Hello fellow preppers. Once again it is time to expand upon our medical reference series, this time with an eye towards addressing infectious disease concerns. Granted, the topic isn’t as sexy as say, field amputations using a hacksaw and flat iron, or do-it-yourself wisdom tooth extraction using a Vice-grip, a razor blade and whipped cream chargers in front of an oil lamp and a mirror. But in the greater scheme of things we need worry about the specter of infectious disease ahead of even gunshot wounds.  Whereas one threatens mostly combatants the other represents a universal threat to man, woman and child alike.

Indulge me for a minute if you will and allow me to offer a brief primer on why we should factor infectious diseases into our preps.

Infectious disease concerns us because any time someplace in the world experiences a significant breakdown in its social order (hostile invasion, widespread natural disaster such as a Cat 4 hurricane, major earthquake, collapse of the national economy, etc.)  there is also an increase in various and sundry infectious diseases. This holds true whether we are talking about a third world nation or the US itself.

There are of course various reasons for such an increase, not the least of which is a decline in public sanitation. One of the greatest developments in public health was the advent of indoor plumbing. Waste was isolated and disposed of, fresh water was available and simple activities we take for granted such as routine bathing, increased dramatically. Illness derived from contaminated water dropped dramatically and we were well on our way to improving life in general.

The Katrina Experience

We’ll use Hurricane Katrina (2005) as an example of the effect of a breakdown in sanitation and how it quickly affects public health. The CDC recorded at least 20 clusters of diarrheal diseases alone amongst evacuees spread across several states, including multiple instances of Vibrio cholerae (Cholera), which happens to love brackish water. One refugee center in Texas reported a cluster of approximately 30 cases of MRSA infections alone, involving both children and adults. Even necrotizing fasciitis occurred, exposure to the bug apparently caused by wading through flood waters in one instance (Red Cross volunteer personally known to me).

Improved sanitation is part of a triad of developments that has brought infectious diseases to a historical low. The other two parts are vaccinations and antibiotics. One aids in preventing the disease to begin with, or diminishing the effect if the disease is acquired (the smallpox vaccine is an example of the former, flu shots of the latter). The other helps fight the disease, assuming it is not viral in nature.

When one leg of that triad is broken as it was during Katrina it offers infectious diseases the opportunity to break into the mainstream once more. We have seen where complacency has caused routine vaccinations to drop off, based on the public assuming that we no longer needed to worry about the diseases, only to see dramatic increases in outbreaks (measles, by way of one example, both in the US and abroad). When natural disaster wrecks the public sanitation system diseases aided by lack of same tend to increase also.

Please note that we are talking about infectious disease. Diabetes, atherosclerosis (hardening of the arteries) and psoriasis are all diseases, but none of them are infectious in nature. That is we cannot acquire them from either the environment or a living host such as an animal source or another person, nor can we transmit them to another person or animal.

Disease as a Combatant

To put matters into perspective during wartime it was not uncommon for far more deaths to occur due to infectious diseases than enemy action. During the American Civil War, of an estimated 660,000 deaths of combatants 2/3’s were estimated to have been the result of diseases rather than enemy action. Diseases such as pneumonias, dysentery, typhoid and even malaria brought down troops by the many hundred score. Disease in that war was sometimes referred to as “the third army” and some historians attribute an extension of the war for up to two years due to the consequences disease had on effective troop counts.

https://www.stratfordhall.org/medical-care-battle-wounds-and-disease/

Note that we are not talking about weaponized germs here, only naturally occurring infections.

Pandemics

In terms of civilian outbreaks historically influenza alone is the cause of an average of 3 pandemics every 100 years, with the first recorded one occurring in 1580. The last one, BTW, was in 2009-10 – our old ‘friend’ H1N1 – fortunately fizzled quickly after a half million deaths, predominantly amongst the young. Previously it was 1968 (Hong Kong – H3N2), and 1957 (Asian – H2N2) before that. There was a long break (40 years) between that one and the (in) famous Spanish Flu of 1917–1919 but only 9 years between the next two.

A pandemic by definition is an outbreak of a particular disease that encompasses a very large region at a minimum (think of everything west of the Mississippi as an example), if not crossing international boundaries (add in Canada to the north, and Mexico, Belize, Honduras and Guatemala and El Salvador to the south, to make it truly international in scope).

There are of course episodes of threatening disease that affect an exceptionally high percentage of the population. The common cold is very widespread in the US during winter, but it affects pretty much the same number of people percentage-wise year in and year out. An indication of something amiss would be percentages of greater proportion than the usual 22-25% each year. Hit 40-45% and we’ll start giving serious consideration to outside influences such as deliberate hostile action.

