germs or soap downstream either!Please don't wash your hands in a stream. Give me a break. Depends on the stream. On the crowded AT maybe, but on the Fundy Footpath I will wash my hands and face in the same water I swim in. Soap. I don't use soap. Soap is generally unneccessary.

If you are asking my were I wipe my butt, and what I do with my hands after that's a different matter entirely. I don't do that near a stream. I do that in the woods. I don't use toilet paper either. If I happen to contaminate my hands I deal with it. This is mostly common sense based on knowledge. It's not supposed to be some sort of voodoo.

The solution to polution is dilution.

[The Old Fhart]

JAK-"Old Ffart, I'm not suggesting we don't need to treat our water. Read the thread."Read it. I never said you suggested anything and my post wasn't directed at you or anyone in particular. Your post#55 'suggests' almost exactly what I said though.:D

[JAK]

[quote=JAK;399232]

What does he mean by prevalence of 5%? Does that mean 5% of of have it, or 5% of us get it every year, whether we know it or not. My guess is the latter, but that is still very common. That is not rare.

======================================

Epidemiologists use 2 terms to predict disease: Prevalence and Incidence

The "prevalence" of a condition means the number of people who currently have the condition

The "incidence" refers to the annual number of people who have a case of the condition.

'SloggerSo perhaps 5% in develop countries include some not so developed countries. He also quoted 100,000 to 2.5 million Americans every year, that is about 0.04% to 1%. I am not sure if that is having diarrhea from giardia, or having giardia without neccessarily having the symptoms. I would guess the former. I'll check his references.

Still seems a lot more common in every day life than those that sell filters would have us believe.

[Footslogger]

[quote=JAK;399255][I am not sure if that is having diarrhea from giardia, or having giardia without neccessarily having the symptoms.

=============================================

Doubtful the data would be stratified at that level, since the number reported is most likely an extrapolation/estimate from a smaller sample.

'Slogger

[Lone Wolf]

JAK. why are you so obsessed with water quality? either filter/treat or don't. the only thing about water on the trail i worry about is availability. very few hikers ever get sick from water sources

[JAK]

Read it. I never said you suggested anything and my post wasn't directed at you or anyone in particular. Your post#55 'suggests' almost exactly what I said though.:DNot really. OK. I admit I only read the first half of your post, but I think it is still a different point. I'm saying we focus too much on trying to prevent every cyst based on fear, rather than a more appropriate and practical layered defence based on knowledge. I am no expert, but I would guess a lot of people get sick because they are run down, just as in everyday life, not just because of issues relating to hygene or water treatment. Sure on a crowded AT you might be more likely to get it than at home, but I would argue that off the beaten trail, if you remain healthy you are more likely to get it at home. People are the problem, not the woods. Sure I still treat my water and wipe my butt, and take extra precautions like a good long boil if I have to drink out of a beaver's bath water, but generally speaking people are the problem, not the woods. Staying healthy while hiking is a very big part of it, and often goes understated because water treatment sells filters. Sorry I flew of on you though. Nothing you said was wrong. I just had trouble making my point.

My point is we should try to learn the real science, not the rules.

[JAK]

JAK. why are you so obsessed with water quality? either filter/treat or don't. the only thing about water on the trail i worry about is availability. very few hikers ever get sick from water sourcesOK Wolf your just dicking with me. :)

I'm not obsessed with water quality. I'm obsessed with science, and nature.
I don't use filters, other than a sock maybe. I use aqua-mira and a Kelly Kettle.

When deciding how to deal with water, or with people, I first consider the source.
Most always the water is cleaner. It's the people that make you sick. ;)

[The Old Fhart]

JAK post#55-"I'm not suggesting we don't need to treat our water. Read the thread."
JAK-post#61-"OK. I admit I only read the first half of your post...."

:D :D now this is funny stuff!!
I think comprehension is part of the problem. If you read my post you will see that the link I included gives a very detailed description of the risks of giardia and how common it might be. What I'm suggesting is that people make up their own minds based on an good information which I feel I've presented. If some people don't want to treat, fine, I cant force them nor do I want to. I just might not be too sympathetic if they have a problem and fall a little behind.:eek:

[SGT Rock]

Water treatement systems are all faith based anyway.

[Lone Wolf]

Water treatement systems are all faith based anyway.

no s chitt there. excuse the funny.

[Footslogger]

Water treatement systems are all faith based anyway.

===================================

Is that where the term "Holy Water" comes from ??

'Slogger

[JAK]

===================================

Is that where the term "Holy Water" comes from ??

'SloggerGood one. Pretty much the same thing eh.

I still say that staying healthy is the first step towards avoiding diarrhea.
You see all these people with diarrhea, they all have one thing in common.
They are all sick.

[The Old Fhart]

SGT Rock-"Water treatement systems are all faith based anyway."Not really, unless your 'faith' is science.;) I'd also wager you've probably seen a few water buffalo (M149A2) in the past few years. One of the first things done when there is a natural disaster is to rush clean water or treatment plants into the area to prevent an epidemic. Treating the suspect water on the A.T. is no different. I remember heading north out of Pearisburg in 2001 and needed water. There is a sign near a nasty looking little stream about 1 mile north that says don't even think about using this water so I was going to get some about 3 miles north. For some reason I didn't feel good about getting it there and when I walked about a tenth of a mile further upstream I found the well decayed carcass of a large animal right in the stream. I'm Glad I waited!

[The Old Fhart]

JAK-"You see all these people with diarrhea, they all have one thing in common.
They are all sick."

:-? I have yet to see a healthy person with diarrhea-TOF;)
I never saw 'many' people that were sick on the A.T. but I'm sure there were a few. 1998 was a drought year and very hot and I did see one person have to take a day off to recover from heat exhaustion. There were lots of complaints about the lack of water from Waynesboro to Vermont.

[JAK]

So how did you know not to go even further upstream?

[JAK]

Glad to see you appreciated my attempt at humour.

[SGT Rock]

Not really, unless your 'faith' is science.;) I'd also wager you've probably seen a few water buffalo (M149A2) in the past few years. One of the first things done when there is a natural disaster is to rush clean water or treatment plants into the area to prevent an epidemic. Treating the suspect water on the A.T. is no different. I remember heading north out of Pearisburg in 2001 and needed water. There is a sign near a nasty looking little stream about 1 mile north that says don't even think about using this water so I was going to get some about 3 miles north. For some reason I didn't feel good about getting it there and when I walked about a tenth of a mile further upstream I found the well decayed carcass of a large animal right in the stream. I'm Glad I waited!
Here is what I mean:

Belief in something without proof is faith.

There isn't any proof that there is guiardia all over the trail. There is proof about what does and doesn't kill that bug or stop it. But that doesn't mean you are ever going to get it if you don't follow the regime you choose. Think about it.

