IV.
In the last section, we discussed infections that usually come as a result of poor sanitation and hygiene, such as diarrheal disease and body lice. There are many other types of bacterial, viral, and parasitic disease that may not necessarily have sanitation and hygiene as a factor but can be as dangerous. Appendicitis, for example, can occur in anyone, regardless of their cleanliness or the conditions at their retreat. A simple ingrown hair may lead to a boil or abscess.
Our bodies’ natural ability to fight illness is impressive. There are, however, no organs that are immune to infections; the ability to recognize and treat these illnesses early is essential for the successful medic. In this section, we discuss some of the more common ones that you might see.
APPENDICITIS AND CONDITIONS THAT MIMIC IT
Appendicitis
There are various infections that can cause abdominal pain, some of which can be treated medically and some which are treated surgically. One relatively common issue that could be life threatening in a long-term survival situation, especially to young people, would be appendicitis. Appendicitis (inflammation of the appendix) occurs in approximately 8 out of every 100 people.
Appendicitis can occur in anyone but most likely affects people under forty. The appendix is a tubular, worm-shaped piece of tissue 2–4 inches long that connects to the intestine at the lower right side of the abdomen. The inside of this structure forms a pouch that opens to the large intestine. The purpose of the appendix is unknown, but one theory is that it is an example of a “vestigial” organ, which means that it is a useless remnant from our evolutionary past that now serves little useful purpose.
The appendix causes trouble when it is blocked or bacteria are passed along from elsewhere in the body. The bacteria can multiply and cause inflammation or infection, and even cause the appendix to fill up with pus. If the problem is not treated, the appendix can burst, spilling infected matter into the abdominal cavity. This causes peritonitis, a condition that can spread throughout the entire abdomen and become very serious. Before the development of antibiotics, it was not unusual to die from the infection.
Appendicitis starts off with vague discomfort in the area of the belly button but moves down to the lower right quadrant of the abdomen after 12–24 hours. This area, also known as “McBurney’s Point,” is located about two-thirds of the way down from the belly button to the top of the right pelvic bone.
Other likely symptoms may include the following:
Nausea and vomiting
Loss of appetite
Fever and chills
Abdominal swelling
Pain worsening with coughs or walking
Difficulty passing gas
Constipation or diarrhea
A patient may resist using his or her legs, because that triggers movement of abdominal muscles. Nausea, vomiting, and fever are other common signs and symptoms of appendicitis.
To diagnose this condition, press down on the lower right of the abdomen. Your patient will probably find it painful. A sign of a possible ruptured appendix may be what is called “rebound tenderness.” In this circumstance, pressing down will cause pain, but it will be even more painful when you remove your hand.
The patient should be restricted to small amounts of clear liquids as soon as you make the diagnosis. Surgical removal of the appendix is curative here but will be difficult to carry out without modern medical facilities.
If modern surgical care is unavailable, your only hope may be giving the patient antibiotics by mouth in the hope of eliminating an early infection. Of course, intravenous antibiotics, such as cefoxitin, are more effective than related oral antibiotics, such as cephalexin (veterinary equivalent: Fish Flex). Studies in the United Kingdom achieved some success using intravenous antibiotics in early (uncomplicated) cases of appendicitis.
A combination of ciprofloxacin (veterinary equivalent: Fish Cin) and metronidazole (Fish Zole) is an option if intravenous antibiotics or surgical intervention is not available. It is also acceptable in those allergic to penicillins. Recovery, although slow, may still be possible if treatment is begun early enough or the body has formed a wall around the infection.
Can surgery be performed in situations where general anesthesia is unavailable? Most surgeries can’t, without risking the loss of the patient. Surgeons in developing countries, however, have done appendectomies under local anesthesia.
Before surgery is contemplated to deal with an inflamed appendix, you must be certain that you are dealing with that exact problem. Sometimes, different medical problems present with similar symptoms, and you will have to do some detective work to differentiate one from another. This is called making the “differential diagnosis.”
There are various conditions that may mimic appendicitis, including those described below.
