[pct-l] Why Rockwell is largely RIGHT on Giardia

Ken Murray kmurray at pol.net
Mon Sep 3 14:16:14 CDT 2012


Buck, 

I take issue with most of the things that you have written, as both a backpacker of 50+ years in the Sierra, and a physician with extensive experience treating GI syptoms and Giardia.

First, one of the main premises of your refutation is various statements testifying that various backpackers get Giardia.  That is undoubtedly true.

But you miss one of the main things that Rockwell talks about:  WHERE are they getting the infection?  He states that he thinks that it is not water, but poor hygiene among hikers.  I can testify to that!

You make a big point of talking about how dated his paper is.  However, the forest service continues to do water testing, although you've not bothered to access or research this, before attacking Rockwell.  It is not online, as far as I know, but because I work as a volunteer Wilderness Ranger in the Sierra (as does Rockwell, on Mt. Whitney), I know many of the Forest Service people who carry out water testing.

For example, Brian Spitek is the Wilderness Manager on the Inyo for the Whitney area, and supervises the collection of water samples yearly.  In a conversation with me, he mentioned earlier this year that he'd seen no change in the water purity (it's pure) along the Whitney Trail at all.  That is undoubtedly one of the most impacted trails in the Sierra.

You have misinformation in your post.  For example, you say:

"The incubation period of Giardia is usually 3 to 25 days or longer."  The 3-25 is hyperlinked, but is a dead link.  the actual statement by the CDC is:

"Symptoms of giardiasis normally begin 1 to 3 weeks after becoming infected."  Which is found here:

http://www.cdc.gov/parasites/giardia/gen_info/faqs.html

It also says on that page:

"What can I do to Prevent and Control giardiasis?
To prevent and control infection with the Giardia parasite, it is important to:

Practice good hygiene
Avoid water (drinking or recreational) that may be contaminated
Avoid eating food that may be contaminated
Prevent contact and contamination with feces (poop) during sex"

Notice that the NUMBER ONE THING they recommend is good hygiene, which you don't even mention, nor even 3 out of their 4 recommendations.  You also don't mention the easily missed "drinking or recreational"--what they mean by recreational is SWIMMING in the water.  Why are you not also making that recommendation that is in the SAME SENTENCE as the advice you choose to Cherry Pick?

In fact Rockwell recommends avoiding water that may be contaminated.  What he does, is suggest how to do that.  Your approach is to treat ALL water as contaminated.  He recommends that people "Drink Smart", not just drink anything.

Your rather disingenuous mention of municipal water supplies borders on an outright lie.  He was SPECIFICALLY talking about the water supply of San Francisco, which was NOT treated.

Your post, which is mainly hysterical in nature, simply adds to the misinformation.

But maybe you just don't like Rockwell.  Here is another expert, a medical researcher, the former head of Emergency Medicine at UC Davis, although he focuses on enteric bacteria, because it is a FAR MORE COMMON PROBLEM:

http://www.pcta.org/help/join/magazines/SierraWater.asp

By the way, the first paper he cites, is Rockwell.

Here are some others:

http://www.ncbi.nlm.nih.gov/pubmed/18666919
http://www.ncbi.nlm.nih.gov/pubmed/15636373
http://www.ncbi.nlm.nih.gov/pubmed/16538940

I'd also note that you are unable to cite ANY reviewable medical experts who have published anything that discredits what Rockwell has written.

Finally, you cite your own experience on your blog.  I think that bears examination.  

First the physicians that you say you talked to that don't report Giardia infections.  That is something that we docs are LEGALLY REQUIRED TO DO.  One has to wonder about the doc that takes the shortcut of not doing legally mandated things, what other shortcuts they don't bother with, like appropriate testing.

Second, you note that you'd had Giardia before.  How do you know that you had successfully gotten rid of the previous infection?  Very few people take an antibiotic prescription until it is all gone.  Many, only until they start to feel better.  It is common with Giardia to feel better after the first pill.  The prescription, Flagyl, is unpleasant tasting, and has to be taken three times a day.  You wonder how many stop the first day, instead of taking it for the 14 days that is required for eradication?

Third, you may have gotten a GI disease on your most recent hike, but you actually don't know if your symptoms were caused by Giardia!  You have have ALREADY had the Giardia resident in your system, picked up the FAR more common bacterial bug, but guess what the test would show?

Forth, you may have had a case of Giardia, but you definitely don't know where you picked it up.  The time frame is suspicious for the Kennedy Meadows area, notorious for people getting illness.  But you were hiking south, so I guess not for you.  Odd that your somewhat dramatic incident did not get recorded in your blog at the time.....

I advise people, as a medical professional, that they should do what makes them comfortable.  If they want to filter bottled water, I have no problem with that (although I'd shake my head).  Who wants to worry?  But I object to hysteria and hype.  I REALLY object to what I consider a marketing campaign to sell products, based on scaring them.  But people should make up their own minds.

















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