People filter, and still get sick. They decide it is something else like food poisoning or poor hygine. It could be very possible that if there was giardia, they cross contaminated the filter system, had a cruddy filter, or their model of filter really doesn't protect. Factis the research shows filter users get sick at the same rate as other people that do not filter. BUT they can quote you chapter and verse why their method is the best vs. Giardia.

People that treat still get sick. They decide it is probably something else as well. It could be they didn't follow the regiment right and the cooties (scientifc term) survived the chemicals. But research shows they get sick at about the same rate as filter users.

People that don't treat or don't filter still get sick too. It may or may not be giardia. They get over it and finish hikes too, usually without needing flagyl - but doctors will probably give it to them (or the filter or chemical treaters too) just to be safe even if they do not detect giardia cysts in them. And, the research for trail use, shows they get sick at the same rate as the other two groups.

Now, in these cases no one can prove their system actually works best to prevent them from getting sick because the truth is - everyone (including those folks sitting in their studies bangging away at the computer on this thread) gets stomach bugs without having to get giardia. Getting sick is not the same as getting giardia. If everyone gets sick anyway without it being giardia, then how do you know that the regime you follow is doing anything other than making a gear company some money?

So the person that buys a filter places faith in the science that says there are bugs out there trying to get you and the filter protects you.

The person that uses chemicals has placed faith in the fact that there isn't a bunch of giardia out there, but other bugs instead. And that their chemicals are just enough to prevent either.

And the person that doesn't treat or filter has placed faith on the fact that the water is probably safer than city water and even if there is something in it, the human immune system will most likely handel it.

Any way you slice it - it is faith. Hard to convince someone of "faith" they could be wrong.

[JAK]

I found this article from McGill University to very informative.
http://www.medicine.mcgill.ca/tropmed/txt/lecture1%20intest%20protozoa.htm

Giardia lamblia
Subphylum: Mastigophora

Biology:
- occurs as both a flagellated trophozoite and a non-flagellated cyst form
- trophozoite (9-21 µm long), motile, with 8 long flagella, ventral sucker which attaches to duodenal mucosa; lives only in small intestine; non invasive.
- cyst (8-12 µm); resistant to external environment, to municipal chlorination; intermittently expelled in stool.

Epidemiology:
- faecal oral spread
- prevalence about 3-5% in Canada; increased in some travelers, backpackers, institutions, day cares and any groups with increased fecal-oral spread.
- zoonosis - found in most mammals; esp. beaver, cattle, cats, dogs, etc.

Pathogenesis: - mechanism unknown; toxin? host immunity?

Clinical:
- 90% of infected are asymptomatic carriers
- acute giardiasis includes diarrhea, gas, anorexia for 1-2 weeks
- chronic giardiasis - diarrhea, malabsorption

Diagnosis:
- stool examination
- duodenal fluid (aspirate or string test)
- giardia antigen detection in stool

Treatment: - metronidazole, atabrine.

-------------------------------------------------------------------------------------
MOST IMPORTANT POINTS
- prevalence about 3-5% in Canada; increased in some travelers, backpackers, institutions, day cares and any groups with increased fecal-oral spread.
- zoonosis - found in most mammals; esp. beaver, cattle, cats, dogs, etc.
- 90% of infected are asymptomatic carriers

http://en.wikipedia.org/wiki/Prevalence
In epidemiology, the prevalence of a disease in a statistical population is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population.

[JAK]

So MANY, like 5% of hikers at any given moment, are already carrying it !
90% of these might not ever show any symptoms from it.

"Prevalence about 3-5% in Canada; increased in some travelers, backpackers, institutions, day cares and any groups with increased fecal-oral spread."
"90% of infected are asymptomatic carriers"

It goes up somewhat amongst backpackers as well as other groups, but on a trail like the AT you are probably just as likely to get it from another human, or are already carrying it, than you are to get it from animal. Should you treat you water when you out in the woods. Yes of course, but that's mostly because of the people in the woods. Also, for preventing diarrhea symptoms its probably just as important if not more important to maintain your general health and condition on the trail as it is to treat your water and maintain good personal hygene, and all of this becomes most important in high traffic areas. The problem is primarily one of human related population density and we should think of it that way and treat it that way.

So we should educate ourselves and do our part to remain reasonably healthy and not affect others. But we shouldn't perpetuate this myth that we need to buy products to maintain this healthy separation between ourselves and nature. The problem is quite literally within us already, but keep things in their proper perspective. We are the primary source of this problem, and it is a relatively minor one.

Stay healthy so you won't get sick.
Treat water, especially when around humans.
Wash hands, especially when around humans.
Minimize the spread of human fecal waste.

[JAK]

"Do I look all rancid and clotted? You look at me, Jack. Eh? Look, eh? And I drink a lot of water, you know. I'm what you might call a water man, Jack - that's what I am. And I can swear to you, my boy, swear to you, that there's nothing wrong with my bodily fluids. Not a thing, Jackie."
- Group Capt. Lionel Mandrake

[Lone Wolf]

******* packsniffers:cool:

[Dr O]

I doubt that. The literature I have read tends to tag this more on some viruses and a few germs. I'm going to use some simple logic. Most people get diarrhea take some tums and stuff and it goes away in a few days on it's own. Giardia is treated with Flagyl for 5-10 days to kill it. Since most diarrhea sufferers on the trail never take this drug, and it goes away that quickly, then chances are it is not a major cause of it.

Giadria on the AT is a bogeyman to sell filters. The largest outbreaks of disease that could be traced to a cause was a Hep A outbreak. Filters do not stop Hep A - hand washing and chemical treatments do.

http://www.wrongdiagnosis.com/g/giardia/prevalence.htm

The overall incidence of infection in the United States is estimated at 2% of the population. Giardiasis is the most frequent cause of non-bacterial diarrhea in North America. (Source: FDA Bad Bug Book)

[Appalachian Tater]

Epidemiology:
- faecal oral spread


That's the key right there. If hikers would wash their hands and use alcohol gel after using the bathroom and before eating, 90% of the GI problems on the trail would be avoided.

[JAK]

http://www.wrongdiagnosis.com/g/giardia/prevalence.htm

The overall incidence of infection in the United States is estimated at 2% of the population. Giardiasis is the most frequent cause of non-bacterial diarrhea in North America. (Source: FDA Bad Bug Book)So what the heck does that mean?

I've seen higher figures of a 3-5% prevalence by the way. That means people up to 1 in 20 people reading this forum have giardia in their guts as we speak.

So what the heck does that mean?

That means we get giardia in our every days lives, from a variety of sources, including perhaps filtered town water and treated town water, but also from people, pets, even from ourselves. We don't just get giardia while backpacking.

So what the heck does that mean?

That means we should treat our water; along with other things like being potty trained and washing our hands; and maintaining a robust state of health through healthy diet, exercise, and recover. We shouldn't just assume someone that gets giardia while backpacking didn't filter their water properly, or that filters or aqua-mira or whatever else is the only way to go.

