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Coconino County Department of Public Health Dispatch
(excerpted and edited)

   River Illness Update. During the month of July, 107 commercial passengers and their guides [the number of private river runners is unknown] became ill while rafting the Colorado River. They experienced nausea, abdominal cramps, vomiting and diarrhea that lasted 1.25 days. The range was 12 hours to 2 days. The outbreak appears to have ended. Few cases have been reported since August 1st. The CDC issued a preliminary report stating that the etiological agent is unknown. Not enough stool samples could be obtained [5 samples out of 433 persons interviewed]. In June, 1995, NPS, the University of Arizona and Coconino County Health Department will examine water samples for pathogens such as Giardia and Cryptospodium. Until the cause of the outbreak is determined, the following procedures should be followed: To effectively treat surface waters such as the Colorado River and its tributaries, first filter with a device using a pore size of .2 microns, or less, followed by disinfection with 2 drops of chlorine per quart of water. Allow the water to sit, and vent, for 30 minutes. Other filtration methods, like those using a UV light may also be effective, provided the manufacturer’s instructions are followed and reasonable precautions are taken.

   Waterborne Disease Workshop. Conducted by Dr. Chuck Gerba, a widely respected expert in the, uh, field... There are many thousands of protozoan species. Only 20 are known to cause disease in humans. But at any given moment one quarter of mankind is afflicted with severely debilitating diseases visited on us by the Gang of Twenty. Pathogenic protozoans come in four main groups: flagellates, amoebas, ciliates, sporozoans. These cysts are passed through feces into the environment and frequently reach water sources where they are ingested by humans, river runners among them. Giardia lamblia is on top of the list. This flagellate can infect any warmblooded animal. It is also called “Beaver’s Revenge” because, it is said, Beaverkind picked-up the disease from humans and, in turn, contaminated the water we drink.

   Hepatitis A Alert. Since January 1, 1994, over 200 confirmed cases of Hepatitis A have been reported in Coconino County. At present, the incidence seems to be declining. This condition is normally present where sanitation is primitive, where water is polluted with human sewage, when infected food handlers contaminate food, or if shellfish are harvested from polluted waters. Hepatitis A, caused by a virus, infects via fecal and oral transmission. Onset of the disease is from 15 to 50 days after infection. Which is bad news if you’re a food handler—you can infect plenty of people before you “get sick.” The FDA has reacted by adding new handwash requirements in a new Model Food Code: food handlers will wash their hands twice after using the restroom, with the aid of a fingernail brush, along with dispensed soap and sanitary hand drying devices like disposable towels. Air drying works, too. Onset is usually abrupt, with fever, malaise, nausea and abdominal discomfort, followed by jaundice. Hepatitis A varies from mild—1 to 2 weeks—to a severely disabling disease lasting a month or longer. Severity increases with age. The general fatality rate is .1%. Infected children do not usually evidence jaundice.

 

Grand Canyon River Guides Dispatch
(likewise excerpted and edited)

   Ever notice that the sicker you think you are, the sicker you get? First its a headache, then a cough and temperature, then bed. Pretty soon you can’t go to school. The doctor comes. He calls an ambulance. You hate the hospital. How sick do you want to be? If you were a kid, and sick in Grand Canyon, you’d probably start out with THE CRUD, severe abdominal discomforts with accompanying side effects. You are out-of-it. For a day or two. That’s something that hits the occasional Grand Canyon boater. Just like normal. THE CRUD is nothing new in these parts. Is it new anywhere? One day comes somebody with... THE CRUD? Uh..?? Then somebody else on the same trip. Then several. Then the guide—or did it start with the guide? Pretty quick NPS knows. Then County Health is FAXing CDC... Colorado River Illness. A study group is on-scene. CNN and newspapers are on this one. National news. The phone rings. From Syracuse: I just heard... Suddenly we’ve got an epidemic on our hands. Which means if you’re not confined to bed, you’re a nurse. If you’re not doing that, you’re deciding on an alternate vacation.

   I’m not going to debate if people got sick on the river this year. You bet they did. Real sick. I would like to know why. And I’d like to know if this outbreak was an especially virile episode of THE CRUD or something different. True, a few trips saw plenty of sick folks. Lets face it, that happens once in a while. That is an accident—and accidents happen. Ask anybody that drives a boat. It’s also, probably, not THE CRUD. It’s something else.

