<xml><p>Carolee Boyles-SprenkelAbout 2650 words
Route 3, Box 2180Copyright 1989
Quincy, FL 32351Carolee Boyles-Sprenkel
(904) 627-2254Second Serial Rights</p>

<p>    WILD DISEASES
   By
   Carolee Boyles-Sprenkel</p>

<p>A few days after Patsy M. returned home from a trip to
Hawaii, she came down with what she thought was intestinal flu. 
After a week of nausea and vile-smelling diarrhea she went to her
doctor.  He couldn't find anything wrong with her and put her on
a liquid diet.  Two weeks and ten pounds later she was becoming
anemic.  </p>

<p>Three stool samples, a sigmoidoscopy and a proctoscopy could
not establish the cause of her illness.  Finally she mentioned
her symptoms to a colleague at work who recognized them as
something he'd heard of before.  A little research turned up
information on an organism that parasitizes the human digestive
tract, Giardia.  After only 24 hours on the antibiotic Flagyl,
Patsy knew she'd solved the problem.  She recovered without
further incident.</p>

<p>Patsy was only one of a number of people who bring back more
from their outdoor experiences that they bargain for.  Any time
we go into the woods, we run the risk of encountering illnesses
and discomforts our urban neighbors don't ever run into.  Few
physicians even think about testing for these "exotic" diseases. 
Untreated, some will run their course in a few days or a few
weeks.  But not all are so benign. </p>

<p>According to epidemiologist Dr. Lisa Conti, doctors term
these diseases "zoonotic."  That means they're caused by
organisms that infect both animals and humans.  Though most
affect humans only rarely, a few are relatively common.  </p>

<p>This is definitely not a case of "what you don't know won't
hurt you."  What you don't know about some of these ailments
will, in some cases, kill you.  </p>

<p>    Lyme Disease</p>

<p>Lyme Disease may be the most visible of the little shop of
horrors found in the woods.  Unlike some other diseases, Lyme
Disease is not rare.  Dr. Robert Craven, a Centers for Disease
Control researcher studying Lyme, says doctors reported more than
2400 cases during 1988.  He believes it's spreading throughout
the country.</p>

<p>A bacterium carried by deer mice and deer causes Lyme
Disease.  Ixodid ticks can pass the organism from infected
animals to people.</p>

<p>The first symptom of the disease is a little red area where
the tick attached itself to you.  The spot grows.  Then fever,
headache, and muscle aches start.  The spot increases in size
until it become a red ring several inches across with a light-
colored center.  "It's kind of like a bull's-eye," says Craven. </p>

<p>If you don't get treatment, the effects can be severe.  "It
can eventually cause cardiac problems, usually rhythm
disturbances," Craven says.  "It can cause arthritis, which can
be fairly severe and debilitating.  It can cause a whole host of
neurologic problems - encephalitis, meningitis type problems,
paralyses, that sort of thing."</p>

<p>Lyme Disease is easy to treat with antibiotics.  According
to Craven, researchers are trying to produce a vaccine, but none
is available at this time.</p>

<p>    Rocky Mountain Spotted Fever</p>

<p>Another bacterium transmitted exclusively by tick bites is
Rocky Mountain Spotted Fever.  Infected ticks can pass the
organism from generation to generation without feeding on a sick
animal.  </p>

<p>According to Dr. Michael Wilder, a state public health
clinician, the first symptoms are fever, cramping stomach pain
and rash.  "Stomach-ache seems to be a common early symptom," he
says.  "There may be some vomiting, but no diarrhea."  The rash
looks like measles but it appears on the wrists and palms of the
hand, which measles rarely does.</p>

<p>Antibiotics will cure Rocky Mountain Spotted Fever.  Of the
patients who are not treated, though, a few die from either shock
or hemorrhaging.
    