It's not about the gear you see. It's really about the bugs.
That's what that means.

[Lone Wolf]

So what the heck does that mean?

I've seen higher figures of a 3-5% prevalence by the way. That means people up to 1 in 20 people reading this forum have giardia in their guts as we speak.

So what the heck does that mean?

That means we get giardia in our every days lives, from a variety of sources, including perhaps filtered town water and treated town water, but also from people, pets, even from ourselves. We don't just get giardia while backpacking.

So what the heck does that mean?

That means we should treat our water; along with other things like being potty trained and washing our hands; and maintaining a robust state of health through healthy diet, exercise, and recover. We shouldn't just assume someone that gets giardia while backpacking didn't filter their water properly, or that filters or aqua-mira or whatever else is the only way to go.

It's not about the gear you see. It's really about the bugs.
That's what that means.

you is whacked. no ifs, ands, or buts, certifiable. you've truly gone fishing. :banana

[JAK]

That's the key right there. If hikers would wash their hands and use alcohol gel after using the bathroom and before eating, 90% of the GI problems on the trail would be avoided.Yes, but alcohol gel can be overdone and should not be used all the time for other reasons. We should carry it and use it when neccessary, which is not neccessarily every time we go to the bathroom or before we eat. We should take extra precautions around other people, or if we are vulnerable to becoming sick, or if there is not much clean water available for washing. Of course if we get fecal matter on our hands that would be a good time also. You develop a sense for these things, but when you get too compulsive about such things that can introduce problems of its own. The bugs are with us. The goal is not to eliminate prevalence, but only to reduce prevalence and degree of exposure and the severity symptoms when they occur. Ideally the first step is learning more about the bugs, not about the products. I suggest recognizing that we are neccessarily a part of nature, not neccessarily apart from it. We should focus more on reducing our impact on nature, not the other way around. The things we do might still be the same, but the degree to which we do them, and when and where we do them, might be done in better balance with a little more knowlege and interest in the real science of nature, and a little less interest and faith in the marketing of consumer products and services.

[JAK]

you is whacked. no ifs, ands, or buts, certifiable. you've truly gone fishing. :bananaYeah, but at least I've learned something today that makes better sense.

[The Old Fhart]

Originally Posted by Dr O View Post
http://www.wrongdiagnosis.com/g/giardia/prevalence.htm

The overall incidence of infection in the United States is estimated at 2% of the population. Giardiasis is the most frequent cause of non-bacterial diarrhea in North America. (Source: FDA Bad Bug Book)
JAK post#79-"So what the heck does that mean?"

If you had even taken the time to read any of the previous post (like I already told you to) before typing some off-the-wall reply you would have seen I said way back in post#51-"This doesn’t mean that you will get giardia lamblia (http://www.cfsan.fda.gov/~mow/chap22.html) (check out this reference if you think giardia is rare)......"

My post#51 had the reference link to the USFDA "Bad Bug Book" that Dr O also referenced. If you had made any effort to read the posts instead of just trolling, this information wouldn't be a complete surprise to you. All the info you would need is in that reference-read it.

[JAK]

Well nobody seems to be listening to anybody, but perhaps we are all learning something.

[Lone Wolf]

Yeah, but at least I've learned something today that makes better sense.

wrong. i've learned. you've preached. not successfully either. they bitin'?

[JAK]

wrong. i've learned. you've preached. not successfully either. they bitin'?Matter of perspective. I'm not preaching. I'm learning. And trying to throw stuff out there. It just comes across as preaching. Perhaps your doing the same, but how would I know what your saying any more than you me. they bitin'? I don't really care who's bitin'. I'm learning and talking to myself and that's all I really care about anyway.

[JAK]

I sure as heck ain't marketing. That's for damn sure.

[hopefulhiker]

Just antecdotal but out of the hundreds of hikers I met in 05, I only heard of one getting Giardia, and it might not even been Giardia..... I admit that I did not treat sometimes.. the water just tasted soo.ooo...good.

[Lone Wolf]

Matter of perspective. I'm not preaching. I'm learning. And trying to throw stuff out there. It just comes across as preaching. Perhaps your doing the same, but how would I know what your saying any more than you me. they bitin'? I don't really care who's bitin'. I'm learning and talking to myself and that's all I really care about anyway.

thought so

[JAK]

Problem with that?

[JAK]

So when cases of diarrhea do occur, in the field, how much do you think is due to insufficient water treatment, how much do you think is due to insufficient hygene, and how much do you think is due to being generally run down and sufficiently vulnerable?

Or is it most likely most often a combination of all three?

[The Old Fhart]

Problem with that?You're just wasting bandwidth. If, as you say, you're "talking to myself ", do it where others can't hear.:rolleyes:

Where is that ignore button??:D

[Lone Wolf]

Problem with that?

go to bed kid. we're way off topic. fd will delete this in he a.m.

[JAK]

Ah the heck with it.
Hike your own hike.

[Lone Wolf]

Ah the heck with it.
Hike your own hike.

and don't be a weenie. treat all water like it's good.

[SGT Rock]

http://www.wrongdiagnosis.com/g/giardia/prevalence.htm

The overall incidence of infection in the United States is estimated at 2% of the population. Giardiasis is the most frequent cause of non-bacterial diarrhea in North America. (Source: FDA Bad Bug Book)

That same source you cited also says:


Giardia is listed as a "rare disease (http://www.wrongdiagnosis.com/medical/rare_disease.htm)" by the Office of Rare Diseases (ORD) of the National Institutes of Health (NIH). This means that Giardia, or a subtype of Giardia, affects less than 200,000 people in the US population

So I have a very very good chance of not getting it according to your citation. But wait, there is more. I can check other citations such as this one from the same site:



Causes: Diarrhea: Causes include viral, bacterial, or parasitic infections; food intolerance; reactions to medicine; intestinal diseases; and functional bowel disorders. (Source: excerpt from Diarrhea: NIDDK (http://www.wrongdiagnosis.com/artic/diarrhea_niddk.htm))
Article excerpts about the causes of Diarrhea:
Diarrhea may be caused by a temporary problem, like an infection, or a chronic problem, like an intestinal disease. A few of the more common causes of diarrhea are
Bacterial infections. Several types of bacteria, consumed through contaminated food or water, can cause diarrhea. Common culprits include Campylobacter, Salmonella, Shigella, and Escherichia coli.
Viral infections. Many viruses cause diarrhea, including rotavirus, Norwalk virus, cytomegalovirus, herpes simplex virus, and viral hepatitis.
Food intolerances. Some people are unable to digest a component of food, such as lactose, the sugar found in milk.
Parasites. Parasites can enter the body through food or water and settle in the digestive system. Parasites that cause diarrhea include Giardia lamblia, Entamoeba histolytica, and Cryptosporidium.
Reaction to medicines, such as antibiotics, blood pressure medications, and antacids containing magnesium.
Intestinal diseases, like inflammatory bowel disease or celiac disease.
Functional bowel disorders, such as irritable bowel syndrome, in which the intestines do not work normally. or this one from the Mayo clinc (http://www.mayoclinic.com/health/diarrhea/DS00292/DSECTION=3)



