Youth FAQ - Can you get sick from caving?

[Cheryl Jones]

Mmmm-mmmm! It's what's in the water that gives JD that very special flavor!!

Cheryl

[Larry E. Matthews]

Well, of course, several things happen there that make the water TOTALLY safe.

First, of course, it is boiled in cooking the mash.

Then, it is boiled again, in the distilling process.

Then, of course, it ends up as 80% alcohol, which would kill anything even if it could make it past the first two steps.

So, Jack Daniels Whiskey won't make you sick. Unless you drink too much !!!!

And, on a really interesting note, Jack Daniels hired cavers to MAP their cave and either bought the land over it, or secured easements. Their water supply is quite secure. The official TN Cave Survey length of their cave is 6,670 feet long.

If you have never been there, the tour is very intresting, and it is FREE. Unfortunately, you can't go in the cave. But the entrance is quite scenic.

Larry E. Matthews
NSS #6792-F

[Teresa]

I don't think I saw this in anybody else's post, but don't drink untreated cave water or spring water.

This seems to be such simple advice, that nobody else thought to mention it.

Um, Larry:
"No matter how clean-looking, cave water should be assumed to be contaminated with something, however the risk is rarely higher than swimming in a river or pond. "

Re Jack Daniels: in Lynchburg, they don't let you sample the product either, which is common practice in Missouri breweries.

RE clean water: I would not drink cave water in the cave. I've been known to drink spring water down the branch a ways-- after it has been exposed to sunlight (UV) and bubbling (oxygenation). Of course, I usually know the recharge area, and I've drunk enough river water while swimming with no ill effects for 50 years, so while it probably isn't smart, I've managed to get away with it. I don't make a habit of either one, though. Girardia may be dumb, but I don't want to find out. I make no recommendations for other people--if giving advice, I'd rather err on the side of caution.

Slightly OT--UV and ozonation are all they do to my municipal water supply (talked to the public works guy). That's all the bottled water/ice plant in town does. Yes, I know they test the water, but it is a karst source- the same regional aquifer which the springs I will drink from originate.

I agree with Larry that for general publicity purposes, drinking raw water isn't recommended, but I've also been on field trips with lots of hydrogeos, and they pile off the bus and drink from springs and artesian wells and that is in Missouri...

[gillip]

I got sick from a little cave surveying a couple of months ago. I had found a small, undecorated, and somewhat miserable cave and thought it would be a good place to survey. You can crawl for the first 50 feet of the cave and then you have to belly crawl. On the first trip to this cave I encountered a racoon. On this trip, I saw plenty of evidence of racoon. There was fungus growing on feces, with fungus growing on other fungus. Obviously not very sanitary. The cave ended in a sump. At some spot near the sump I had to turn my head sideways and got water in my mouth. The water tasted very sweet, which is not a good sign. When I got back to camp, I gargled but still ended up with a sore throat.
I will second Larry's advice about not drinking the water. My M.S. advisor told be a story about taking his M.S. advisors son caving and they both drank what looked like clean water and both became violently ill. It was some bacterial infection.
I have taken water samples from caves that have had bateria counts as high as surface water. Especially in exposed or shallow manltled karst the water infiltrates very quickly with little filtration.
Also, think of all the cave fauna. No one (sane) would put guano in their mouth.

[cavedoc]

I got sick from a little cave surveying <snip> On this trip, I saw plenty of evidence of racoon. There was fungus growing on feces, with fungus growing on other fungus. Obviously not very sanitary.

You might get very sick. This is the abstract about a brain infection you can get from close contact with raccoon excrement. Especially a propos in a forum on youth groups.

Clin Infect Dis. 2004 Nov 15;39(10):1484-92.
Raccoon roundworm encephalitis.Murray WJ, Kazacos KR.

The raccoon roundworm, Baylisascaris procyonis, is increasingly recognized as a cause of zoonotic visceral, ocular, and neural larva migrans and, in particular, of devastating encephalitis in young children. Exposure occurs mainly at raccoon latrines, where large numbers of infective eggs may be accidentally ingested. Risk factors for infection include contact with raccoon latrines, pica/geophagia, age of <4 years, and male sex. The severity of central nervous system (CNS) disease depends on the number of eggs ingested, the extent and location of larval migration, and the severity of ensuing inflammation and necrosis. Diagnosis of Baylisascaris encephalitis is based on clinical CNS disease, peripheral and cerebrospinal fluid eosinophilia, deep white matter lesions visible by magnetic resonance imaging, and positive results of serologic tests. Treatment efficacy in clinical cases is poor, but albendazole prevents disease if given promptly after infection. Considering the seriousness of this disease and limitations of diagnosis and treatment, prevention of infection with eggs is of utmost importance.