The LIST

So, with the preliminaries out of the way it is time to jump once more into the fray. The offerings made for your consideration are presented in no particular order of importance as that will vary based on individual circumstance, physical resources and personal perceptions of threat.

The Complete Idiot’s Guide to Dangerous Diseases and Epidemics by David Perlin, Ph.D., and Ann Cohen Softcover, 315 pages. Pearson Education Inc. Copyright 2002 ISBN 0-02-864359-3 $18.95 USD

The author takes a light-hearted approach while also offering legitimately authoritarian information. One invaluable feature is the panic/don’t panic information. The writing style makes reading this volume enjoyable rather than a stale slog-through academic work. A very useful guide to rapid decision making without getting bogged down by details. A much better than average starting point when seeking quick information about specific infectious diseases, as well as interesting history behind previous historical outbreaks and information about what can be done today to address future outbreaks before they occur.

As of 2017 it appears to be out-of-print but used copies are readily available through several sources including Abe Books for well below list price.

Communicable and Non-Communicable Disease Basics: A Primer by Madeline M. Hurster. Published by Praeger, November 1997. ISBN-10: 0897895088 Softcover. List price $27.95 Hardcover also available.

A basic primer in what disease is and how it affects humans. This is not a how-to manual but rather provides information needed to understand how diseases can be spread. The language is basic medical rather than scientific, making it easy for non-medical people to understand. Under 150 pages it is easy to read. Not as entertaining as the Complete Idiot’s Guide nor is it intended to be. Neither is it excessively dry reading but rather basic, to-the-point information. It has the added benefit of offering information on a variety of non-infectious diseases.

I do not consider this to be a must-have reference by any means. Rather I regard it as a starting point for further study or training a future medical provider in a world where the system has broken down. It is included here for consideration purposes, but unless you want to build a well-rounded library it won’t be missed.

Expedition Home: Journey To Safety From Pandemic Influenza by Skip Hofstrand, M.D., PhD Introduction by Will Steger, Polar Explorer.  Illustrated.  Singing River Publications, Ely, Minnesota, 2006 ISBN 0-9774831-8-5   98 pages. Price: $14.95 USD + $5 shipping.

This book was last referenced in the Prepper Nursing article and bears repeating. The following is the original review I wrote back in 2009 for this work. If you plan on any manner of large group or community setting you owe it to yourself have a copy of this book.

“Dr. Hofstrand has put together an excellent work that details the rationale behind the Preventive Quarantine concept for addressing a likely future influenza pandemic. Not only does he make a simple yet succinct case for such action but he continues by offering the reader a guideline for making such quarantine practical never mind possible.

For the medical professional the book offers advice in such fashion that they may in turn offer it with little to no rewording to their own patients. The author does not rely on hysterics or hype to make his point, nor does he need to. As he points out pandemic influenzas are natural cyclical events. What we as humans tend to forget is the manner in which to address them when they occur.

The Preventive Quarantine, where a family or group of individuals isolates themselves from the outside world, represents the best chance for remaining medically unaffected by such an event. It is neither of course not a guarantee nor without its own risks. The chief risk though is extreme boredom leading to breaking isolation that in turn leads to infection with a virus with an extremely high (for influenza) mortality rate.

There are considerations for what to do when accepting people in from the “outside” as well as those who have been forced to break quarantine – perhaps because they needed medical treatment that could not be offered by the group – and now wish to re-enter. There is also special note made of the time in which children may continue to shed the virus (it’s longer than for adults) and the added time that a separate quarantine needs to be maintained for them apart from the main group when joining/rejoining the group.

The book is comprehensive without being tedious. The appendixes alone are worth the cost of this book; Dr. Hofstrand has done a good job of covering not only the basics of pandemic preparedness but also covers areas other prep books tend to overlook. There is no coverage of defensive preparations, which are well covered by innumerable other sources. However he does mention financial, social and other areas of concern for those contemplating retreating for quarantine purposes.”

Graphic Guide to Infectious Disease 1st Edition by Brian Kloss, DO, JD, PA-C and Travis Bruce, BFA Paperback. 380 pages. Comic book-style illustration.  ISBN: 9780323442145 Published by Elsevier Inc. List price: $39.99. Currently (01/16/19) promoted at $31.99 with free shipping. Publication date: January 2019      https://evolve.elsevier.com/cs/product/9780323442145?role=student

I have previously stated that I am personally loath to recommend any book I have not actually laid hands on, and this one is no exception. Having said that, considering that it was just released this month I am going to bend that rule a wee bit and go with the author’s professional reputation and the one professional review I have been able to find thus far.