The most common causes of diarrhea include:
<LI class=doublespace>Viruses. Common viruses that cause diarrhea are the Norwalk virus, cytomegalovirus, viral hepatitis and the herpes simplex virus. Rotavirus is the most common cause of acute childhood diarrhea. Viral diarrhea spreads easily.
Bacteria and parasites. Contaminated food or water can transmit bacteria and parasites to your body. Parasites such as Giardia lamblia and cryptosporidium can cause diarrhea. Common bacterial causes of diarrhea include campylobacter, salmonella, shigella and Escherichia coli. This type of diarrhea can be common for people traveling to developing countries.And from the site you sited (http://www.wrongdiagnosis.com/symptoms/diarrhea/common.htm)

Giardia is listed as "Very Rare" after a HUGE list of other causes. Lets see:


▲Top (http://www.wrongdiagnosis.com/symptoms/diarrhea/common.htm#abstop)Causes of Diarrhea that are very common


The following causes of Diarrhea are diseases or medical conditions that affect more than 10 million people in the USA:
Alcoholism (http://www.wrongdiagnosis.com/sym/alcohol_abuse.htm)
Allergies (http://www.wrongdiagnosis.com/a/allergies/intro.htm) - diarrhea
Anxiety disorders (http://www.wrongdiagnosis.com/sym/anxiety_disorder.htm) - some may cause diarrhea.
CMV (http://www.wrongdiagnosis.com/c/cytomegalovirus/intro.htm) - with AIDS (http://www.wrongdiagnosis.com/h/hiv_aids/intro.htm) or immune compromise (http://www.wrongdiagnosis.com/risk/immunosuppression.htm)
Cytomegalovirus (http://www.wrongdiagnosis.com/c/cytomegalovirus/intro.htm)
Diabetes (http://www.wrongdiagnosis.com/sym/diabetes_like_symptoms.htm) - diabetic diarrhea
Diabetes mellitus (http://www.wrongdiagnosis.com/sym/diabetes_like_symptoms.htm)
Diarrhea (http://www.wrongdiagnosis.com/sym/diarrhea.htm) - watery stool
Digestive Diseases (http://www.wrongdiagnosis.com/d/digest/intro.htm) - Diarrhoea
Endometriosis (http://www.wrongdiagnosis.com/e/endometriosis/intro.htm) - diarrhea
Food poisoning (http://www.wrongdiagnosis.com/f/food_poisoning/intro.htm) - diarrhea
Infectious diarrhea (http://www.wrongdiagnosis.com/sym/infectious_diarrhea.htm)
Lactase deficiency (http://www.wrongdiagnosis.com/l/lactose_intolerance/intro.htm)
Lactose intolerance (http://www.wrongdiagnosis.com/l/lactose_intolerance/intro.htm) - diarrhea
Pollen allergy (http://www.wrongdiagnosis.com/p/pollen_allergy/intro.htm) - Diarrhoea
Thyroid disorder (http://www.wrongdiagnosis.com/t/thyroid/intro.htm)
Traveler's diarrhea (http://www.wrongdiagnosis.com/t/travelers_diarrhea/intro.htm) - diarrhea
Type 2 diabetes (http://www.wrongdiagnosis.com/sym/diabetes_like_symptoms.htm) - diabetic diarrhea▲Top (http://www.wrongdiagnosis.com/symptoms/diarrhea/common.htm#abstop)Causes of Diarrhea that are common


The following causes of Diarrhea are diseases or conditions that affect more than 1 million people in the USA:
Adverse reaction (http://www.wrongdiagnosis.com/a/adverse_reaction/intro.htm) - Diarrhoea
Autoimmune diseases (http://www.wrongdiagnosis.com/sym/immune_symptoms.htm) - Diarrhoea
Campylobacter (http://www.wrongdiagnosis.com/c/campylobacter_food_poisoning/intro.htm)
Campylobacter food poisoning (http://www.wrongdiagnosis.com/c/campylobacter_food_poisoning/intro.htm) - bloody diarrhea
Celiac (http://www.wrongdiagnosis.com/c/celiac_disease/intro.htm)
Celiac disease (http://www.wrongdiagnosis.com/c/celiac_disease/intro.htm) - diarrhea
Coeliac disease (http://www.wrongdiagnosis.com/c/celiac_disease/intro.htm)
Colitis (http://www.wrongdiagnosis.com/c/colitis/intro.htm) - diarrhea
Constipation (http://www.wrongdiagnosis.com/sym/constipation.htm) - diarrhea
Cyclic vomiting syndrome (http://www.wrongdiagnosis.com/c/cyclic_vomiting_syndrome/intro.htm) - diarrhea
Diverticular disease (http://www.wrongdiagnosis.com/d/diverticular_disease/intro.htm) - diarrhea
Diverticulitis (http://www.wrongdiagnosis.com/d/diverticular_disease/intro.htm)
Enteritis (http://www.wrongdiagnosis.com/e/enteritis/intro.htm) - diarrhea
Fecal incontinence (http://www.wrongdiagnosis.com/sym/fecal_incontinence.htm) - diarrhea
Food allergies (http://www.wrongdiagnosis.com/f/food_allergies/intro.htm) - diarrhea
Food allergy (http://www.wrongdiagnosis.com/f/food_allergies/intro.htm)
Gastritis (http://www.wrongdiagnosis.com/g/gastritis/intro.htm) - diarrhea
Generalized anxiety disorders (http://www.wrongdiagnosis.com/g/generalized_anxiety_disorder/intro.htm)
Hepatitis B (http://www.wrongdiagnosis.com/h/hepatitis_b/intro.htm) - diarrhea
Hepatitis C (http://www.wrongdiagnosis.com/h/hepatitis_c/intro.htm) - diarrhea
Insect sting allergies (http://www.wrongdiagnosis.com/i/insect_sting_allergies/intro.htm) - Diarrhoea
Irritable bowel syndrome (http://www.wrongdiagnosis.com/sym/irritable_bowel_syndrome.htm) - diarrhea
Middle ear infection (http://www.wrongdiagnosis.com/sym/middle_ear_infection.htm) - diarrhea
Panic disorder (http://www.wrongdiagnosis.com/p/panic_disorder/intro.htm)
Peanut allergies (http://www.wrongdiagnosis.com/p/peanut_allergies/intro.htm) - Diarrhoea
Penicillin allergy (http://www.wrongdiagnosis.com/p/penicillin_allergy/intro.htm) - Diarrhoea
Peptic ulcer (http://www.wrongdiagnosis.com/p/peptic_ulcer/intro.htm)
Rotavirus (http://www.wrongdiagnosis.com/r/rotavirus/intro.htm) - diarrhea
Salmonella (http://www.wrongdiagnosis.com/s/salmonella_food_poisoning/intro.htm) - can cause greenish stool (usually diarrhea (http://www.wrongdiagnosis.com/d/diarrhea/intro.htm))
Salmonella food poisoning (http://www.wrongdiagnosis.com/s/salmonella_food_poisoning/intro.htm) - diarrhea
Sjogren's Syndrome (http://www.wrongdiagnosis.com/s/sjogrens_syndrome/intro.htm) - diarrhea
Thyrotoxicosis (http://www.wrongdiagnosis.com/g/graves_disease/intro.htm)
Urinary tract infections (child) (http://www.wrongdiagnosis.com/u/urinary_tract_infections_child/intro.htm) - loose stool▲Top (http://www.wrongdiagnosis.com/symptoms/diarrhea/common.htm#abstop)Causes of Diarrhea that are uncommon


