Colorado Trail water treatment (or not)

Dean said: Your claim that the testing has a lot of false negatives because cyst excretion is episodic was true… decades ago. And that’s why a proper test involved three samples, not just one. But this is no longer true with modern immunoassays.

“To help diagnose giardiasis, your doctor is likely to test a sample of your stool. For accuracy, you may be asked to submit several stool samples collected over a period of days.” Mayo Clinic, February 23, 2016,

If you weren’t lab tested during your last illness then you weren’t well diagnosed, no matter what your opinion is of your own or your doctor’s familiarity with the disease.

It takes arrogance to claim you know better than my doctor and myself combined. Steatorrhea, sulfur burps, severe nausea coming and going over many days, weight loss, all after drinking untreated water. The time before I knew what I had, and lab tests confirmed it.

Because making a definitive diagnosis is difficult, empiric treatment can be used in patients with the appropriate history and typical symptoms.  CDC July 2015

“It must be Giardia, here’s some Flagyl” absolutely is a study. Zell. There is no way to draw a rational conclusion on the rate of over diagnoses based on that study involving a single empirically treated case, nor to know with any degree of certainty whether that patient was infected.

Yes, if you take a small inoculum you will produce cysts in the stool, but your body will clear them before you become symptomatic. Unless you become symptomatic, or unless you ingest more cysts to reach the infective dose.

Over-prescription of antibiotic agents is such a problem in the US that it gets discussed on Oprah, for God’s sake. Really? You’re going to contest this? Nice straw man argument. Antibiotics are commonly abused. What is complete bull is your claim that a hiker sick enough to see a physician almost certainly doesn’t have giardiasis.

“…is commonly considered [ubiquitous]” means nothing without a cite.

“Giardia cysts are ubiquitous in surface waters worldwide”

“Cryptosporidium and Giardia are ubiquitous in surface waters worldwide”

Dozens more references in Google Scholar.

“Ubiquitous” almost implies that it would be impossible not to catch it if you drank untreated water, which is clearly nonsense. Baloney. Germs on hands are ubiquitous, usually we don’t get sick if we eat without washing.

I worry about treating my water only about as much as I worry about washing my hands. Not too much. I try to do both though.

he concludes that something other than giardiasis explains the vast majority of intestinal distress among hikers. Undoubtedly true, just as it’s true that for severe gastro-intestinal distress among backpackers giardiasis is common.

And I’m done arguing with you. I guess we’ll see.

Oh, I’m not going to claim that you aren’t very good at cherry-picking phrases out of context for all of your cites- including some in that last post above- while ignoring other parts or even the actual conclusions of them, Buck.  (Which, since you had the chutzpah to call me arrogant, I will point out is quite intellectually dishonest.)  I just said that I was done arguing with you.

Hey Dean – totally out of curiosity – can you sicken yourself from your own fecal matter?  i.e. let’s say someone’s ex-boyfriend isn’t the cleanest person around……and let’s say he cooks his own food right after doing some business in the woods and NOT using hand sanitizer….i get that I COULD get sick if I ate that food…but could he get sick from his own poo?

Wasn’t there a whole thread here about that a while ago, Jen?  :)

My immediate suspicion- bearing in mind that I’m totally making this up on the fly- is that E.coli does not belong in your stomach and duodenum.  That said, E.coli is an unlikely culprit.

You often shed pathologic organisms even though they aren’t making you sick.  Actually, Giardia is a great example- if you ingest even one cyst you’re likely going to shed cysts in your stool for a while even if you aren’t symptomatic.  And you might shed them in a high enough concentration to make yourself sick if you don’t wash your hands.  At the very least you’re giving them another shot at a lucky low-dose infection.  This applies to other organisms as well.

Buck is right when he says that there is a chance, albeit small, of getting a symptomatic infection from just one organism.  We usually talk about ID50 in this context, but statistics isn’t much a surcease if you’re the unlucky guy with giardiasis from ingesting one cyst.

So.  Who wants to volunteer for the double-blinded autofecalization trial?  I’m almost certain that I could get grant money for it.  :)

IMO, before poopooing asymptomatic Giardia, one should consider the potential for an asymptomatic person to transmit it to household members and others after return from the wilderness.

Cheers,

Bill S.