The medical author – Dr. Brian Kloss – has a good reputation in the community for his annual medical missions to Haiti and his adventuring to places such as Mt. Kilimanjaro. His specialty is Emergency Medicine and he has cross-qualifications in several other areas as well, including a juris doctorate. Frequenting Haiti he is no doubt well acquainted with several infectious diseases most of would never encounter in a lifetime spent practicing in the US.

The review quoted below is by Patricia Schlagenhauf with the University of Zürich, Switzerland. She writes in part:

“Indeed, the front cover is in comic-book style but this is actually a valuable and, yes, sometimes, comic guide to infectious disease information. The format is simple but successful. On the left-hand page, the essential information on a particular infection is briefly summarized providing the name of the infection, synonyms, causative agent, lifecycle, incubation period, geographic distribution, brief description of transmission pathways, symptoms of the infection, diagnostic testing and treatment. In the right-hand page there is a full-sized comic illustration highlighting the key features of the infection that were described in the text on the left. Irreverent, provocative and unconventional are terms that have been used to describe these visual aids. The author team of the book combines the knowledge and talents of a physician and an illustrator.”

And further:

“The book is divided into the following sections: viral hepatitis, infectious diarrhea, childhood illness, tick borne illness, worms, fungal, sexually transmitted diseases, pulmonary,  mosquito borne illness, rat borne illness, oropharyngeal, viral parasites and prions, bacterial.”

There is a further breakdown of each chapter available through the link above. This book has all the appearances of being a potential one-stop experience. I am putting it near the top of my to-be-acquired list and once I have a chance to read it in person I’ll be doing a further review of my own.

As a final note: as I was finalizing this article I went back and reviewed each of the links and found that since I first discovered this book Amazon has added an extensive Look Inside view, over 100 pages in all. I am moving this one to near the top of my personal Must Acquire list as a result, and removing any hesitation at recommending this work. The illustrations alone make this book rock!

Antibiotics Simplified 4th Edition Gallagher, PharmD, BCPS, MacDougall, PharmD, MAS, BCPS   Spiral bound edition (personal recommendation, paperback and Kindle versions available) $34.94 Published Dec. 2016   352 pages. Profusely illustrated with graphs, diagrams, etc. NOTE: used student copies are available but offer no appreciable cost savings. Your personal experience may vary.

This is one of those books aimed at the student market which has excellent cross-over potential for preppers willing to put forth a modest bit of effort to study the material. Rather than a ‘use this antibiotic for this diagnosis’ guide this work will guide you to making an appropriate selection based on symptoms and, if available, test results.

They divide antibiotics into the differing classes, i.e. Beta-Lactams, Fluoroquinolones, Tetracyclines, etc. You will also find sub-sections for anti-parasitics, antivirals, antifungals, etc.

What are particularly useful are the listings for the spectrum of activity (which drugs cover which general infection classes) and the empiric regimens for common infections. Different medications have differing dosing levels and schedules depending on what you are trying to address. Clinicians rely on references like these to jog their memories even though they presumably have learned about each drug and its uses. If they need reminders how much more might we? Just because you have heard of a particular antibiotic doesn’t mean you know all the potential uses or caveats for same.

There are 3 previous editions available for purchase used. Note that perusing the used book sites the prices quickly escalate towards the cost of a new edition. As the 3rd edition is nearly 6 years old more recent developments that may be pertinent would not be included, so the buyer will have to decide for themselves if missing that is likely to be an issue in their circumstances or not.

Avian Influenza Disinfection

Yes, our old friend bird flu, the same general variety of the strain that that killed 10’s of millions back in 1917-1919 worldwide (H1N1). It is worth an article by itself but of also including a short reference to it here in the meantime. The link is to a disinfection chart that covers pretty much everything from people to aircraft and how best to disinfect them. Even ponds and livestock tanks are covered. It is only two pages so print it off and tuck it away on your infectious disease procedures binder. You do have one, don’t you?

http://www.fao.org/avianflu/en/disinfection.html

In Conclusion

A future article will address specific issues with regard to infectious disease management. Meantime, select what you believe best suits you of the aforementioned references and start improving your understanding.

 

[Editor’s Note: If you’d like to get in on the Medical Q&A webinar being offered here at AP featuring Reasonable Rascal, the author of our Medical Reference series and a licensed medical professional in his own right, there’s still time. It’s January 31st; you can find out more here.]

 

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