Tubal Pregnancy
In women of childbearing age, a tubal pregnancy should be ruled out. This is a condition that occurs in 1 in every 125 pregnancies. In this condition, a fertilized egg fails to implant in the normal location (the uterine wall) and implants in the fallopian tube instead. It grows in this tiny canal until it reaches a size that bursts the tube. This, oftentimes, will cause pain and internal bleeding; in the past, it was not uncommon for a tubal pregnancy to be fatal.
In this case, the pain is due to the presence of blood instead of an infection. If you have women of childbearing age in your family or survival group, have some pregnancy tests in your medical supplies. A woman with a missed period, positive pregnancy test, and severe pain on one side of the lower abdomen is a tubal pregnancy until proven otherwise.
Diverticulitis
Diverticulitis, unlike appendicitis, is seen mostly in older patients. Diverticula are small pouches in the large bowel that resemble an inner tube peeking out of a defect in an old-timey car tire. These areas may become blocked just as the appendix might. The symptoms are very similar, but most diverticulitis patients will complain of pain in the lower left quadrant instead of the right.
Other inflammatory conditions in the bowel, such as Crohn’s disease or ulcerative colitis, may present with pelvic pain. These are commonly treated with steroids but may require surgery, as well.
Pelvic Inflammatory Disease
A female pelvic infection often caused by sexually transmitted diseases, such as gonorrhea or chlamydia, may imitate some of the symptoms of an inflamed appendix. This is known as “pelvic inflammatory disease” (or “PID”). These patients will, however, usually have pain on both sides of the lower abdomen, associated with fever and, sometimes, a foul vaginal discharge.
Pelvic inflammatory disease can cause major damage to internal female anatomy. Scarring ensues as the body tries to heal, sometimes causing infertility and chronic discomfort. Serious female infections involving the pelvis are best treated with antibiotics, such as doxycycline, sometimes in combination with metronidazole twice a day for a week. It is a good idea to treat sexual partners, too.
Ovarian Cysts
Other female issues in the pelvis, such as large or ruptured ovarian cysts, could also cause pain due to pressure or bleeding. An ovarian cyst is an accumulation of fluid within an ovary that is surrounded by a wall. Many arise from egg follicles, but others can be benign or, less often, cancerous, tumors.
Most cysts cause pain by rupturing. A rupture may cause a painful irritation of the abdominal lining, internal bleeding, or both. Sometimes, ovarian cysts go away spontaneously, but a ruptured cyst that is actively bleeding will require surgery. A right-sided ruptured cyst could appear similar to appendicitis as the pain is in the same location.
The diagnosis of appendicitis or other causes of abdominal pain without modern diagnostic equipment will be challenging. Despite this, we have to remember that medical personnel, in the past, had only the physical signs and symptoms to help them reach a diagnosis.
URINARY TRACT INFECTIONS
Besides the bowels, bodily waste is excreted through the urinary tract. The urinary tract includes the kidneys, ureters, bladder, and urethra. It is, essentially, the body’s plumbing.
Most women, at some time of their lives, have experienced a urinary tract infection (UTI). An infection of the bladder (cystitis) usually affects the urethra (the tube that drains the bladder) as well. Various bacteria may cause this infection; Escherichia coli (E. coli) is the most common. Although men are not immune from a bladder infection, the male urethra is much longer. Therefore, it’s more difficult for bacteria to reach the bladder.
Some urinary infections are sexually transmitted, such as gonorrhea. In men, painful urination (dysuria) is very common, though most women might only note a yellowish vaginal discharge.
Although painful urination is not uncommon in cystitis, the most common symptom is frequency of the need to urinate. Some people notice that the stream of urine is somewhat hesitant (“hesitancy”) or may feel an urgent need to go without warning (“urgency”). If not treated, a bladder infection may possibly ascend to the kidneys, causing an infection of those organs (pyelonephritis). Once an infection is in the kidney, your patient may experience the following symptoms:
One-sided back or flank pain
Persistent fever and chills
Abdominal pain
Bloody, cloudy, or foul urine
Dysuria
Sweating
Mental changes (in the elderly)
Antibiotics will be necessary in this instance. If the infection is not treated, the condition may progress to sepsis, where the infection reaches the bloodstream through the kidneys. These patients may show signs of shock, such as rapid breathing, decreased blood pressure, fever and chills, and confusion or loss of consciousness.