The following causes of Diarrhea are diseases or conditions that affect more than 200,000 people, but less than 1 million people in the USA:
Acute Appendicitis (http://www.wrongdiagnosis.com/a/acute_appendicitis/intro.htm) - diarrhea
AIDS (http://www.wrongdiagnosis.com/h/hiv_aids/intro.htm)
Appendicitis (http://www.wrongdiagnosis.com/a/acute_appendicitis/intro.htm)
Chronic Fatigue Syndrome (http://www.wrongdiagnosis.com/sym/chronic_fatigue_syndrome.htm) - diarrhea
Crohn's disease (http://www.wrongdiagnosis.com/c/crohns_disease/intro.htm) - diarrhea
Digestive system cancer (http://www.wrongdiagnosis.com/d/digestive_system_cancer/intro.htm) - Diarrhoea
HIV/AIDS (http://www.wrongdiagnosis.com/h/hiv_aids/intro.htm) - diarrhea
Inflammatory bowel disease (http://www.wrongdiagnosis.com/i/inflammatory_bowel_disease/intro.htm) - diarrhea
Intestinal obstruction (http://www.wrongdiagnosis.com/sym/intestinal_obstruction.htm)
Liver conditions (http://www.wrongdiagnosis.com/l/liver/intro.htm) - Diarrhoea
Pernicious anemia (http://www.wrongdiagnosis.com/sym/pernicious_anemia.htm) - diarrhea
Poisoning (http://www.wrongdiagnosis.com/p/poisoning/intro.htm) - Diarrhoea
Progressive systemic sclerosis (http://www.wrongdiagnosis.com/s/scleroderma/intro.htm)
Regional enteritis (http://www.wrongdiagnosis.com/c/crohns_disease/intro.htm)
Systemic sclerosis (http://www.wrongdiagnosis.com/s/scleroderma/intro.htm)
Type 1 diabetes (http://www.wrongdiagnosis.com/sym/diabetes_like_symptoms.htm) - diabetic diarrhea
Viral hepatitis (http://www.wrongdiagnosis.com/v/viral_hepatitis/intro.htm) - diarrhea▲Top (http://www.wrongdiagnosis.com/symptoms/diarrhea/common.htm#abstop)Causes of Diarrhea that are rare


The offical US government definition of a "rare" disease is one that affects 200,000 people or less. The following causes of Diarrhea appear in the population at a rate of less than 200,000 people per year in the USA:
Behcet's Disease (http://www.wrongdiagnosis.com/b/behcets_disease/intro.htm) - diarrhea
Cutaneous mastocytosis (http://www.wrongdiagnosis.com/c/cutaneous_mastocytosis/intro.htm) - Diarrhoea
Ménétrier's disease (http://www.wrongdiagnosis.com/m/menetriers_disease/intro.htm) - diarrhea
Mastocytosis (http://www.wrongdiagnosis.com/m/mastocytosis/intro.htm) - Diarrhea
Zollinger-Ellison syndrome (http://www.wrongdiagnosis.com/z/zollinger_ellison_syndrome/intro.htm) - Diarrhoea▲Top (http://www.wrongdiagnosis.com/symptoms/diarrhea/common.htm#abstop)Causes of Diarrhea that are very rare


