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Don't Drink the Water

by Michael Strahan


Few things are so evocative of the wilderness experience as a cool, refreshing drink from a clear mountain stream. Kathleen Meyer, in her insightful book dealing with answering the call of nature, quotes Edward Abbey's book, Desert Solitaire:

Chugach and Wrangell mountains ~ Spring by David Johnson"When late in the afternoon I finally stumbled- sun-dazed, blear-eyed, parched as an old bacon rind- upon that blue stream which flows like a miraculous mirage down the floor of the canyon, I was too exhausted to pause and drink soberly from the bank. Dreamily, deliriously, I waded into the waist-deep water and fell on my face. Like a sponge I soaked up moisture through every pore, letting the current bear me along beneath a canopy of overhanging willow trees. I had no fear of drowning in the water- I intended to drink it all."

Alas, we can no longer abandon ourselves to such pleasures. Gone are the days when we could savor the mountain waters without fear of sickness or contamination, and live for a time as a creature free on the earth. There's a new sheriff in town, and we have to play by his rules.

STAND BY TO PERCOLATE!

Steve dipped the water and slowly straightened, his hip boots leaving polka-dotted imprints in the shoreline mud as he sipped from his lexan cup, contemplating the drink like a connoisseur sampling fine wines. Wiping his lips, he turned and smiled, smacking in deep satisfaction. He looked at me and said in reverent tones, "Ahhh, that's good; some of the best I've ever tasted." "You're not drinking from the river, are you?" I shouted, in an obvious understatement. He wasn't just drinking; he was savoring the contaminated water. "I told you we had to FILTER all of our water!" "Hey, no worries!" He replied, self-assuredly. "I've been drinking it for three days and haven't felt a thing yet!" He had no way of knowing that within three weeks he'd be seventeen pounds lighter- his body racked by violent diarrhea while millions of giardia trophozoites stewed, brewed and partied in his intestinal tract. He was sick- he just didn't know it yet.

First-time visitors to Alaska frequently take home much more than souvenirs, postcards. fish, and big-game trophies. Back-country visitors frequently take with them a visitor that can cause headaches, nausea, weight loss, diarrhea and a host of other related symptoms within two weeks of leaving the state! Giardia lamblia, an intestinal parasite , is ravaging the once pristine waters of Alaska.
 

WHERE DID IT COME FROM? (AND CAN WE SEND IT BACK?)

The first documented case of a waterborne outbreak giardia in the United States was in 1970, in Aspen, Colorado; possibly carried there by travelers who had recently returned to Colorado from Leningrad, Russia. It is known that Leningrad's municipal water supply was contaminated with giardia at that time. From there, giardia swept the nation's remote waters at a phenomenal rate, being carried from state to state by humans and other mammals. Early records by residents and visitors of the Alaska Territory make no mention of giardia, but by the 1980's it was well established in the state. Some maintain that it's been here all along- and we just started noticing it . (Yeah, RIGHT! Like I'm not gonna notice my guts knotted up like a balloon animal for a couple of weeks!) Since that time, it has spread throughout the state at a phenomenal rate to the point where most river systems and lakes are potentially affected. Those that aren't soon will be. It's just a matter of time.

¿QUE ES?

Giardia lamblia is a teardrop-shaped protozoan that exists in two forms. Its motile, reproducing form, called a trophozoite, lives in the intestinal tract of host mammals, where it swims along aided by its five flagella. The cyst form (the phase that's resistant to the elements and can survive outside the host) occurs in the feces of infected hosts, and is carried out of the hosts' body during defecation. Whether the fecal material is deposited directly in the water or breaks down and ends up in the water through erosion, the cysts drift along waiting to be ingested by a drinking human or an animal. Once ingested, it lodges in the intestinal tract where it comes out of its cyst form (excysts) and begins to reproduce at an exponential rate.

The cyst form of the organism can survive for several months without a host, but the trophozoites are very fragile and quickly die outside the hosts' body. Because the cysts are most easily carried by water, they're most readily picked up by mammals that live in or near contaminated waters. Beavers are therefore common hosts and transmitters of the disease (hence the term Beaver Fever). Dogs, like all other mammals, can also contract giardia by drinking contaminated water . Humans, though, are the greatest spreaders of the disease. Because outdoors-types are the most likely people to contract giardia, they're also the most likely to spread it into back-country locations that were previously unaffected. In the United States, it's unlikely that giardia would have spread as rapidly as it has without the help of humans (animals just don't do as much traveling as we do- probably because they can't get credit cards and generally can't afford a bush flight into the wilds of Alaska).

SIGNS THAT SOMETHING'S ROTTEN IN DENMARK!

The chief carriers of giardia are mammals, including humans. Humans can exhibit giardia symptoms by ingesting as few as ten cysts . Some of the symptoms of giardia include nausea, bloating, stomach cramps, vomiting, flatulence, explosive diarrhea (now there are two words that shouldn't be used in the same sentence), headaches and weight loss . These symptoms frequently take up to two weeks to manifest themselves, therefore individuals who show no symptoms after drinking contaminated water in the field should not assume they're out of the woods yet. You probably won't notice anything until after your trip. Then you'll start percolating like a pot of hot coffee!