Preventative medicine plays a large role in decreasing the likelihood of this problem. Adherence to basic hygiene methods in those at high risk, especially women, is warranted. Standard recommendations include wiping from front to back after urinating or defecating, as well as urinating right after an episode of sexual intercourse. Also, never postpone urinating when there is a strong urge to do so.
Adequate fluid intake is also a key to remaining free of bladder issues. Consider natural diuretics (substances that increase urine output) to flush out your system.
Treatment revolves around the vigorous administration of fluids. Lots of water will help flush out the infection by decreasing the concentration of bacteria in the bladder or kidney. Applying warmth to the bladder region is soothing. Antibiotics are another mainstay of therapy (brand names and veterinary equivalents in parenthesis):
• Sulfamethoxazole/trimethoprim (Bactrim, SeptraTM; veterinary equivalent: Bird Sulfa)
• Amoxicillin (Amoxil; veterinary equivalent: Fish Mox)
• Nitrofurantoin (MacrobidTM)
• Ampicillin (veterinary equivalent: Fish Cillin)
• Ciprofloxacin (CiproTM; veterinary equivalent: Fish Flox)
An over-the-counter medication that eliminates the painful urination seen in urinary infections is phenazopyridine. (Brand names include Pyridium, UristatTM, and Azo.) Don’t be alarmed if your urine turns reddish-orange; it is an effect of the drug and is temporary. Vitamin C supplements are thought to reduce the concentration of bacteria in the urine.
A few natural remedies for urinary tract infections are also available:
• Garlic or garlic oil (preferably in capsules)
• Echinacea extract or tea
• Goldenrod tea with 1–2 tablespoons of vinegar
• Uva ursi (1 tablet)
• Cranberry juice or tablets (1–3 pills)
• Alka-SeltzerTM in 2 ounces warm water (poured directly over the urethra)
Use any of these remedies 3 times a day.
HEPATITIS
The largest internal organ in the human body is the liver. This organ is extremely important for survival, and any impairment in its function is dangerous. The liver has many duties, including the following:
• Production of bile to help digestion
• Filtration of toxins from the blood (for example, alcohol)
• Storage of certain vitamins and minerals
• Manufacture of amino acids (for protein synthesis)
• Maintenance of normal levels of glucose (sugar) in the blood
• Conversion of glucose to glycogen for storage purposes
• Production of cholesterol
• Making of urea (main component in urine)
• Processing of old red blood cells
• Development of certain hormones
Hepatitis is the term used for inflammation of the liver. Mostly caused by viruses, this condition keeps the body from being unable to process toxins and perform the other functions listed above, and can be life threatening.
There are various types of hepatitis, generally referred to by letters, such as hepatitis A, hepatitis B, and hepatitis C. Hepatitis can also occur because of adverse reactions to drugs and alcohol.
Hepatitis may also be caused by oral or fecal contamination. As such, we were in a quandary regarding whether to put this in the last section on hygiene and sanitation or here. I decided to place it here because some types of liver damage are not hygiene-related, such as those caused by alcohol abuse. Hepatitis can also be spread by sexual contact.
The hallmark of hepatitis is “jaundice,” the yellowing of the skin and whites of the eyes. Urine becomes darker and stools turn grey. The liver, which can be found on the right side of the abdomen just below the lowest rib, becomes enlarged or tender to the touch. There is also a sensation of itchiness that is felt all over the body. Added to this is a feeling of extreme fatigue, weight loss, nausea, and sometimes fever. In some circumstances, people with hepatitis may have no symptoms at all and still pass the illness to others.
The hepatitis A virus is found in the bowel movements of an infected individual. When a person eats food or drinks water that is contaminated with the virus, they develop a flu-like syndrome that can quickly become serious.
Hepatitis B can be spread by exposure to infected blood, plasma, semen, and vaginal fluids. Symptoms are usually indistinguishable from hepatitis A, although they may lead to a chronic condition known as “cirrhosis,” which in turn leads to permanent liver damage.