   But I am going to debate if we’ve got an epidemic on our hands. I say no. I say that 107 known cases in a population of about 22,000 visitors is less than 1%. In terms of statistical significance, 1% usually doesn’t mean much—which has nothing to do with if it happened or not. Of course it happened. Anybody who ever got sick on a Grand Canyon river trip knows what I mean by that. Its the last thing people want down there. Its the last thing people want anywhere. I also say people get sick for various reasons. Pretrip anxieties, for some the number of days spent away from a flush toilet, the effects of Mexican Night and its main component, Tequila, or both, or are you dehydrated, or pregnant, or what? I’m not saying it can’t happen again, that “the outbreak” shouldn’t be better understood or studied or that river guides shouldn’t be further educated. I am saying there’s nothing out of the ordinary happening here. Not really. Except more regulations. I further say: Educate. Don’t legislate... Please don’t legislate. The wider the parameters, the sicker you get. I’m saying 1% is not 99%. Don’t turn the boat upside-down. CRUD is not Colorado River Illness (CRI). It was never meant to be. It is, whatever it is, further, not an epidemic. Please turn off your camera. Thank you. Goodnight.

 

But I Can’t Sleep...

   As we go to press, Colorado River commercial guides and outfitters face Coast Guard certification, inspection, rule and regulation.

   This is good. Good because, after you’re certified, you’re not stuck in Grand Canyon to get old and creaky. You can apprentice yourself on rivers all over the country, or world. When you get very old you can retire to the deep blue sea.

   And bad. Really bad. More time. More money. Travel. Tests. Another paper. Another physical. Another license. Inspections. Running lights; bells; whistles. Rites of passage. This one’s pretty scary. If Coast Guard Grand Canyon regulations become a reality, they’ll mean the end of Grand Canyon boatmen.

   River runners, not just in Grand Canyon, are today’s mountain men, fur trappers and whitewater renegades. We’re throwbacks to the old days. We are modern Hudson’s Bay Company voyagers. Culturally, this is our history, our heritage, and, more than anything, our hope. We do what we do because we agree with what has gone before, and wish to carry it on. Early river runners were a breed apart. They sought the freedom found only on moving water, in rock walls, with starlit nights. They understood hope and majesty. Once in a while they took friends. The industry we choose to inherit, they defined. And now, although the times have changed, “the river” is still our home, our peace, quietude, our great solace, our dream. Our bread and butter. And wine. It is everything important and fine to us. Everything.

   And nothing. Nothing if we cannot maintain our unique heritage. As a matter of cultural integrity, we must remain singular and committed to our wilderness upbringing, lifestyle and future—our past. But, at present, we are being regulated out of existence. Professional guides must be so many places to be certified and inspected and schooled and otherwise inculcated that we have little time for the river itself—the very thing we love most. Our individuality is disappearing, if not already having vanished. But we are the experts here. We are not interested in the modern world. In Grand Canyon, we should be certifying the US Coast Guard. You never know when you’ll need a swamper.

   River runners know the Colorado River like the US Coast Guard could never imagine. We know because we learned the hard way. We figured it out by ourselves. We were shuttle drivers and deck mates and galley slaves and go-fers before we were boatmen or company owners. These days we are a community, tried and true. We have been there. We are “there” now more than ever. Our tests came from the school of hard knocks, and sometimes from NPS. There were plenty of chances to fail our exams. But we didn’t flunk the course. We are still trappers. We will remain trappers, voyagers. And, like Hudson’s Bay Company, we won’t kill all the beaver. Not all at once. Not yet.

Shane Murphy

 

Untangling the Bureaucratic Web

   The National Park Service already has a licensing system in place for Grand Canyon boatmen, who take a written test every three years to recertify. If the Coconino County Health Department, the US Coast Guard or any other agency feels that something in our training is “missing”, wouldn’t it make sense to integrate that additional training into the system already in place?

   Already the operating requirements address health and safety issues. Augmenting our study materials and adding a few questions to the written test sounds a great deal simpler than having already overburdened governmental agencies independently develop expensive, new training and testing programs.

Jeri Ledbetter