The following causes of Diarrhea appear in the population at a rate of substantially less than 200,000 people per year in the USA:
Addison's disease (http://www.wrongdiagnosis.com/sym/adrenal_gland_symptoms.htm) - severe diarrhea
Alcohol (http://www.wrongdiagnosis.com/f/fetal_alcohol_syndrome/intro.htm)
Amebiasis (http://www.wrongdiagnosis.com/a/amebiasis/intro.htm) - Diarrhoea
Amyloidosis (http://www.wrongdiagnosis.com/a/amyloidosis/intro.htm) - diarrhea
Anthrax (http://www.wrongdiagnosis.com/a/anthrax/intro.htm) - severe diarrhea
Bacillary dysentery (http://www.wrongdiagnosis.com/s/shigellosis/intro.htm)
Botulism (http://www.wrongdiagnosis.com/b/botulism_food_poisoning/intro.htm)
Botulism food poisoning (http://www.wrongdiagnosis.com/b/botulism_food_poisoning/intro.htm) - diarrhea
Bowel cancer (http://www.wrongdiagnosis.com/c/colorectal/intro.htm)
Brainerd diarrhea (http://www.wrongdiagnosis.com/b/brainerd_diarrhea/intro.htm) - explosive diarrhea
Cholera (http://www.wrongdiagnosis.com/c/cholera/intro.htm) - severe diarrhea
Chronic Granulomatous Disease (http://www.wrongdiagnosis.com/c/chronic_granulomatous_disease/intro.htm) - diarrhea
Colon cancer (http://www.wrongdiagnosis.com/sym/bowel_problems.htm)
Colorectal cancer (http://www.wrongdiagnosis.com/c/colorectal/intro.htm) - Diarrhea
Crypto (http://www.wrongdiagnosis.com/c/cryptosporiosis/intro.htm)
Cryptosporidiosis (http://www.wrongdiagnosis.com/c/cryptosporiosis/intro.htm)
Cryptosporidium (http://www.wrongdiagnosis.com/c/cryptosporiosis/intro.htm)
Cryptosporiosis (http://www.wrongdiagnosis.com/c/cryptosporiosis/intro.htm) - diarrhea
Cyclosporiasis (http://www.wrongdiagnosis.com/c/cyclosporiasis/intro.htm) - explosive diarrhea
Cystic fibrosis (http://www.wrongdiagnosis.com/c/cf/intro.htm) - persistent diarrhea
Diabetes Insipidus (http://www.wrongdiagnosis.com/sym/diabetes_insipidus.htm) - diarrhea
E coli (http://www.wrongdiagnosis.com/e/e_coli_food_poisoning/intro.htm)
E-coli food poisoning (http://www.wrongdiagnosis.com/e/e_coli_food_poisoning/intro.htm) - bloody diarrhea
Ehrlichiosis (http://www.wrongdiagnosis.com/e/ehrlichiosis/intro.htm) - diarrhea
Escherichia coli (http://www.wrongdiagnosis.com/e/e_coli_food_poisoning/intro.htm)
Escherichia coli O157:H7 (http://www.wrongdiagnosis.com/e/escherichia_coli_o157_h7/intro.htm) - diarrhea
Giardia (http://www.wrongdiagnosis.com/g/giardia/intro.htm) - acute diarrhea
Giardia lamblia (http://www.wrongdiagnosis.com/g/giardia/intro.htm)
Giardiasis (http://www.wrongdiagnosis.com/g/giardia/intro.htm)
Glanders (http://www.wrongdiagnosis.com/g/glanders/intro.htm) - diarrhea
Glucagonoma (http://www.wrongdiagnosis.com/g/glucagonoma/intro.htm)
Hantavirus (http://www.wrongdiagnosis.com/h/hantavirus/intro.htm) - Diarrhoea
Hemolytic uremic syndrome (http://www.wrongdiagnosis.com/h/hemolytic_uremic_syndrome/intro.htm) - diarrhea
Hepatitis A (http://www.wrongdiagnosis.com/h/hepatitis_a/intro.htm) - diarrhea
Hepatitis D (http://www.wrongdiagnosis.com/h/hepatitis_d/intro.htm) - diarrhea
Hepatitis E (http://www.wrongdiagnosis.com/h/hepatitis_e/intro.htm) - diarrhea
Heroin dependence (http://www.wrongdiagnosis.com/h/heroin_dependence/intro.htm) - Diarrhoea
Invasive group A Streptococcal disease (http://www.wrongdiagnosis.com/i/invasive_group_a_streptococcal_disease/intro.htm) - Diarrhoea
Kawasaki disease (http://www.wrongdiagnosis.com/k/kawasaki_disease/intro.htm) - diarrhea
Legionella pneumophila (http://www.wrongdiagnosis.com/l/legionnaires_disease/intro.htm)
Legionnaires' disease (http://www.wrongdiagnosis.com/l/legionnaires_disease/intro.htm) - diarrhea
Leptospirosis (http://www.wrongdiagnosis.com/l/leptospirosis/intro.htm) - diarrhea
Listeriosis (http://www.wrongdiagnosis.com/l/listeriosis/intro.htm) - diarrhea
Lymphoma (http://www.wrongdiagnosis.com/sym/lymphoma.htm)
Melioidosis (http://www.wrongdiagnosis.com/m/melioidosis/intro.htm) - diarrhea
Meningitis (http://www.wrongdiagnosis.com/sym/meningitis.htm) - diarrhea
Multiple endocrine neoplasia type 1 (http://www.wrongdiagnosis.com/m/multiple_endocrine_neoplasia_type_1/intro.htm) - diarrhea
Mycobacterium avium Complex (http://www.wrongdiagnosis.com/m/mycobacterium_avium_complex/intro.htm) - diarrhea
Norwalk virus (http://www.wrongdiagnosis.com/n/norwalk_like_viruses/intro.htm)
Norwalk-like viruses (http://www.wrongdiagnosis.com/n/norwalk_like_viruses/intro.htm) - diarrhea
Ovarian Cancer (http://www.wrongdiagnosis.com/sym/ovarian_cancer.htm) - diarrhea
Q fever (http://www.wrongdiagnosis.com/q/q_fever/intro.htm) - diarrhea
Rectal cancer (http://www.wrongdiagnosis.com/r/rectal_cancer/intro.htm) - diarrhea
Reiter’s syndrome (http://www.wrongdiagnosis.com/r/reiter_s_syndrome/intro.htm) - diarrhea
Rocky Mountain spotted fever (http://www.wrongdiagnosis.com/r/rocky_mountain_spotted_fever/intro.htm) - diarrhea
SCID (http://www.wrongdiagnosis.com/s/scid/intro.htm) - diarrhea
Septicemia (http://www.wrongdiagnosis.com/s/septicemia/intro.htm)
Shigella (http://www.wrongdiagnosis.com/s/shigellosis/intro.htm)
Shigella food poisoning (http://www.wrongdiagnosis.com/s/shigellosis/intro.htm)
Shigellosis (http://www.wrongdiagnosis.com/s/shigellosis/intro.htm) - bloody diarrhea
Somatostatinoma (http://www.wrongdiagnosis.com/s/somatostatinoma/intro.htm)
Stomach cancer (http://www.wrongdiagnosis.com/s/stomach_cancer/intro.htm) - Diarrhea
Toxic shock syndrome (http://www.wrongdiagnosis.com/t/toxic_shock_syndrome/intro.htm) - Diarrhea
Trichinella spiralis (http://www.wrongdiagnosis.com/t/trichinosis/intro.htm)
Trichinosis (http://www.wrongdiagnosis.com/t/trichinosis/intro.htm) - diarrhea
Tuberculosis (http://www.wrongdiagnosis.com/t/tuberculosis/intro.htm)
Typhoid (http://www.wrongdiagnosis.com/t/typhoid_fever/intro.htm)
Typhoid fever (http://www.wrongdiagnosis.com/t/typhoid_fever/intro.htm) - diarrhea
Vibrio (http://www.wrongdiagnosis.com/v/vibrio/intro.htm) - Diarrhoea
Vibrio parahaemolyticus (http://www.wrongdiagnosis.com/v/vibrio_parahaemolyticus/intro.htm) - watery diarrhea
Vibrio parahemolyticus (http://www.wrongdiagnosis.com/v/vibrio_parahaemolyticus/intro.htm)
Vibrio vulnificus (http://www.wrongdiagnosis.com/v/vibrio_vulnificus/intro.htm) - diarrhea
Viral Hemorrhagic Fevers (http://www.wrongdiagnosis.com/v/viral_hemorrhagic_fevers/intro.htm) - Diarrhoea
Viral meningitis (http://www.wrongdiagnosis.com/sym/meningitis.htm) - diarrhea
Western equine encephalitis (http://www.wrongdiagnosis.com/w/western_equine_encephalitis/intro.htm) - Diarrhoea
Whooping Cough (http://www.wrongdiagnosis.com/w/whooping_cough/intro.htm) - diarrhea
Yellow fever (http://www.wrongdiagnosis.com/y/yellow_fever/intro.htm) - Diarrhoea
Yersinia enterocolitica (http://www.wrongdiagnosis.com/y/yersiniosis/intro.htm)
Yersiniosis (http://www.wrongdiagnosis.com/y/yersiniosis/intro.htm) - diarrhea So based on your citations, I have about the same chance of getting giardia as I do getting hantavirus. BUT as I said before, there are a whole lot of other things that can get you before you gotta worry about the giardia boogyman. Everyone that gets sick in the back country has a better chance it is something other than giardia, and given that they get it so fast from the supposed source, loose it so quickly, and often do not need the flagyl, I reckon that means they are mis diagnosing themselves.