In cirrhosis, the functioning cells of the liver are replaced by nodules that do nothing to help metabolism. Cirrhosis can also be caused by long-term alcohol and chemical abuse. Possible signs and symptoms of liver cirrhosis include “ascites,” an accumulation of fluid in the abdomen, varicose veins (enlarged veins, especially in the stomach and esophagus), jaundice, and swollen ankles.
About two hundred million people are chronically infected with hepatitis C virus throughout the world. It is a blood-borne virus contracted by intravenous drug use, transfusion, and unsafe sexual or medical practices. A percentage of these patients will progress to cirrhosis over time.
Other than making your patient comfortable, there isn’t very much that you will be able to do in an austere setting regarding this condition. Most cases of hepatitis, however, are self-limited, which means that they will resolve on their own after a period of time. Expect at least 2–6 weeks of down time. There is a vaccine available for hepatitis B.
You can, however, practice good preventive medicine by encouraging the following policies for your family or community:
• Wash hands after using the bathroom and before preparing food.
• Wash dishes with soap in hot water.
• Avoid eating or drinking anything that may not be properly cooked or filtered.
• Make sure children don’t put objects in their mouths.
There are a few “detoxifying” and anti-inflammatory herbal remedies that may help support a liver inflicted with hepatitis. Some of these supplements include the following:
• Milk thistle
• Artichoke
• Dandelion
• Turmeric
• Licorice
• Red clover
• Green tea
These are not cures but may assist your other efforts by having a restorative effect.
There are also nutritional strategies that may help:
• Avoid fatty foods and alcohol.
• Increase zinc intake.
• Decrease protein intake.
• Improve hydration status, especially with herbal teas, vegetable broths, and diluted vegetable juices.
FUNGAL INFECTIONS
Athlete’s Foot
Athlete’s foot (tinea pedis) is an infection of the skin caused by a type of fungus. This condition may be a chronic issue, lasting for years if not treated. Although usually seen between the toes, you might see it also on other parts of the feet or even on the hands (often between fingers). It should be noted that this problem is contagious, passed by sharing shoes or socks and even by wet surfaces.
Any fungal infection is made worse by moist conditions. People who are prone to athlete’s foot commonly
• Spend long hours in closed shoes.
• Keep their feet wet for prolonged periods.
• Have had a tendency to get cuts on feet and hands.
• Perspire a lot.
To make the diagnosis, look for
Flaking of skin between the toes or fingers.
Itching and burning of affected areas.
Reddened skin.
Discolored nails.
Fluid drainage from surfaces traumatized by repeated scratching.
If the condition is mild, keeping your feet clean and dry may be enough to enable slow improvement of the condition. However, topical antifungal ointments or powders, such as miconazole or clotrimazole, often are required for elimination of the condition.
A favorite home remedy for athlete’s foot involves adding a liberal amount of tea tree oil to a foot bath and soaking for 20 minutes or so. Dry the feet well and then apply a few drops onto the affected area. Repeat this process 2 times a day. Try to keep the area as dry as possible between treatments.
Ringworm
Ringworm represents a fungal infection on the surface of the skin. It will often appear as a raised, itchy patch that is darker on the outside. As such, it may resemble a sharply-defined ring. Ringworm has nothing to do with worms.
If ringworm occurs in a hairy area, it will likely cause bald patches. Consistent scratching at the patches will cause blistering and oozing. Treatment, both conventional and natural, follows a similar process as that described for athlete’s foot:
• Keep skin as dry as possible.
• Use an antifungal (miconazole, clotrimazole) or drying powders or creams.
• Avoid tight-fitting clothing on irritated areas.
• Wash regularly.
• Wash sheets daily.
Yeast Infections
In addition to viruses and bacteria, our body may be susceptible to yeast, a one-celled fungus that reproduces by budding off the parent. The human body naturally harbors certain types but can be damaged by others.
