News of a Georgia graduate student's horrific battle with a flesh-eating bacteria she is believed to have picked up from the Little Tallapoosa River has drawn attention to microbial hazards in the water. But doctors say that while the recent case is severe, it is also unusual.
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On May 1, 24-year-old Aimee Copeland fell from a homemade zipline and gashed her calf on rocks in the river. The wound got infected and bacteria set in causing a condition known as necrotizing fasciitis. Doctors were forced to amputate Copeland's left leg, right foot and both hands to save her life.
While such bacteria doesn't often have such devastating effects, paddlers and anyone else in the water should pay attention to any scrapes or cuts, according to Dr. Michael Callahan in the Division of Infectious Diseases at Massachusetts General Hospital.
"Wounds contaminated by seemingly clean river water are not uncommon," says Callahan, who is a former member of the famous Yosemite Search and Rescue Team and a lecturer at last year's RiverRocks Medical Conference in Chattanooga.
Almost all cases of waterborne pathogens result in simple diarrhea and do not require antibiotics, Callahan points out. The real danger, like in Copeland's case, comes from open wounds. "These require aggressive and very painful wound cleansing, using appropriate solutions and careful observation," he says.
Callahan also recommends that all paddlers have their adult tetanus booster and consider taking antibiotics if they are on extended trips where evacuation would be difficult.
The germs, many of which enter the rivers from human or livestock waste, are too small to see so it's impossible to know if you're in clean water. "You cannot tell if water is safe," Callahan explains. "Tropical, warm, muddy waters are higher risk than pristine whitewater, however, the clean water is still risky."
But that doesn't mean you have to stay on the banks. The germs can't harm you unless they find a way inside your body. "The most dangerous bacteria on your skin can do no harm unless it is deeply inoculated into a wound, which allows it to set up shop and cause an infection," Callahan says, adding that hand sanitizer and diluted bleach as well as good camp hygiene are key components to preventing disease.