Hand Sanitizers & Parasites: Are we living in a fool's paradise?

[Valerie E]

I just read that hand sanitizers are not effective against intestinal parasites, including (but not limited to) giardia.

Does anyone know if that statement is true?  If so, have we been living in a fool’s paradise by bringing hand sanitizer to use on the trail for after pooping?!

If hand sanitizer won’t work against parasites, what can we do, practically, while long-distance backpacking to prevent ingesting them?

[Ken Thompson]

I still take soap. Like I did before there was hand sanitizer.

 

[BlackHatGuy]

Two links to help:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604385/

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

And no, I don’t live in Mar-a-Lago…

[Valerie E]

@idester – oh, whew!  I mean, 80% at the low end isn’t perfect, but it’s “effective” by any interpretation of the word, IMHO.

My new Gastroenterologist – my third one (after being sick on & off for over 5 years, and getting repeatedly mis-diagnosed because my symptoms don’t present normally) — just treated me for parasites, and it’s a “day-and-night” difference.  If only they’ll stay gone.  Understandably, I’m now a bit paranoid about making sure I don’t get sick again on my trips this year!

@here – I bring a teeny dropper of camp soap, but find that I don’t use it as much as I should, especially where water is less available (need lots of water to rinse off soap!).

[BlackHatGuy]

“getting repeatedly mis-diagnosed because my symptoms don’t present normally”

I hear ya. I was mis-diagnosed for years. Finally my docs came up with the right diagnosis – some weird disease called ‘obstreperousness’.

[Valerie E]

@idester —   We like you despite your occasional bout of mental dyspepsia! :^)

[Rex Sanders]

Also, from our fearless (BPL) leader and former microbiologist:

https://backpackinglight.com/hand_sanitizers_best_practices_wilderness_hygiene/

TL;DR: Ryan switched from sanitizer to soap and water, because he didn’t like what sanitizer did to his skin.

Preventing ingestion: drink clean water (pick your filter or poison); don’t share food, bottles, pots, cups, or utensils; wash your own pots, cups, and utensils in soap and water (boiling ain’t good enough); and wash or sanitize hands before every meal/snack and after every deposit.

— Rex

[Greg Mihalik]

^^^

… and make sure your trail mates do the same.  My wife and I already share flora and fauna, but when it comes to hiking with others we insist on over-the-top hand washing and no hand-picked food sharing.

Sanitizers are meant as a final touch to already scrubed parts, and even so are highly over-marketed and over-rated.

YMMV

[BlackHatGuy]

“Sanitizers are meant as a final touch to already scrubed parts”

+1, and this is pointed out in at least one of the articles I linked to – clean hands first or the sanitizer can’t work as it’s supposed to.

[Nick Gatel]

I still take soap. Like I did before there was hand sanitizer.

+1

[Cameron M]

“no hand-picked food sharing”

+1

[Valerie E]

Hmmm, having accidentally licked my fingers after using sanitizer (blechhhh, strong, nasty alcohol taste!), I wish it were more feasible to use the sanitizer first… soap, when adequately rinsed leaves no aftertaste.

@greg23 — sharing flora & fauna with my husband may be where I got the parasites!!! Yikes.  And I never hand share food with anyone else!

A CAUTIONARY TALE:

Over the past few (up to 5 years), my digestion got worse and worse.  I did not have diarrhea.  I sought medical help repeatedly.  One GI said it was lactose intolerance (despite my having done 10 days of “zero dairy” with no change!  Why is that man in practice?).  About 1.5 years ago, I got sicker.  My stomach didn’t seem to be working properly, I had pain, and no elimination diets worked (including FODMAP).  No diarrhea.  The second GI did a stomach emptying scan (I failed spectacularly) so she diagnosed me with idiopathic gastroparesis.  I took rx domperidone and adjusted my diet, but didn’t feel better.  The third GI listened to my tale of woe, said I didn’t have gastroparesis (I went off meds, felt no worse), said he thought it was either post-infectious IBS or — because of my history of long-distance backpacking — parasites.  We tried more FODMAP (in case it was IBS) but no change.  Last week, he treated me for parasites, and within two days, I experienced a day-and-night turnaround.  I may need further treatment to eradicate parasites that have been growing in me for several years.

But I urge you, if you backpack, and are experiencing ANY type of digestive problems that don’t respond to medically-validated elimination diets – EVEN if you don’t have diarrhea – consider the possibility that you could have parasites.  I would not want anyone to have to go through what I did.

[BlackHatGuy]

“Last week, he treated me for parasites, and within two days, I experienced a day-and-night turnaround.  I may need further treatment to eradicate parasites that have been growing in me for several years.”