Fungal infections may be local, as in vaginal infections, “ringworm,” or “athlete’s foot,” or they can be systemic (throughout the entire body). Some people are affected by intestinal fungal infections that can affect digestion. Systemic fungal infections have been blamed for many illnesses, but proven cases seem to occur mostly in the very young, the elderly, and those with compromised immune systems.
Vaginal Yeast Infections
Vaginal yeast infections (also called monilia) are extremely common and are not an indication of a sexually transmitted disease. A woman with a yeast infection will have a thick, white discharge reminiscent of cottage cheese and vaginal itchiness.
This infection is often easily treated with short courses of over-the-counter creams or vaginal suppositories, such as MonistatTM (miconazole), but may recur. Resistant infections may be treated with prescription fluconazole (DiflucanTM) 150 mg orally once; repeat in 3 days if symptoms persist.
Nonyeast vaginal infections, those caused by bacteria or protozoa, also exist and are called bacterial vaginosis and trichomoniasis respectively. These tend to have a foul odor and are treated with the prescription antibiotic and antiparasitic metronidazole (veterinary equivalent: Fish Zole), which is taken orally.
The time-honored vinegar and water douche, performed 1 time a day, is very effective in eliminating minor vaginal infections.
Douche with 1 tablespoon of vinegar in 1 quart of water. Use this method only until your patient feels better. Women who douche often are, paradoxically, more likely to get yeast infections.
Acidophilus supplements, in powder or capsule form, may be a good oral treatment. Cranberry juice and yogurt are good foods for vaginal infections because they change the pH of the organ to a level inhospitable to yeast.
Oral Yeast Infections
A related yeast infection may be seen in the mouth of some infants and others. This infection is known as “thrush” and is identified by white patches on the inside of the cheeks, the roof of the mouth, and other areas of the oral cavity. Thrush can cause irritation, and the white patches are adherent, causing bleeding if wiped off. Occasionally, nipple tissue is affected in breastfeeding mothers.
Oral thrush may be treated conventionally with liquid fluconazole (Diflucan) 1 time a day for 1 week. Nystatin, another antifungal, is available as a “swish-and-swallow” version for oral thrush or can be applied topically 4 times a day to infected nipples for 5–7 days.
CELLULITIS
Any soft-tissue injury carries a risk of infection. Infections from minor wounds or insect bites are relatively easy to treat today, because of the wide availability of antibiotics.
Despite your best efforts to care for a wound, there is always a chance that an infection will occur. Cellulitis is an infection in the soft tissues below the superficial level of the skin. Below the epidermis are the main layers of soft tissue, the dermis (you’ve seen this area when you scraped your knee as a kid), subcutaneous fat, and muscle layers.
Although preventable, the sheer number of cuts, scrapes, and burns will make cellulitis one of the most prevalent medical problems. This infection can easily reach the bloodstream, and, without antibiotics, can cause sepsis, a life-threatening condition. Cuts, bites, blisters, or cracks in the skin can all be entryways for bacteria to cause infections that could lead to sepsis if not treated. We believe that cellulitis will be the cause of many otherwise-preventable deaths in an off-grid scenario. Conditions that might cause cellulitis include the following:
• Cracks or peeling skin between the toes
• Poor circulation, including varicose veins
• Injuries that cause a break in the skin
• Insect bites and stings, animal bites, or human bites
• Ulcers from chronic illness, such as diabetes
• Use of steroids or other medications that affect the immune system
• Wounds from previous surgery
• Intravenous drug use
The symptoms and signs of cellulitis are as follows:
Discomfort or pain in the area of infection
Fever and chills
Exhaustion
General ill feeling (malaise)
Muscle aches (myalgia)
Warmth in the area of the infection
Drainage of pus or cloudy fluid from the area of the infection
Redness, usually spreading towards torso
Swelling in the area of infection (causing a sensation of tightness)
Foul odor coming from the area of infection
Although the body can sometimes resolve cellulitis on its own, treatment usually includes the use of antibiotics. These can be topical, oral or intravenous. Most cellulitis will improve and disappear after a 10–14-day course of therapy with medications in the penicillin, erythromycin, or cephalosporin (Keflex) families. Amoxicillin and ampicillin are particularly popular. If cellulitis is in an extremity, keeping the limb elevated is helpful.
