Article from January, 2011

relic_diseases

When Lord Carnarvon, the financial partner of famed Egyptologist, Howard Carter, died shortly after the opening of King Tutankhamun’s tomb in 1922, some close to the project were quick to attribute his demise to a “mummy’s curse.” Frighteningly romantic as such notion may be, Carnarvon actually died of an infected mosquito bite, his immune system compromized by years of ill health. It must be said, however, that tombs and other reliquaries host a variety of organisms that are dangerous to our health.

Explorers tend to poke their noses into obscure places in search of adventure or scientific knowledge. Nothing is more exciting than discovering relics from an ancient civilization, identifying a new animal species, or exploring ecosystems in remote areas. Although most of us take precautions to prevent problems such as malaria and typhoid, venturing into undisturbed environments leads us to intersect with vectors and animal hosts of infectious agents rarely seen in the urban setting.

Histoplasmosis is a fungal infection affecting the lungs and occasionally other organs. This worldwide fungus rarely causes disease in ordinary travelers but is a real risk to those exploring caves. Exposure is the result of contact with contaminated bat guano. Prevention includes avoiding known areas of disease and washing ones hands upon leaving a cave. Masks, unless sealed, do not prevent spores from entering the lungs. Respiratory symptoms occur within 2 weeks of exposure, are usually mild and do not require treatment, but occasionally can cause high fevers, cough, and pain. Another pulmonary fungal infection, coccidioidomycosis, is found predominantly in the southwestern United States, Central America, and parts of South America.

Residing in soil and dormant in dry times, spores develop with rain and break off, becoming airborne when soil is disturbed. Known also as San Joaquin Valley fever, this infection manifests as a flu-like syndrome with rash, and is usually mild. However, severe pneumonia and a devastating fatal spread throughout the body can result. The incidence rate in many areas is unavailable but there were 16,970 cases and 752 deaths reported in California from 2000 to 2007. Fortunately, neither histoplasmosis nor coccidioidomycosis are contagious, and treatment for both consists of antifungal medication.

A 1993 outbreak of unexplained sudden pulmonary illness that killed numerous young adults on an Indian reservation in the southwestern United States raised the alarm about a viral disease carried by rodents, particularly deer mice. Hantavirus infects humans exposed to contaminated dust or droppings from mice nests. Early flu-like symptoms of fever, chills, and muscle aches subside for a few days then quickly worsen, leading to respiratory and kidney failure. Although only recently recognized, hantavirus has been around far longer than originally thought and has been found in much of the United States and throughout Europe, Asia, and South Asia. The disease was not thought to be passed between humans but recent case reports suggest direct human transmission can occur.

People may encounter contaminated dust in enclosed areas when cleaning longempty homes or tool sheds, or while working on archaeological digs. Easily mistaken for other illnesses, hantavirus is often treated inappropriately with antibiotics, wasting valuable time. The United States Army has reported that the use of intravenous antiviral drugs has shown to be effective in decreasing renal failure. This virus is one bad actor; remember that dust in empty buildings can be treacherous. Extremely rare but worth mentioning to those who traipse in tropical rainforests are the viral hemorrhagic fevers (VHF) not caused by mosquitoes. The reservoirs for Lassa fever and Crimean-Congo hemorrhagic fever (CCHF) are rodents or small mammals, while bats, particularly the Egyptian fruit bat, are thought to harbor Marburg and Ebola viruses. Marburg and Ebola are usually confined to small areas in central Africa because they are so highly virulent with high fatality rates, but the less often fatal Lassa fever is endemic in West Africa. CCHF, with lower fatality rates, is spread by ticks and also found in Asia, Eastern Europe, and the Middle East. VHF illness is characterized by the rapid onset of fever, malaise, muscle pain, headache, and pharyngeal inflammation. Vomiting and bloody diarrhea are followed by a rash with bleeding at needle sites and bodily orifices.

Currently there is no treatment for these diseases but research suggests that a breakthrough is on the horizon. No discussion about field exploration is complete without mention of tetanus and rabies. Tetanus is caused by neurotoxin from an infection with bacteria ubiquitous in soil. All dirty wounds, punctures, burns, bites, and crush injuries can harbor the organism. Tetanus toxoid with a booster shot every 10 years is needed to prevent this disease, which killed an estimated 290,000 unvaccinated people worldwide in 2006. Rabies is a fatal viral disease transmitted in the saliva of infected animals. Although dogs are the most likely source for infection in a developing country, source animals for the 6,417 cases documented in the United States and Puerto Rico in 2005 were raccoons (40 percent), skunks (23 percent), bats (22 percent), foxes (6 percent), cats (4 percent), cows (1.5 percent), and dogs (1.2 percent). Prophylactic treatment after contact with the saliva for unvaccinated individuals is costly, time-consuming, and must be done within days. Best to avoid animals you do not know in strange villages…..and maybe some you do. Rabid cows? Wow!

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This article was published in The Explorers Journal

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THE EXPLORERS JOURNAL.
The Official Quarterly Of The Explorers Club Since 1921
The Explorers Journal brings you engaging writing and superb photography by Club
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