Talk:Wilderness-acquired diarrhea

Move to Wilderness-acquired diarrh(o)ea?

The reliable source for the title uses a hyphen, i.e. "Wilderness-acquired diarrh(o)ea". Should the article be moved to that title? --Bob K31416 (talk) 15:21, 29 November 2009 (UTC)

Yes, it should be moved to the grammatically correct title. WhatamIdoing (talk) 00:01, 4 December 2009 (UTC)

Thanks. I had second thoughts since both forms are used in sources, so maybe it's OK as is. Anyhow, I added wilderness-acquired diarrhea to the first sentence. --Bob K31416 (talk) 00:18, 10 December 2009 (UTC)

Meta analysis

(sigh) There was a consensus based on compromise and a desire for balance or whatever....

But the article is again veering toward a non-neutral point of view.

All I suggest is that sentence at issue remain in lede as fair reflection of what's out there.

As a reminder, the only true meta analysis on topic was done by Welch. Zell looked at various studies and referred to "hydrophobia" (or some similar vaguely humorous word) among back-country users. Derlet et al. cites extensive literature. Rockwell has been active with this subject for a fair number of years, and his work is well-known. Ignoring it raises at minimum an elephant in the room problem.Calamitybrook (talk) 16:57, 3 December 2009 (UTC)

Calamitybrook (talk) 02:38, 4 December 2009 (UTC)

Last sentence of intro

Seems like very approximately half (or perhaps more) of rather small number of cited articles that have reviewed macro question in terms of available research, have raised questions regarding whether problem is over-stated or whether the "public" (to whom, presumabably a Wikipedia article is addressed) misunderstands risk.

I invite skeptics to review list of citations.

The article, as it roughly stands, was product of minor consensus.

Calamitybrook (talk) 00:55, 19 December 2009 (UTC)

I take that back.

Of the authorities cited in this article who directly address topic, all but one discuss (in varying degrees) a broadly misperceived risk.

Calamitybrook (talk) 21:06, 27 December 2009 (UTC)

Regarding last sentence of lede

One ought to add Derlet and TB Gardner. Thus seven of the eight sources that have directly investigated question at hand have raised questions.

Sentence could be reasonably recast as "The majority" of researchers, instead of "some researchers.

Inclusion of Boulware is important outlier.

Calamitybrook (talk) 01:52, 28 January 2010 (UTC)

I've fixed lede to reflect available relevant sourcing, which is apparently exhaustive.

Existing citations are imperfectly formatted, and I do expect format can be improved.

The aim of edit, however, is well-accomplished with regard to sources.

Calamitybrook (talk) 02:10, 28 January 2010 (UTC)

"Various" is preferable to "most," as we aren't omniscient and perhaps slightly overstepped.

However, the sentence indeed fits all but one of the (somewhat numerous) relevant researchers cited by this article.

Note this list of researchers matches closely those found in a number of purportedly exhaustive bibliographies/citation lists published elsewhere.

Calamitybrook (talk) 17:09, 7 April 2010 (UTC)

• In the list of references for the subject sentence, the last reference 'Gardner2002' didn't support the statement and was removed from the list.

Gardner TB, Hill DR (2002). "Illness and injury among long-distance hikers on the Long Trail, Vermont". Wilderness & environmental medicine. 13 (2): 131–4. PMID 12092966.

--Bob K31416 (talk) 00:41, 20 April 2010 (UTC)

Calamitybrook, Could you recheck the other references for that sentence that you added and see if they support the sentence? Thanks. --Bob K31416 (talk) 02:46, 20 April 2010 (UTC)

You are correct about Gardner. I meant to cite "Health care needs of Appalachian Trail hikers

Journal of Family Practice, May, 1993 by Byron J. Crouse, David Josephs," [[1]] itself cited by Gardner.

Although this particular citation too, may not support the sentence in question, it consisted of a hiker survey and does say:

"There were no significant differences in the frequency of diarrhea between those who drank untreated water and those who treated their water."

This citation was stripped from earlier versions of WAD article, in accordance with one editor's particular conception of excluding sources.

As for the other citations, they look fine to me. More checking is good.

Calamitybrook (talk) 15:27, 20 April 2010 (UTC)

Proposal

Article has 40 citations but less than 10 authors directly address topic of article.

General thrust of nearly ALL of these directly relevant sources is that WAD is overblown at best. This isn't reflected in Wikipedia article. Readers won't understand the available research from reading article.

Only 3-4 of these authors attempt to broadly summarize research or wide fields of data. These deserve emphasis.

Only one author claims to perform a peer-reviewed "meta-analysis" of available and scientifically acceptable research (according to fairly high standard that intentionally excludes much stuff) and thrust of results is, that there is no evidence that water is source of WAD.

Another author has performed impressive review of extensive literature using a journalistic perspective, and draws a very similar conclusion.

A third author reviews health-department data from vast majority of US states, finding no evidence that water is source of disease for backpackers.

Most of other authors express skepticism to varied degree, of the notion that WAD acquired from water is significant relative to public perception.

But this stuff is inadequately reflected in article.

Among 10 authors, a few unambigously endorse popular notions of WAD.

One of these authors is cited in text several times, in different contexts, as "One study found..." yet reader cannot understand that this is same author.

I believe this particular author is afforded undue weight, especially in that his survey (?) is/are something of an outlier among cited research.

