Outbreak of Wilderness/Backcountry/Travelers’ Diarrhea at a Himalayan Base Camp at 4000 m/13,125 ft

Abstract

Introduction Wilderness or backcountry diarrhea is a type of travelers' diarrhea affecting backpackers, trekkers, campers, hikers, soldiers, wilderness and outdoor enthusiasts. Giardia and Cryptosporidium are the most common pathogens causing wilderness diarrhea followed by bacteria (Campylobacter, Shigella, enterotoxigenic Escherichia coli, E. coli O157:H7, Yersinia enterocolitica, Aeromonas hydrophila) and viruses (hepatitis A virus, hepatitis E virus). Giardia and Cryptosporidum cysts, Salmonella Typhi, Shigella, and the hepatitis A virus can survive freezing temperatures in mountain streams and lakes. Furthermore, protozoal cysts have a low infective dose of 10-25 cysts compared to bacteria which have higher infective doses of 10 6-10 8 colony-forming units/ml of water. 1,2 Campsites, wilderness, and mountain environments pose additional risks worldwide irrespective of developing or developed regions. Wilderness and outdoor environments restrict the maintenance of adequate culinary hygiene, washing hygiene, and hand hygiene due to limitations in http://ijtmgh.com

Common-Source Outbreak of Hepatitis A in an Indian Himalayan Mountain Camp

“…Poor sanitation and hand hygiene, improper food handling, contamination of food, and sewage contamination of water pipelines are also very common modalities of transmission frequently reported. Due to the hospital-based nature of the study, the exact source of infection could not be identified by means, such as water sample testing (17).…”