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
manufacturers 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 Beavers 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 youre a food handleryou 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 mild1 to 2 weeksto 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 cant 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, youd probably start out
with THE CRUD, severe abdominal discomforts with accompanying side effects. You are
out-of-it. For a day or two. Thats 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 guideor 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 weve got an epidemic on our hands. Which means if youre not confined
to bed, youre a nurse. If youre not doing that, youre deciding on an
Im 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 Id 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
accidentand accidents happen. Ask anybody that drives a boat. Its also,
probably, not THE CRUD. Its something else.
But I am going to debate if weve 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 doesnt mean muchwhich 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? Im not saying it cant happen again, that
the outbreak shouldnt be better understood or studied or that river
guides shouldnt be further educated. I am saying theres nothing out of the
ordinary happening here. Not really. Except more regulations. I further say: Educate.
Dont legislate... Please dont legislate. The wider the parameters, the sicker
you get. Im saying 1% is not 99%. Dont 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 Cant 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 youre certified, youre 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 ones pretty scary. If Coast Guard Grand Canyon regulations become a
reality, theyll mean the end of Grand Canyon boatmen.
River runners, not just in Grand Canyon, are todays mountain men, fur
trappers and whitewater renegades. Were throwbacks to the old days. We are modern
Hudsons 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 futureour 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 itselfthe
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 youll need a
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 didnt
flunk the course. We are still trappers. We will remain trappers, voyagers. And, like
Hudsons Bay Company, we wont kill all the beaver. Not all at once. Not yet.
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, wouldnt 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.