    Encephalitis</p>

<p>Several different types of encephalitis cause problems from
time to time.  St. Louis Encephalitis follows a 10-year cycle in
the Mississippi Valley, according to Craven.  Eastern Equine
Encephalitis and Western Equine Encephalitis appear in small
scattered outbreaks each summer.</p>

<p>Birds carry the viruses that cause encephalitis, which
mosquitoes spread from the birds to humans and other mammals.
Early symptoms include confusion and fever.  Some varieties of
the ailment cause nausea and vomiting.  Then, Craven says,
convulsions, coma, and other neurologic involvement may occur.</p>

<p>"Eastern Equine is a particularly virulent form of
encephalitis in humans," he says.  "It frequently kills, and the
people who do survive are usually brain damaged to a greater or
lesser degree for life."</p>

<p>Antibiotics are useless against encephalitis, he says. 
Researchers have developed a vaccine against both Eastern and
Western Equine, but officials recommend using it only during
epidemic conditions.
    
    Tularemia</p>

<p>According to Dr. Thomas Quan with the CDC's Fort Collins,
Colorado unit, most people acquire tularemia infections from
rabbits and hares, and the ticks associated with them.  He says
people can pick up the versatile organism in a number of ways.</p>

<p>"Most human cases occur through the bite of a tick or
through direct contact with rabbits that are infected," he says. 
"There are other modes of infection, such as deer fly bites and
mosquito bites." Sheep-shearers have acquired it from working
with infected sheep in Colorado.  Some people have become ill
from drinking contaminated water.  Farm workers can inhale the
organism from hay dust.</p>

<p>Early symptoms are fairly vague.  You'll develop a bit of a
fever, and generally not feel too good.  If you've inhaled the
organism, you'll have respiratory symptoms; if you've swallowed
it, you'll think you'll have intestinal flu. Swelling of the
armpits - called buboes - and other plague-like symptoms will
follow a tick bite or infection through a cut.  For untreated
cases, the fatality rate is about 5 to 7 per cent.  With
antibiotic treatment, patients can expect complete recovery. 
"The people who get sick with it wish they'd die, but they
usually don't," Quan says.  "But eventually they overcome it."

   Giardia</p>

<p>CDC worker Dr. David Addiss says the biggest source of
Giardia is contaminated water.  Biologists have found the
organism from many streams and rivers.  "It's found fairly
commonly throughout the United States in untreated surface
water," he says.  "You don't find it very much in wells or big
lakes, but you do see it in streams."</p>

<p>A number of different animals, especially beavers, may carry
the protozoan that causes the illness. Symptoms include loose
stools or full-blown diarrhea, cramping, gas and burping, and
rarely nausea and vomiting.  The disease may be more chronic than
acute.  Giardia attaches itself to the wall of the small
intestine, where it lives and reproduces.  Untreated, the ailment
may go away on its own.  In many people, through, the infection
persists until it's treated with a course of antibiotic.  </p>

<p>Don't rely on iodine or chlorine tablets to treat stream
water.  They may work if the water is warm and only contains a
few Giardia cysts.  But in cold or heavily infested water,
they're not particularly effective.</p>

<p>   Relapsing Fever</p>

<p>Craven also works with relapsing fever another tick-borne
disease related to Lyme Disease. He says it's fairly rare in the
United States.  </p>

<p>The last big epidemic of Relapsing Fever occurred in the
Grand Canyon in the 1970s, and was related to squirrels nesting
in cabins where Canyon staff people were living.  Generally,
though, the cases are fairly scattered.</p>

<p>The disease produces flu-like symptoms, including fever and
muscle aches.  If it's not treated, the symptoms subside, and
patients think they're well.  Then it comes back.  This cycle
continues until the disease is treated.  Fortunately, it doesn't
seem to produce any serious long-term effects like Lyme Disease
does.</p>

