Have you ever gotten sick after filtering water?

[Bob Gross]

Determining that you got sick from impure water can be difficult. You might try to run by external symptoms only, but that is far from foolproof. As was stated, several other trailwise maladies look about the same.

I was trekking in Nepal, and our Sherpa cook was supposedly boiling all of our water. Somebody might have slipped up on that. One woman trekker was getting bad symptoms one day. Her bowels were getting so loose that she had to get off the trail into the bushes a dozen times. That gets extra bad when your elevation is too high for bushes.

That afternoon, we reached our campsite at Pheriche (about 14,000'), and we went to the trekker's aid post to have afternoon tea with the two western doctors who worked there treating trekkers and locals. Since the woman trekker was so concerned, she asked one of the doctors about her symptoms. One doctor stated that the standard symptoms of Giardia lamblia might be this or that, but the only way to be sure is by a microscopic examination of a stool specimen. The woman responded that they probably won't need to wait long for a new specimen.

A few minutes later the new specimen was under the microscope, but the doctor stated that it might take 15 minutes of looking before the necessary count of cysts was reached. Within seconds, the doctor had the count. It was quite obvious, because there were millions. This was an extreme case.

An hour later she had started taking drugs to kill the cysts, and she made a full recovery after some days.

How many of you Through-Hikers are carrying a microscope along?

–B.G.–

[Jerry Adams]

water treatment and infection are probabilistic

just because you haven't got sick with chemicals, but did this one time with mini, could just be coincident

if you got a doctor diagnosis, then you'd have to ask if you mis-used – let some untreated water drip into treated container or whatever. Or maybe touched your mouth with your hand regardless of which treatment method.

hard to get any diffinitive answer about water treatment

[Buck Nelson]

Like others have said, there is no way of knowing how she got sick.

The higher pore size will increase the risk a bit although it shouldn't matter for giardia, which is the pathogen of greatest concern in the backcountry for most people.

If it's the washer I'm thinking of it looks like unfiltered water could end up in your "good" water. I'd replace the washer, not the filter. http://adropofrain.net/2012/08/simple-modifications-for-sawyer-squeeze-filter-prefilter-hose-adapter-evernew-water-bladder/

Any untreated water that you swallow COULD make you sick, but the less it is the less likely it is. I don't worry about splashing water on my face and then licking my lips in the backcountry, for example, but I do treat virtually all my drinking water.

With a fever I'm guessing she doesn't have giardiasis, but it's important to know that the incubation period for giardiasis can be as little as one day. Here's what the CDC says: Acute giardiasis develops after an incubation period of 1 to 14 days (average of 7 days)

The EPA cites some sources: Rendtorff (1954a, b;1979) found that the incubation period of giardiasis in human volunteers ranged from 9 to 22 days with a mean of 13.1 days. Benenson (1995) reported that the incubation period is usually 3 to 25 days or longer, with a median of 7 to 10 days. In a prospective epidemiological study, Jokipii et al.(1985)found that the incubation period for giardiasis was typically 12 to 19 days. In human volunteers, Nash et al.(1987) found that diarrhea or loose stools appeared within 7.25 (± 2.99) days of inoculation with G. lamblia…

Rick, it sounds suspicious that you do have giardiasis especially if you can't shake it or it keeps coming back. The only way to know for sure is if you've been tested. Lots of ways you could have acquired it. Tinidazole will usually kick giardia's butt with one treatment.

[Bob Gross]

I had been using a water filter in gravity-fed mode. On one trip, I noticed a rattle sound from inside the filter element. So, I took all of the hoses and caps apart. To my amazement, the outer plastic casing came apart, and I was staring at the inside.

Obviously the thing was broken, so it was never going to see any more use. I investigated more deeply. Basically, the way it broke it allowed the inlet water to mix with the outlet water, so the whole thing was allowing my water to be contaminated. Not cool! I don't know how long it had been that way, so I don't know if I drank any contaminated water. I boiled water for the rest of that trip.

I didn't get any symptoms, but that doesn't prove anything.

–B.G.–

[M B]

Some years on the AT, norovirus becomes rampant in areas with dozens of NOBO thruhikers getting extremely sick.