After all, if I came into a doctor and told him I have rectal cancer - he would want some tests to prove it before starting treatmetns, but if I come in and say I drank some bad water and have giardia, that is an easy perscription and send me on. If it didn't go away, then more tests are needed. If it does go away, then maybe the drug helped or maybe it would have ended anyway - but I am cured and no more doctor visits required.

[The Old Fhart]

Ah, Rock, you have lots of data but you seem to have missed some vital info to put it in perspective. One site referenced the Mayo Clinic as saying(emphasis mine):

Acute diarrhea is an unpleasant digestive disorder that nearly everyone experiences at one time or another. In fact, it's estimated that most Americans can expect to have diarrhea about four times every yearYou can interpret that as meaning the average person has about a 100% chance of getting 'acute diarrhea' at least once. If this is so, then 2% of the population having giardia, most not displaying symptoms, isn't that far fetched. Even one of your own references from the Mayo Clinic says(emphasis mine):

The most common causes of diarrhea include:
• Viruses. Common viruses that cause diarrhea are the Norwalk virus, cytomegalovirus, viral hepatitis and the herpes simplex virus. Rotavirus is the most common cause of acute childhood diarrhea. Viral diarrhea spreads easily.
• Bacteria and parasites. Contaminated food or water can transmit bacteria and parasites to your body. Parasites such as Giardia lamblia and cryptosporidium can cause diarrhea. Common bacterial causes of diarrhea include campylobacter, salmonella, shigella and Escherichia coli. This type of diarrhea can be common for people traveling to developing countries.
Remember the FDA site stated that(emphasis mine)
The overall incidence of infection in the United States is estimated at 2% of the population. Giardiasis is the most frequent cause of non-bacterial diarrhea in North America.

While you are talking about all types of diarrhea from all causes, and diarrhea has obvious symptoms, giardia can be carried by an infected person without displaying the more common thought of symptom, diarrhea. Also saying that giardia is the most common non-bacterial cause has you looking at a specific subset of diarrhea. Also you can gather from the above quote and talking to most travelers, that all types of diarrhea can be more common people traveling to developing countries where sanitation and water purity is not that high. The A.T. and thru hikers kind of fits right in there with possible poor water sources and poor hygiene.

As a last thought, and this is on topic, did you ever wonder why there are no left-handed people in China?:-?

[SGT Rock]

While you are talking about all types of diarrhea from all causes, and diarrhea has obvious symptoms, giardia can be carried by an infected person without displaying the more common thought of symptom, diarrhea. Also saying that giardia is the most common non-bacterial cause has you looking at a specific subset of diarrhea. Also you can gather from the above quote and talking to most travelers, that all types of diarrhea can be more common people traveling to developing countries where sanitation and water purity is not that high. The A.T. and thru hikers kind of fits right in there with possible poor water sources and poor hygiene.

As a last thought, and this is on topic, did you ever wonder why there are no left-handed people in China?:-?

I think this is my point entirely. There are so many types of infections, conditions, parasites, viruses, diet issues, etc that can cause diarrhea that there is a HUGE chance anyone reporting they got giardia simply because they got sick is a monstrous leap of logic. There are so many other causes to the disease that focusing on what water treatment you are going to use because of the off chance you could catch giardia is like deciding to get a tank instead of a car on the off chance you might get shot at while driving.

There is a much higher chance you are going to get something else because of dirty hands - either yours or someone else's, than you are going to get sick drinking from water in the wild.

And add to that, it isn't as simple as getting a filter to avoid it. The method of contamination is another whole issue. You can get a filter and still be a knuckle head. You can use treatments and still mess it up by incorrect timing. Or you can go 21 years backpacking with 7 thru-hikes without doing either (like someone we know) and never get it (giardia) once.

Sure, it may be the most common form of a very specific sort of vector, but in the big scheme of things that sort of vector (per all the cited information) is VERY rare - substantially less than 200,000 people in the US per year. If everyone in the US is expected to get diarrhea 4 times, that means at least 1.2 billion cases of diarrhea in the US every year. But if 200,000 people in the US got giardia, then your chances to get giardia is 1:1,500 (or less). Think about it... That means that 1:1,500 people are going to get it anyway. If 3,000 people finish a thru-hike this year, statistically 2 of them have it anyway. If 30,000 people start a thru-hike this year (probably a high number) 20 of them are going to get diarrhea from giardia anyway.

Boogyman:banana

[JAK]

Don't mean to interject, but I'm still confused about the prevalence thing. What does 3-5% prevalence of giardia mean, and 20% in undeveloped countries and so forth? Does that mean that many people have at least some detectable trace of giardia at any given moment, but perhaps not enough to present symptoms if they happen to be vulnerable to symptoms? And when they say 90% are asymptomatic, does that mean the other 10% have full blown symptoms for 1-2 weeks, or that only 10% of the population are at all vulnerable, if they get enough giardia in them.

How many giardia cysts is enough to count as being prevalent, and how much is neccessary to present symptoms in such people that are vulnerable? Does it not also partially depend on what general state of health and fatigue that individual happen to be in at the time, and the rate at which he is being further exposed, and the rate at which his body might naturally be expelling such material without resorting to diarrhea? When we get symptoms of diarrhea, whether in the field or at home, isn't it most likely that it is caused by a combination of factors. Doesn't a more holistic approach make more sense than a silver bullet. Also a more adaptive knowledge based approach to suit the specific circumstances, rather than a strict and overly generalized regimen?

[JAK]

My other point was whether we should be more concerned or at least equally concerned about being a source and incubators of giardia, rather than just a potential victims and vectors. We can't just blame the beavers. I think that's more along the lines of what the Old Phart was saying about the AT being closer to third world conditions, but not only because of lack of modern water treatment and waste management, but also because of the high human population and traffic along the trail. Perhaps the cure is still the same either way, but I think the mindset is distinctly different. Not to belabour the point, but we might have an obligation to others and to the natural environment to treat or water, just as we do with hygene and waste management. I'm not saying neccessarily all the time, or always by one particular means or another, but at least to consider in view of all the mechanisms and consequences, to the extent that we are able to understand them.

Still not sure if giardia is a grey thing, or more black and white. I think its more grey.

[JAK]

I think it all goes back to more precise definitions and measure of such things are prevalence rates and incidence rates and so forth, and the definitions are complicated by such things are symptoms often being a result of multiple and often inter-related causes.

Also precise measures are likely to contain large degrees of uncertainty, and also vary considerably in both space and time. Further complications are that dogs and cats and domestic animals are also common carriers with high prevalence rates, whatever that means exactly. Nature is complex, more complex than we like to make her out to be, so we try and find useful ways to simplify and generalize, and then we often misinterpret and make mistakes on top of that. Then we have to find a way to educate the public at large, without confusing the heck out of them, or worse, undermining the myth of infalibility of authourity on which our civilization so depends. Then enter the marketeers, that simple have something or other to sell. Yes of course, we are all marketeers to some degree or other. So can you really blame a guy for shouting never use a damn filter, or always use a damn filter, across the internet.