<p>   Brucellosis</p>

<p>Unless you hunt wild hogs in the southeastern United States,
brucellosis is one problem you probably don't need to worry
about.  This is not to say the disease isn't found in other
species; biologists have reported it in desert rats and other
rodents, hares, foxes, goats, sheep, deer, elk and bison, and
even dogs and cats.  But Dr. Arnold Kaufmann, a physician with
the CDC in Atlanta, says he's never heard of hunters contracting
brucellosis from any animal except hogs.  </p>

<p>The organisms which cause brucellosis are a group of
bacteria that live in the blood, bone marrow and lymphatic
system, including the liver and spleen.  You can become infected
in a couple of ways.  If you clean a hog without wearing gloves,
bacteria can enter through small cuts and scratches on your
hands.  As you cut into the carcass of the animal a number of the
organisms are released into the air, where you can inhale them.</p>

<p>Heat kills the bacteria, so you're not at risk if you eat
well-cooked meat from a sick animal.  In fact, when domestic
animals such as cattle are found to have brucellosis, one cure is
to send the animals to the slaughterhouse.</p>

<p>In humans, brucellosis is a vague sort of illness, according
to Kaufmann.  It causes headache, fever, and exhaustion.  You may
have achy joints and in general feel like you have a severe case
of the flu.</p>

<p>"It goes on and on and doesn't go away," says Kaufmann. 
"It's a very complex disease.  It can involved a variety of
organs."  Untreated, most patients eventually recover; for a few,
though, it continues as a chronic illness.  Treatment is simply a
course of antibiotics.</p>

<p>   Q Fever</p>

<p>Q or Query Fever may be under reported, according to CDC
microbiologist Russell Regnery.  As a result, the CDC doesn't
have any good data on how many cases occur in this country each
year.</p>

<p>"I think it's an important disease, but one for which very
little data can be found," says Regnery.  In his opinion, 
hunters and fishermen in sheep country need to be aware of the
disease as a potential long-shot ailment.  "If, for example, you
were to shoot a sheep that had Q Fever and you butchered it out,
especially if that animal is a pregnant female, you would really
be asking for the possibility of exposure," Regnery says.  The
organism reaches its highest concentration in amniotic fluid and
fetal tissues.</p>

<p>The agent is a specialized bacterium.  It can infect humans
through cuts on the hand, but it's very infectious if inhaled. 
As a result, clothes and other items can become contaminated by
the organism. </p>

<p>Symptoms include headache and fever, plus muscle pain. 
Pregnant women may suffer complications.  Untreated, the disease
usually resolves itself after a few days or a few weeks.  A few
people, though, develop Q Fever endocarditis, or inflammation of
the heart.  This can be a chronic problem, hard to treat, and
sometimes leading to death.  Q-fever has been associated with
rabbit hunting in Canada.
    
   Rabies</p>

<p>Despite modern vaccinations, rabies is still a potential
threat.  Unlike most of the other diseases you can acquire in the
woods, rabies has no treatment - if you get it, you die.  It's
that simple.</p>

<p>"Any warm-blooded animal can get rabies," says Wilder.  "But
certain animals seem to play a more important role as a
reservoir.  The main ones throughout most of the country are
insectivorous bats, skunks, foxes, and of course raccoons."  Even
deer and antelope can become infected if a rabid animal bites
them.</p>

<p>You're only at a slight risk to pick up rabies if you dress
an infected deer or other ungulate without gloves on. 
Theoretically, though, it's possible for you to get it,
especially if you skin out the head and get saliva on your hands.</p>

<p>Direct contact is not the only way you can acquire rabies. 
In rare cases, spelunkers have become infected from inhaling the
virus in bat caves. </p>

<p>If you're bitten by a rabid animal, the first symptom of the
disease is what Wilder terms "an unusual sensation" at the site
of the bite.  "It's an increased sensitivity, a feeling of
prickliness, just an odd sensation arising from the healing
wound."  A fever and stiffening of the neck follow.  Then you'll
have convulsions.  You'll salivate because you're unable to
swallow.  Death will follow in of days or weeks.</p>