It can live on contaminated surfaces and clothing for…..weeks. In one study one strain of norovirus survived 5 months.

The best solution is to have some hygiene, and completely avoid other people and places and things they touch.

It doesnt sound like it was waterborne.

[Diane Pinkers]

How many of you WASH YOUR HANDS? With SOAP? Particularly before eating? Hand sanitizer may not be effective enough. Unless you are practicing proper back country hygiene every time, all the time, your water filter may not be to blame.

http://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html

Edit:grammar

[jscott]

+1 Diane. I once was hiking with a friend who hadn't brought hand soap or Purel. I mentioned this after he'd done his business and he just shrugged. I did not share my gorp after that.

I use Purel, hand soap and a streripen (or filter) religiously; no giardia so far.

[Greg Mihalik]

"I did not share my gorp after that."

I always "pour" food into someone's hands.
Never allow them to stick a hand in a snack bag.

[Jerry Adams]

I never go with anyone else : )

[Dimeo Train]

Interesting topic. Nothing quite ruins a trip like illness.

It'd be hard to know for sure exactly where the illness came from. There's likely some contamination that comes from unclean hands handling food. Also properly cooking foods to prevent food borne illness, For example, meat pattys or sausages can look done on the outside if roasted over a hot fire, but not having reached internally, esp when cooking from frozen.

It's not happened to me but I've heard that with the Steripen the UV light doesn't reach the rim of the bottle. So if you scoop your bottle into a river or lake, there's still a risk with untreated water droplets remaining on the rim or lid.

I've also watched a few YouTube videos from hikers who are "going fast and light" and not wanting to have to carry more than a half litre. They end up drinking their water too quickly after treating it with drops or tablets not allowing the full required time.

[Matt V]

"It's not happened to me but I've heard that with the Steripen the UV light doesn't reach the rim of the bottle. So if you scoop your bottle into a river or lake, there's still a risk with untreated water droplets remaining on the rim or lid. "

That is true, but the instructions say to wipe off any contaminated water from the threads of the bottle. The theory is that wiping it off will remove most the germs, and drying inactivates even more germs since some can't live in a dry environment. I'm always careful to keep the lid of my Nalgene out of contaminated water since it;s hard to wipe dry, and I wipe the threads of the bottle off with my shirt. I'm somewhat skeptcal that that's enough, but I've filtered at least 40L with it, and no I've filtered water for has gotten sick yet. If you are really concerned you could have a designated dirty bottle and pour from that into a clean bottle that you use with the steripen. The dirty bottle could be a lightweight narrow mouth or collapsible bottle if that works with the water sources you fill from. A disposable plastic water bottle could work well. Does anyone know of any instances of someone getting waterborne illness while using a steripen?

Norovirus is particularly difficult since it is highly contagious, and it only takes a very small number of virus particles to catch it. Hand sanitizer doesn't seem to be effective against it. The good news is that after you get it you get temporary immunity to that strain, so you won't keep getting it from your own contaminated stuff. I definitely wouldn't want to deal with that on the trail.

[Greg Mihalik]

^^^^

"Hand sanitizer doesn't seem to be effective against [norovirus]."

From WebMD –
"Alcohol-based hand sanitizers [>65% alcohol] are clearly a very useful and important method to prevent most bacterial and viral infections, with rare exceptions," says Aaron E. Glatt, MD, executive vice president of Mercy Medical Center, Rockville Centre, Long Island, N.Y. He is a spokesman for the Infectious Diseases Society of America."
.
.
.

"The sanitizers are meant to supplement, not replace, good old-fashioned soap and water washing, Sansoni says.

From the CDC –
"Although alcohol-based hand sanitizers can inactivate many types of microbes very effectively when used correctly, people may not use a large enough volume of the sanitizers or may wipe it off before it has dried. Furthermore, soap and water are more effective than hand sanitizers at removing or inactivating certain kinds of germs, like Cryptosporidium, norovirus, and Clostridium difficile."

So, when it comes to sanitizers, Operator Error is a major factor, not the product in its intended setting. It won't sterilize that crud under your finger nails. Sanitizer is meant to be used on the clean hands found in a clinical setting.