I wonder if this treatment would work to make kids finally move out of the house….

[ben .]

hey valerie, i’m so sorry to hear your story. i’ve had my own run-ins over the years with major stomach issues, but they’ve ultimately been diagnosed as either giardia or e. histolytica.

being treated for “parasites” is pretty vague. were you tested and shown to be positive for anything more specific? or did he just give you a course of antibiotics and you felt better?

giardia (etc) can apparently be tricky to catch with standard tests. i’ve been fortunate enough to live near one of the major “tropical disease” docs here in nyc, who has his own testing method. he’s very expensive and very old, though.

[Valerie E]

@frozenintime – thank you for your sympathy.

I did stool tests, but they were negative.  OTOH, looking for microscopic eggs in poop is known to be a “needle in the haystack” task, so false negatives are commonplace.  I asked about more specific tests, but was told that there weren’t really any (?).

I assume it’s been either giardia or e.histolytica, too.  I’ve done Kilimanjaro, and a camping safari in South Africa, and I’ve traveled to other “less hygenic” countries, too — sometimes camping, sometimes not.

My GI has ordered an antibodies test for 14 days after the tinidazole treatment.  That’s next week.  I feel “somewhat better”, but not “cured”, so I suspect I’ll need more treatment.

Maybe I should talk to a tropical diseases specialist?  That’s a good point.

[Anonymous]

Regarding the controversy over the efficacy, or lack thereof, of alcohol hand sanitizers:  In a previous thread on the subject, Dean Fellabaum, a  US Army surgeon with several deployments to Afghanistan to his credit, commented that he hoped it was effective, because he used it many times daily while on duty.  He would seem to me to be a pretty credible source.  Like him, I hope it is effective, because I, too, use it frequently while on duty in the Sierra.  So far, so good.  What I do not do is share my food or sample the food of others, FWLIW.

 

[Anonymous]

“Maybe I should talk to a tropical diseases specialist?  That’s a good point.”

Most definitely.  Part of the life cycle of amoeba is spent as cysts in the liver.  Yours may be “hibernating”.  Or at least that is what I was told by an Indian physician years ago.  He didn’t have to run any tests.  He just palpated my abdomen and told me matter of factly that I had amoebic dysentery.  He prescribed a round of metronidazole, followed by a second round a month later to get the ones holed up in my liver.  I suppose the scientific skeptics among us would say that without a definitive test, how did he know, but for me the proof was in the pudding, or rather the swift cessation of same gushing from my nether orifice with alarming frequency.  It certainly was good enough for me.  What I am getting at here is that parasites are so common in places like India that every doc is trained to recognize the symptoms, diagnose, and treat accordingly.  That is not the case here in the US, where parasitic infections are relatively rare.  By all means, Valerie, do see a doc trained in tropical medicine.  That is by far your best bet to put this ordeal behind you.  You have my condolences and compassion.  It is a miserable affliction.

 

[W I S N E R !]

What I do not do is share my food or sample the food of others, FWLIW.

All this time I thought you just didn’t like my cooking…but it was the feces on my hands you were afraid of.  It all makes sense now.  ; )

[Anonymous]

“All this time I thought you just didn’t like my cooking…but it was the feces on my hands you were afraid of.”

That thickened the soup you poached those trout steaks in quite nicely.  But I did make sure you brought it to a rolling boil.  I confess to breathing a sigh of relief, however, when you decided not to go fishing again.  ;0)

 

 

 

[Window walker]

I don’t use hand sanitizer, only because it kills the good bacteria on my skin that prevents bad bacteria from growing.  Also proper wiping techniques and you won’t get any fecal matter on your hands in the first place. Seams simple enough.

Ben

 

PS- yes I wash my hands after with soap and water =)

[Anonymous]

“Also proper wiping techniques and you won’t get any fecal matter on your hands in the first place. Seams simple enough.”

 

Couldn’t have said it better.  An enthusiastic +1

 

[BlackHatGuy]

“Also proper wiping techniques and you won’t get any fecal matter on your hands in the first place. Seams simple enough.”

Some of us ‘clean up’ with our hand and some water, after using sticks or moss or stones.

[Anonymous]

“Some of us ‘clean up’ with our hand and some water, after using sticks or moss or stones.”

Which is why some of the rest of us don’t shake hands with people in the backcountry or share our food.

CYOB is the operative principle.

[jscott]

And another thread goes down the toilet.

[Katherine .]

I have a friend, albeit not a long distance backpacker, who had a very similar sounding experience.

I do soap & water cause I hate the how the gel dries out my skin.

[Author]

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