[tropicalbats]

Roger,

Baylisascaris is arguably the single most nasty bit that a caver could get short of rabies. But cavers are not keeling over from it (nor rabies), or going blind as is more likely, so it hasn't really come up. The abstract you posted is money on, but possibly a bit obscure for the average caver to understand the risk. Is there any chance you have a map of the geographic distribution of this parasite, and maybe could post up some guidelines for the average caver. I'm a biologist who has had to collect those feces for study, not a doc, so while I am informed, you are a much better person to put out a layman's bit on how to avoid/treat it.

There is a comment saying that it would be unhealthful to eat bat guano. Maybe so, but honestly nothing in there (in most of the US) that is problematic. Eating a bit of raccoon feces with your gorp, however, could have some less than fun results.

Keith

[cavedoc]

Is there any chance you have a map of the geographic distribution of this parasite, and maybe could post up some guidelines for the average caver.
Keith

This is from the CDC:

http://www.cdc.gov/ncidod/dpd/parasites ... scaris.htm

The distribution is widespread but as the CDC points out, only 25 cases in humans have been described. So I'm not changing the way I cave for fear of raccoon roundworm. I just thought it was worth bringing up given the exposure described above that does sound significant. I suspect that exposure is only a risk in holes that many cavers wouldn't deign with the title of "cave." But if you're crawling through the stuff to be sure that it doesn't go, be careful.

[gillip]

I appreciate the information on racoon roundworm encephalites. It doens't look like it has been documented in Arkansas, but it does raise concern. I guess I will have to stay out of some of the smaller caves in my area that are used as racoon dens.

[Bobatnathrop]

I have gotten sick from caveing.
Acouple of years ago I got a fungal infecton covering both of my legs, from about my ankle to my waist. The "colonies" were about the size of quaters. They were red with a white dime size square right in the middle of it. It wasnt so bad for about the first 4 weeks, but for a few weeks right int he middle I could barely walk they were so painful. It took about 9 weeks of RX and over the counter meds to get rid of it. I think at the time I posted some pictures on the old forums, I am not sure if they are still floating around though.
Ok so the story behind how I got this...It involved a cow, a pig, and a cave....Not really though.

We were doing a winter trip to a cave here in Colorado. The walk to the cave is about 1-2miles through 3 feet of snow. Once we were in the cave I was wadeing through alot of water and stuff so I was soaking wet the whole time and only wearing jeans. So on the way out we crawled down this side passage that was filled with dust and dirt and stuff, there was mouse droppings and all that good stuff mixed in there too I am sure. So by the time we got out I was soaking wet and covered in dirt, and I had about 2 miles to walk..through snow...in wet jeans...with lots of chaffing..and rubbage..I think yall can figure out the rest...
But anyway the Dr. said I probably just rubbed somthing under my skin and away it went.

And before someone asks, no it did get to my , or

[cavedoc]

I appreciate the citations below. This is a good way to have a reasonable discussion. I thought I would include one another. I might have posted it before but it's appropriate to this discussion. It describes the two alleged transmissions in Frio Cave and gives what it believes to be better explanations.

http://download.journals.elsevierhealth ... 965297.pdf

From the description of the cave contained in the article I don't think I would go in without a mask for many other reasons before rabies. Should I buy my lottery ticket at the same time? Don't know. Would I take a youth group there? No. But not because of rabies risk. To my knowledge there still have been no transmissions to cavers in usual circumstances. To describe the risk that might occur in a cave that no youth group will ever visit needlessly amplifies the perception of risk that will be applied to all the other NO RISK situations.

My $0.02 from a medical professional who is interested in rabies but does not claim to be an expert.

We've finally had enough time to do some more research on this topic.

Here are several articles documenting airborne transmission of rabies:
The Journal of Infectious Diseases - Effects of Aerosolized Rabies Virus Exposureon Bats and Mice (Publication Date April 15, 2007)
Journal of Wildlife Diseases - Airborne Rabies Virus Isolation
American Journal of Epidemiology - An Outbreak Of Non-Bite Transmitted Rabies In A Laboratory Animal Colony
A Journal for the Society for General Microbiology - Airborne transmission of lyssaviruses


How do we proceed? What do other people think? Are there any medical professionals that could provide some guidance?