Acetaminophen (Tylenol) or ibuprofen (Advil) is useful to decrease discomfort. Warm-water soaks have been used for many years for symptomatic relief. The full 10–14 days of antibiotics should be completed to prevent any recurrences.
Abscesses (Boils)
An abscess is a form of cellulitis that is, essentially, a pocket of pus. Pus is the debris left over from your body’s attempt to eliminate an infection; it consists of white and red blood cells, live and dead bacteria, and inflammatory fluid.
If the abscess was not caused by an infected wound or diseased tooth, it is possible that it originated in a “cyst,” a hollow structure filled with fluid. There are various types of cysts that can become infected and form abscesses:
Sebaceous–skin glands that are often associated with hair follicles and concentrated on the face and trunk.
Inclusion–where the skin lining is trapped in deeper layers as a result of trauma. Inclusions continue to produce skin cells and grow.
Pilonidal–cysts located over the area of the tailbone, which are easily infected.
Abscesses have a tendency to wall off infections; this makes it hard for antibiotics used for cellulitis to penetrate effectively. Intervention may be necessary.
To deal with an abscess, an opening must be made for the evacuation of pus. The easiest way to facilitate this is to place warm moist compresses over the area. This will help bring the infection to the surface of the skin, where it will form a “head” and perhaps drain spontaneously. This is called “ripening” the abscess. The abscess will go from firm to soft, and have a “whitehead” pimple at the point of exit.
If this fails to happen by itself over a few days, you may have to open the boil by a procedure called “incision and drainage.” Using the tip of a scalpel (a number 11 blade is best), pierce the skin over the abscess where it is closest to the surface. The pus should drain freely, and your patient will probably experience immediate relief from the release of pressure.
Finally, wash thoroughly and apply some triple antibiotic ointment to the skin surrounding the incision. Cover with a clean bandage. Alternatives to triple antibiotic ointment include lavender oil, tea tree oil, and raw honey.
Incision and drainage may be helpful for dental abscesses as well but may not save overlying teeth. (See how to extract a tooth in the dental section of this book.)
Tetanus
Classic position associated with tetanus
Most of us have dutifully gone to get a tetanus shot when we stepped on a rusty nail, but few have any real concept of what tetanus is and why it is dangerous.
Tetanus is an infection caused by the bacterium Clostridium tetani. The bacteria produces spores (a reproductive cell, or inactive bacteria-to-be) that primarily live in the soil or the feces of animals. These spores are capable of living for years and are resistant to extremes in temperature.
Tetanus is relatively rare in the United States, with about 50 reported cases a year. Worldwide, however, there are more than 500,000 cases a year. Most victims are found in developing countries that have poor immunization programs.
Tetanus infections usually occur when a person has experienced a break in the skin. The skin is an important barrier to infection, and any chink in the armor leaves a person open to infection. The most common cause is some type of puncture wound, such as an insect or animal bite, a splinter, or even that rusty nail. This is because the tetanus bacterium doesn’t like oxygen, and deep, narrow wounds give less access to it. Any injury that compromises the skin, however, is eligible: Burns, crush injuries, and lacerations can be entryways for tetanus bacteria.
When a wound becomes contaminated with tetanus spores, the spores become activated as full-fledged bacteria and reproduce rapidly. Damage to the victim comes as a result of a strong toxin excreted by the organism, tetanospasmin. This toxin specifically targets nerves that serve muscle tissue.
Tetanospasmin binds to motor nerves, causing “misfires” that lead to involuntary contraction of the affected areas. This neural damage can be localized or affect the entire body. The patient may exhibit the classical symptom of “lockjaw,” where the jaw muscle is taut. However, any muscle group is susceptible if affected by the toxin, including the respiratory musculature, which can inhibit normal breathing and become life threatening.
The most severe cases seem to occur at extremes of age, with newborns and people older than 65 most likely to succumb to the disease. Death rates from generalized tetanus hover around 25–50 percent, higher in newborns.