<p>A post-exposure vaccine for people has been available for
many years.  Recently, scientists have developed a pre-exposure
vaccine.  Wilder says whether or not you need to get vaccinated
depends on what you're hunting.  Most people don't need to worry
about it.  But if you're a woodchuck or raccoon hunter, he
recommends it.  At a cost of about $100, it's cheap insurance.</p>

<p>Wilder also stresses that hunters need to have their dogs
vaccinated against the disease.  Some raccoon hunters in
particular fear the inoculation will affect the dogs' ability to
hunt, and so don't have them vaccinated.  </p>

<p>Don't do the vaccination yourself.  In Florida and perhaps a
few other state, rabies vaccine is available over the counter at
feed stores. "We've been most fortunate that no identified cases
of rabies have occurred from this practice," Wilder says.</p>

<p>   Plague
Remember the bubonic plague, the disease that decimated
Europe in the Middle Ages?  It's still with us in the western US. </p>

<p>Any rodent in the west can harbor the plague organism. 
"Most people in the United States who acquire plague are getting
it from ground squirrels," Quan says.  "On the west coast, it's
the California Ground Squirrel.  In the Rocky Mountains it's the
Rock Squirrel.  Then you have other smaller squirrels and
chipmunks."  Even if you don't have direct contact with rodents,
you're still not immune.  Your dog and cat may catch a squirrel,
pick up the fleas carrying the organism, and bring it home to
you.</p>

<p>Plague is transmitted to humans through flea bites.  Early
symptoms are similar to those of tularemia: high fever, muscle
aches, fatigue.  You'll have pain, sometimes quite severe, in the
area where the buboes, or swollen lymph glands, are going to
develop.  </p>

<p>Untreated, plague kills.  The organism produces toxins that
cause problems with blood clotting, and eventually gangrene. 
Fifty-five to sixty per cent of patients die.  Even treated,
plaque kills 15 to 20 per cent of patients. </p>

<p>As dreadful as plague is, it's easily treated.  A variety of
antibiotics, including Tetracycline and sulfa drugs, will knock
it out.  </p>

<p>"People who see a physician early on after symptoms, and who
have the savvy to know they were possibly exposed tend to
survive," Quan says.  "A large percentage of those who die have
septicemic plague, which does not have a bubo."  These cases look
like a lot of other diseases, are hard to diagnose, and as a
result often don't get treated early enough.</p>

<p>Fortunately, plague is rare.  Quan says in 1983 doctors
reported a high of 40 cases, but in general the number is 10 to
20.  This compares to 200-plus for tularemia each year.</p>

<p>   Prevention</p>

<p>Most members of this hall of villains are easy to prevent
with little effort.  First, don't drink untreated water.  Carry
water or soft drinks with you.  </p>

<p>Second, any time you dress game, don't do it bare-handed;
wear gloves.  "If you don't wear gloves, you're really taking
your chances," Quan says.  </p>

<p>Third, avoid contact with mosquitoes, ticks and fleas.
"Most of these things can be prevented with repellents," Craven
says.  He notes especially Permanone, a permethrin compound that
is both an insecticide and a repellent useful for ticks. </p>

<p>If, after being in the woods, you begin to show symptoms
like any of the ones described here, go straight to the doctor. 
Don't wait to see if you get better on your own.  And be sure you
tell him or her what you suspect.</p>

<p>"Be sure you tell the physician you had the contact," Quan
says.  "It's one way we have of making an early, proper
diagnosis.  Tell the doctor you had contact with such-and-such an
animal.  Then the physician is at least alerted that tularemia is
as possibility, or in the western states, plague."  </p>

<p>These are only some of the weird and exotic diseases you may
encounter on a hunting or fishing trip.  Others include
Leptospirosis, Anthrax, and a variety of fungal organisms.  But
by following some common-sense preventive techniques, you can
avoid bringing home these unwanted freeloaders from the woods.</p>

<p>    -End-
</p>

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