So it would at least be nice to start with some more precise definitions and measures. Of course when things really do collapse, it will probably be some other bug, and always someone else, or nature, to blame. :)

[weary]

A summing up. Giardia critters are found in a lot of lakes and streams. But drinking one cyst won't cause an infection. A piece I posted some months ago said at least a dozen cysts are needed before disease is likely. Very few water bodies are likely to have that concentration. There is considerable evidence that humans are the primary source of giardia in wild places. Streams have more giaRDIA below a campsite than above a campsite. That suggests that humans infect animals, not vice versa

You can't give yourself giardia. Washing your hands after defecating doesn't protect you, but, rather, the next person you shake hands with or who you offer gorp to.

For decades I drank water from streams without even thinking about it. Now with all the hype from folks selling devices and chemicals, I occasionally worry. I still drink untreated water from springs and clear, cold streams, especially on hot days. But I also boil a quart or two of water many nights on the trail -- especially if I'm in farming country.

I once was treated for giardiasis. The conventional medicine did not clear up the symptoms. I somewhat by happenstance changed my breakfast cereal to one with high fiber and the symptoms went away.

Fiber is not a good source of calories. But it still is needed for a well functioning digestive system.

Weary

[JAK]

Very nice summary. Perhaps the most useful article I have read in a while.
If I could write a fraction as well, and focus, I might finish my darned thesis.

A Nearest Neighbour Methodology for Long Term Wind Resource Assessments.
Totally different topic, but related to nature, so naturally as complex and uncertain.
I'm so doomed. :(

Ah well, I'll just fake it. Who's going to read it anyways. :banana

[Dr O]

That same source you cited also says:
[affects less than 200,000 people in the US population]
So I have a very very good chance of not getting it according to your citation.

US population ~307,000,000
rare <= 200,000
rare : US genpop | <= 1 : ~1535

Extremely good chance you won't get it. Pretty good chance some on the AT will though, and that's assuming AT hikers are only at equivalent risk as genpop. (for lack of actual demographics as AT hikers as a population demographic)


But wait, there is more. I can check other citations such as this one from the same site:
[/list]or this one from the Mayo clinc (http://www.mayoclinic.com/health/diarrhea/DS00292/DSECTION=3)

[/list]And from the site you sited (http://www.wrongdiagnosis.com/symptoms/diarrhea/common.htm)

Giardia is listed as "Very Rare" after a HUGE list of other causes. Lets see:
[/list]So based on your citations, I have about the same chance of getting giardia as I do getting hantavirus. BUT as I said before, there are a whole lot of other things that can get you before you gotta worry about the giardia boogyman.Risks added increase, each individual risk increase your chances (assuming same definition of "rare") from <=1 : ~1535 to (<= X : ~1535) where X is the number of rare diseases listed that are possibly contractible from untreated water.

Hypothetically, if X is 3... | <= 1 : ~512
or if 5... | <= 1 : ~307

Chances are very good you won't get anything, but chances you get something that could have been prevented carrying a few ounces of water treatment are similar to the chances of hurting yourself in the various ways you carry other emergency supplies for, yet I still carry less weight in Chlorine than emergency supplies.


Everyone that gets sick in the back country has a better chance it is something other than giardia, and given that they get it so fast from the supposed source, loose it so quickly, and often do not need the flagyl, I reckon that means they are mis diagnosing themselves. True, but illness is unpleasant even if you're wrong about what caused it, and the same precautionary treatment prevents most of the others as well, if the water is the source anyway.


After all, if I came into a doctor and told him I have rectal cancer - he would want some tests to prove it before starting treatmetns, but if I come in and say I drank some bad water and have giardia, that is an easy perscription and send me on. If it didn't go away, then more tests are needed. If it does go away, then maybe the drug helped or maybe it would have ended anyway - but I am cured and no more doctor visits required.I wouldn't actually treat giardia without knowing if I had it, but I'd try and prevent myself from getting it within reason. A few ounces isn't heavy, and bleach isn't expensive, and resupply is available as often as I do laundry. For hand sanitising I just use stove alcohol.

Has anyone ever sampled water sources along the AT for parasites? I haven't been able to find anything. The only statistic I could find specific to the AT is the anecdotal "65% reported getting diarhria", although that to me is worth a few ounces, YMMV ;)

[SGT Rock]

I pretty much agree with carrying a little weight to do some prevention because there are other things besides giardia that can get you (also my point) and many of them can get past a filter but not chemicals - so Polar pure is my decision based on risk mitigation. But since we are running the numbers, I decided to find out what "significantly less than 200,000" ment. Here is what I found:


Incidence Rate: approx 1 in 6,138 or 0.02% or 44,308 people in USA [about data (http://www.wrongdiagnosis.com/admin/preval.htm#rates)]
from http://www.wrongdiagnosis.com/g/giardia/stats.htm

So I take that to mean even if your risk of infection went up 300% when you go backpacking (which I don't think it does) your chance of getting giardia is still only 1 in 2,064.

Edit:

Here are some statistical things to compare that too. http://funny2.com/odds.htm I have a better chance of hitting a hole in one than I do to get giardia.

[Footslogger]

[quote=weary;399617]

I once was treated with giardiasis. The conventional medicine did not clear up the symptoms. I somewhat by happenstance changed my breakfast cereal to one with high fiber and the symptoms went away.

=======================================

Unless you had definitive lab testing that confirmed the condition I would submit to you then that you most likely were not suffering from Giardiasis infection.

'Slogger

[JAK]

[quote=weary;399617]

I once was treated with giardiasis. The conventional medicine did not clear up the symptoms. I somewhat by happenstance changed my breakfast cereal to one with high fiber and the symptoms went away.

=======================================

Unless you had definitive lab testing that confirmed the condition I would submit to you then that you most likely were not suffering from Giardiasis infection.

'SloggerI would agree, but I'm not sure the original poster wasn't making the very same point. That's not to say there wasn't some giardia in his system though, perhaps as a slight contributing factor, or that there isn't a good change that you and I don't have some giardia in our systems even as we speak. We tend to want to think in black and white terms, like we either have it or we don't, and it is either the cause or it isn't, and we should either do something about it or we shouldn't. Of course at the end of the day we do need to think and act in those terms in order to function, but the real truth is always more complicated and uncertain.

[JAK]

Do a search on the prevalence of giardia amongst various human populations compared to various domestic animals and wild animals yields some very interesting results. We do tend to shift the blame towards other people, and other animals, and even water. The primary source we should be most concerned about for these little beasties is our own gut. I like the idea of eating more oatmeal, whether you are infected or sick or not. It's the right thing to do. :)

Fun little article. Love the pic.
http://www.biovir.com/Images/pdf027.pdf