You will be on the lookout for the following early symptoms:
Sore muscles (especially near the site of injury)
Weakness
Irritability
Difficulty swallowing
Lockjaw
Initial symptoms may not present themselves for up to 2 weeks. As the disease progresses, you may see the following:
Progressively worsening muscle spasms (may start locally and become generalized over time)
Involuntary arching of the back (sometimes so strong that bones may break or dislocations may occur)
Fever
Respiratory distress
High blood pressure
Irregular heartbeats
The first thing that the survival medic should understand is that, although an infectious disease, Tetanus is not contagious. You can feel confident treating a tetanus victim safely, as long as you wear gloves and observe standard clean technique. Wash the wound thoroughly with soap and water, using an irrigation syringe to flush out any debris. This should limit growth of the bacteria and, as a result, decrease toxin production.
You will want to administer antibiotics to kill off the rest of the bacteria in the system. Administering 500 mg of metronidazole (veterinary equivalent: Fish Zole) 2 times a day or 100 mg of doxycycline (veterinary equivalent: Bird Biotic) 2 times a day is known to be effective. The earlier you begin antibiotic therapy, the fewer toxins will be produced. Intravenous rehydration, if you have the ability to administer it, is also helpful. The patient will be more comfortable in an environment with dim lights and reduced noise.
Ventilators, tetanus antitoxin, and muscle relaxants or sedatives, such as ValiumTM (diazepam), are used to treat severe cases but will be unlikely to be available to you. For this reason, it is extraordinarily important to watch anyone who has sustained a wound for the early symptoms listed above.
Tetanus can be prevented by vaccination. Booster injections are usually given every ten years. Tetanus vaccine is not without its risks, but severe complications, such as seizures or brain damage, occur in less than one in a million cases. Milder side effects, such as fatigue, fever, nausea and vomiting, headache, and inflammation in the injection site, are more common.
MOSQUITO-BORNE ILLNESSES
Mosquito bites are common vectors (transmitters) of various infectious diseases. Anaphylaxis (severe allergic reaction) as seen with bee stings is rarely an issue with mosquitos and is covered later in this book. Only female mosquitos bite humans.
The increased amount of time we would spend outside in a survival situation would increase the chances of exposure to one or more mosquito-borne illnesses. One of the most notorious diseases caused by mosquito vectors is malaria.
Malaria is caused by a microscopic organism called a protozoan. When mosquitos bite you, they inject these microbes into your system. Once in the body, the protozoa colonize your liver. From there, they go to your blood cells and other organs.
Symptoms of malaria appear flu-like, and classically present as periodic chills, fever, and sweats. The patient becomes anemic as more blood cells are damaged by the protozoa. With time, periods between episodes become shorter and permanent organ damage may occur.
Anyone that experiences periodic fevers with severe chills and sweating should be considered candidates for treatment. Medications used for malaria include chloroquine, quinine, and quinidine.
Sometimes an antibiotic, such as doxycycline or clindamycin, is used in combination with the medications mentioned above. Physicians are usually sympathetic towards prescribing these medications to those who are contemplating trips to places where mosquitos are rampant.
Other mosquito-borne diseases include yellow fever, dengue fever, and West Nile virus. The fewer mosquitos near your retreat, the less likely you will fall victim to one of these diseases. You can decrease the population of mosquitos in your area and improve the likelihood of preventing illness by taking the following precautions:
• Look for areas of standing water that could serve as mosquito breeding grounds. Drain all water that you do not depend upon for survival.
• Repair any holes or defects in the screens on your retreat windows and doors.
• Be careful to avoid outside activities at dusk or dawn. This is the time that mosquitos are most active.
• Wear long pants and shirts whenever you venture outside.
• Have a good stockpile of insect repellants.
If you are reluctant to use chemical repellants, you may consider natural remedies. Plants that contain citronella may be rubbed on your skin and clothing to discourage bites.
When you use an essential oil to repel insects, reapply frequently and feel free to combine oils as needed. Besides citronella oil, you could use the following oils:
• Lemon eucalyptus
• Cinnamon
• Peppermint
• Geranium
• Clove
• Rosemary