ASYMPTOMATIC CARRIERS- IT'S NO GAS

Some carriers are asymptomatic, meaning that they exhibit none of the symptoms that plague those who are infected (lucky them). This doesn't mean that an asymptomatic carrier can't pass giardia cysts or that they're not hosting the protozoan- it just means that they have few or no symptoms. It's possible that such individuals are actually hosting huge quantities of cysts and trophozoites that are just waiting their turn to continue the cycle of contamination. If you or someone you know "drinks from every river and creek" and never gets sick, this is probably why. In addition to asymptomatic human carriers, other mammals can also carry the disease without showing symptoms that they have it. Watch carefully for signs and seek treatment immediately. If a member of your party starts brewing something in their "Lower 48", it's time for everyone in the group to head for the Doc for a checkup.

FILTER IS BETTER THAN SELTZER!

Avoiding giardia is of course much better than dealing with the results of getting it in the first place. What follows is a listing of the best methods of saying "Adios, Amoeba!" to the little critter, and keeping your intestinal tract smiling.

Unless you enjoy the taste of iodine tablets in your water or have plenty of extra fuel lying around with which to boil your water (giardia and other similar critters will be dead by the time the water boils), the single best option (besides staying home and watching the nature channel) is to filter your water. ALL of it. Giardia cysts are about 13 microns in length , which is well within the filtration capacities of recreational water filter systems. If you're traveling alone or with one or two other people you can get by with a simple individual water filter such as the MSR Waterworks II filter or the Miniworks filter.  Both of these filters allow you to screw your wide-mouth Nalgene® bottles directly to the filter, which makes filling them much easier than the filters by Pur or Katadyn- which have hoses out the end. Additionally, the MSR filters pump from the side, which is more user-friendly than the end-pumpers that Pur and Katadyn offer. End-pumpers leave you looking for a rock to brace the filter on, but since the hose comes out the end you're mostly out of luck. For three people or more, you should take a serious look at a bulk filtration system such as the one offered by Cascade Outfitters.  This is a gravity-feed system that filters three gallons of water for you in about fifteen minutes! Just think- you can be cooking dinner while your water is filtering- no more endless pumping, pumping, p-u-m-p-i-n-g! It's the best system by far for groups, and costs about $200. Money well spent. On rafting trips, we just hang the three-gallon water bag on a tripod made of oars, set the hose and filter up and filter our water right into a three-gallon clear jug with a spigot! Simple!

Be sure to wash your hands with filtered water before you eat, and use filtered water to wash produce- rather than raw river water. Raw river water can be used to cook with because the boiling action will kill the cysts- but all other water you use should be filtered.

TAKE THE LIME AND THE COCONUT

If you're showing signs of giardia, you should immediately seek the help of a doctor. A stool sample will have to be taken (sometimes several samples are necessary- but usually just a squirt will do). The sample will be analyzed for trophozoites and cysts. If the test shows positive, a treatment regimen will be prescribed.

The most common treatment for giardia is the administration of metronidazole (Flagyl®) by a physican. This treatment takes a week or more and should rid you of the organism. There are other treatments available, including furazolidone (Neftin®), which is used in children because it comes in an easy-to-administer liquid. Neftin is not as effective a treatment as Flagyl, however. Many other treatments are also available in other countries- but not in the United States. In a nutshell, your best bet at this writing is Flagyl. Your doctor should know about it.

It should be noted that if you do nothing as far as treatment is concerned, giardia will eventually clear up on its own- but not before you've been through the gauntlet. Those who opt for non-treatment may want to alter summer vacation plans to include only locations within fifty yards of a public rest room.

IN CONCLUSION

Giardia is no fun. If you drink directly out of any creek, river, pond or lake in Alaska, you're putting yourself at risk. Do this, and giardia will get you in the end- perhaps in both ends. Filter all of your water and make sure you tell everyone in your group about the risks. Enjoy your Alaska river trip. Bring home lots of memories. Take lots of photos. Bring your fish and game trophies home to show your friends. But don't take chances with giardia!

THRONE ROOM READING

Meyer, Kathleen, How to Shit in the Woods, 1994, Ten Speed Press
Kathleen's book is an excellent resource on dealing with human waste and related issues in the backcountry. An entertaining must-read for guides, commercial operators, and private recreational users alike, this book deals with many creative solutions, tips and tricks that will help you be a better citizen of the woods. Besides, it's printed on a softer, multi-use paper that could come in handy!

Websites worth checking out:

Michael Strahan is a registered float hunting guide in Alaska. Although he hasn't experienced the agony of giardia personally, he's been a silent witness to the suffering of others and remains committed to helping you keep your digestive tract a 'Giardia-Free Zone'".

Discussion on the Alaska outdoor forums about drinking from Alaska outdoor water sources

Hunting trip report (bout with giardiasis)
Waterborne pathogens

Search for all forum articles about giardiasis

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