Illness & Waterborne Disease

Overview

GI illness saps fluids and energy. Your priorities are hydration, electrolytes, and preventing spread. Most cases resolve with supportive care; know red flags for evacuation.

Diarrhea Management

Most field GI illness resolves with rest and fluids. The priority is hydration and electrolyte replacement.

• Fluids: Oral rehydration solution (ORS) in small, frequent sips.
• Diet: Bland foods as tolerated (rice, oats, crackers); avoid dairy/fatty foods initially.
• Hygiene: Wash/sanitize hands; segregate cook gear; treat water carefully.
• Red flags: Blood in stool, high fever, severe abdominal pain, persistent vomiting preventing fluids, signs of severe dehydration (no urine 8+ hours, lethargy/confusion). Evacuate/seek medical care.

ORS Recipe

1 L safe water + 6 level tsp sugar + 1/2 level tsp salt. Stir until dissolved; taste should be lightly salty, not briny.

• Administration: Adults: frequent small sips; children: 5–10 mL every 1–2 minutes; increase as tolerated.
• Variants: Commercial ORS packets; half‑strength sports drink + pinch of salt if nothing else.

Anti-Diarrheals — When to Use/Avoid

Use cautiously.

• Loperamide: May reduce stool frequency for non‑bloody, non‑febrile diarrhea (e.g., traveler’s diarrhea) in adults. Avoid if blood, high fever, or suspected invasive infection.
• Bismuth subsalicylate: May reduce symptoms; avoid in salicylate allergy, children with viral illness (Reye’s risk).
• Antibiotics: Prescription‑guided for specific scenarios; not covered here.

☑️ Checklist — GI Management

• Confirm safe water supply and multi‑barrier treatment
• Mix ORS correctly; deliver small, frequent sips
• Separate sick person’s utensils; strict hand hygiene
• Monitor hydration (urine output, mentation)
• Evacuate with red flags (blood, fever, severe dehydration)

Examples

• Traveler’s diarrhea: No blood/fever; ORS + rest; optional loperamide for essential travel; improve within 24–48 h.
• Backcountry group: Two sick with vomiting; institute hand hygiene, separate cooking kit, treat water more rigorously; plan slow exit.

---

Key Takeaways

• Hydration and electrolytes are the main treatment; mix ORS precisely.
• Avoid anti‑diarrheals in bloody diarrhea or high fever; seek care.
• Prevent spread with strict hygiene and better water treatment.

Scenario

🧭 Scenario (Camp GI spread): Two of four have diarrhea after a river swim.
🔍 Decisions: Keep moving vs rest; anti‑diarrheals; hygiene controls.
✅ Outcome: You rest, mix ORS, improve water treatment, separate cook gear, and recover next day.
🧠 Lessons: Hydration + hygiene > speed
🏋️ Drill: Pack ORS packets in each kit and learn the home recipe by heart.