Soap and water plus vigorous washing action for minutes, not seconds, is your best bet.

[Valerie E]

I've been meaning to ask this for a while:

When washing my hands in the backcountry, I use UNTREATED water and Dr Bronner's soap. Am I just flooding my hands with crypto, bacteria, etc.? Do I really need to use TREATED water?

What do others do?

[Jerry Adams]

I just wash them in water and wipe on my pants : )

I haven't noticed getting sick

[Eric Blumensaadt]

I use only water PURIFIERS. (Steripen and Katadyn chlorine dioxide tablets).

And I'm very careful about cleaning my hands with sanitizer when I use cattle troughs or known beaver pond streams.

Doing those two things should keep you from getting water-borne diseases.

I know, when backpacking in popular areas like Southern Utah's Coyote Gulch it's difficult to know if some 12 year old Boy Scout or clueless hippie has pooped in a tributary stream or a coyote has used the Gulch for his crapper. I bathe in the stream with caution, i.e. I don't submerge my head. I've seen human turds on a rock right beside a stream on the AT in Virginia. Disgusting!

[jscott]

On a related note: I've found those lightweight plastic clams filled with leaves of soap to be pretty great. You have to get the leaves out with dry hands, however.

I also wash my hands with unfiltered water…hmmm. But in the Sierra, it's almost always a clean looking source. I suppose that you could use Purel after washing.

[Greg Mihalik]

"You have to get the leaves out with dry hands, however."

… and if cleverly remove several in anticipation of wet hands, place them carefully so a breeze doesn't waft them away. (Don't ask me how I know.)

[Russell Lawson]

unless her immune system is prone to foreign bacteria attacks due to using hand sanitizer all her life, that doesn't seem like enough time for giardia. Just in case though ask if she washed anything in the natural water, spork, bandana, dish. If not that then food poisoning or stomach flu from a chef or bathroom sink nob or even hidden under her fingernails is my guess.

I work in a lab from time to time and it gave me a good prespective as to how bacteria travel ever so slightly, it takes a lot of imagination and planned procedure to remain sterile. My biggest concern with a filter is that if I place it in a bag, then the moisture from the oring will travel and get near the spout. Either way if I dunk my hand into the creek and then start touching stuff it can contaminate my gear. So my solution is to leave the sawyer on all the time with it capped and religiously put the straw on before I dunk the bottle. Sometimes i hike with my guide buddy who assures me of spring quality, in that case I keep my filter in a chia seed bag with a flat bottom and pack it upright. Never been sick except when I ate to many blueberries.

[Rick McDaniel]

Valerie asked about washing hands. Dr. Bonners with water is a great idea, but then you may wish to try something like this: http://www.amazon.com/Adventure-Hand-Sanitizer-Pegable-Medical/dp/B000WXX11U

No alcohol to dry out skin.Yes,i know it seems expensive but it goes a long way.

[BPLwiia]

I'm not nearly vigilant as others here and have never gotten sick. Could be just luck but I do not adhere to the procedures some have described above. Don't get me wrong, I think that good procedures make for good results. It's just not me.

[Stephen M]

Maybe I am completely wrong (and if I am go easy on me) but I always thought that its a number game with bacteria, that it takes x amount of bacteria in water to make someone sick, under that number and one should be ok.

[Greg Mihalik]

For some, under the right/wrong conditions X=1.

[Lori P]

All the " never got sick" people were very likely never going to get sick, even if they are positive for Giardia. There will always be a certain number of people exposed will never have symptoms. On the other hand, I've known quite a number of people who've gotten sick repeatedly. Water rescue exposes one to water intake in new invasive ways….

[Sunny Waller]

This year at the Appalachian Trail Kickoff-ATKO I hosted a class called Gear Lab. Water purification was the hot topic among all the thru hikers, gear vendors and hostel owners. The general consensus was to double treat..using clorox, tablets, or aquamira to cover virus's combined with a Sawyer. This lines up with what the CDC website recommends.

[Bob Gross]

"The general consensus was to double treat..using clorox, tablets, or aquamira to cover virus's combined with a Sawyer."

I'll bet that the gear companies liked that. They get to sell twice as many filters and chemicals.

–B.G.–

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