In one case, the concept is that one study found that vitamin intake is sigificant in avoiding WAD, which is perhaps interesting but is close to approaching a fringe theory, so far as I know.

(Note the similar survey item "Health needs of AT backpackers" found "no correlation" between water treatment and WAD, and is largely disregarded in text.)

Am merely suggesting that the article more closely approach a fair summary of the various 10 most relevant sources.

Calamitybrook (talk) 02:21, 19 May 2010 (UTC)

The above is a "false consensus." For example the first and third author are the same person, and his paper is extremely biased and contains proven misinformation: http://bucktrack.blogspot.com/2012/09/backpacker-giardia-debunking-skeptical_8.html. The CDC has specifically refuted his opinions, saying Although the advice to universally filter and disinfect backcountry drinking water to prevent disease has been debated, the health consequences of ignoring that standard water treatment advice have been documented. The CDC, FDA, EPA and most (if not all) other public health organizations who have commented on the issue DO have a consensus, and say that epidemiological studies have shown that backpackers are in a high-risk group for waterborne giardia which is only one of many human pathogens found in backcountry water.```` — Preceding unsigned comment added by 74.117.245.19 (talk) 00:23, 7 November 2013 (UTC)

great article

This article does a great job of accurately presenting the best and most current scientific evidence. It's refreshing to see that we're finally getting beyond the outdated and empirically unsupported claims that WAD commonly comes from contaminated drinking water, and focusing on what research shows to be the the real risks, which involve hand-to-mouth contamination.--75.83.70.28 (talk) 09:53, 31 May 2012 (UTC)

Exercise-induced diarrhea

Many who find themselves in the wilderness will at times exercise to the point of extreme fatigue, thus leaving themselves vulnerable to exercise-induced diarrhea, a well-documented condition.

Vulnerability is said to be enhanced by dehydration and/or a sudden change in diet, both of which are extremely common among wilderness visitors. Very good sources are available on this general topic.

"Wilderness-Acquired Diarrhea" according to this article is unrelated, which thus creates potential confusion. Point is extremely obvious to non "brain dead," yet is case of pure "original research" in the land of the brain dead.

I am permanently banned from editing Wikipedia, yet feel justified to make this point on talk page. — Preceding unsigned comment added by 76.250.61.95 (talk) 18:31, 11 March 2013 (UTC)

I question whether Giardia lamblia and Giardiasis With Particular Attention to the Sierra Nevada should be cited in this article. It is not a peer-reviewed scientific paper, but rather an opinion piece with numerous and significant factual errors. http://bucktrack.com/Giardia_Hiking_Water.html — Preceding unsigned comment added by 75.175.185.88 (talk) 14:07, 31 October 2013 (UTC)

I just reverted an edit I'd made.

As far as the question above regarding Sierra Nevada article, really it's been discussed previously. Some editors want to make this article into a medical treatise. Really, "wilderness diarrhea" is as much about context, i.e., "wilderness" as it is about a medical condition, "diarrhea." I'm all in favor of science, but there's lot's of hooey here. Given that nearly everyone gets a little diarrhea once in a while, a certain percentage of those people will find themselves in the wilderness & explain the condition as "wilderness diarrhea." Fooey! 76.250.61.95 (talk) 00:01, 8 April 2014 (UTC)

Lede

I added/changed a couple of things:

NOLS data indicates that one individual person, on average, who spends 4,000 days on a NOLS trip or trips, would get sick one time. The AT study, in the universe of medical studies, was not a "major" study.

35.10.217.22 (talk) 19:07, 31 May 2014 (UTC)

A European POV

WAD is unknown to European hikers. So is the term Giardia. The idea of every hiker carrying some type of water filter is cute. Diarrhea that resolves without treatment is usually not pathogen caused. Maybe the constant exposure of US citizens to toxic chlorinated tap water makes them over-sensible to harmless microbes in water. On a personal anecdotal note I just spent 3 months in the US drinking untreated creek water, no diarrhea. --92.202.85.198 (talk) 15:06, 15 July 2014 (UTC)

As a medical doctor, and avid wilderness hiker, I can attest that almost every one of the above statements is wrong. Just sayin'. 143.85.18.26 (talk) 19:25, 19 March 2015 (UTC)

Yes, I would agree; but it's an 8-month-old post that nobody deemed worthy of a response at the time. DoctorJoeE ^{review transgressions}/_{talk to me!} 19:33, 19 March 2015 (UTC)

Just sayin'. (Joe.) 143.85.18.18 (talk) 19:38, 19 March 2015 (UTC)

Removed this sentence from lead

"Yet NOLS says gastrointestinal issues are the leading cause of illness in wilderness settings, and trains its participants to avoid disease. "

To say that NOLS recorded one incident per 5,000 field days AND calls it "the leading cause of illness in wilderness settings" on its face, appears a bit nonsensical, questionable, odd, jarring, or whatever you will.

The juxtaposition raises questions that require too much context for lead to answer. But certainly the simple data from NOLS is valuable for lead, and it seems an obvious supposition that a "school" would, after all, train its participants.

35.22.83.2 (talk) 22:50, 9 April 2015 (UTC)

Also, I can't get that weird "reference" note left by Buck Track guy to stay where it is supposed to... (Sorry)....I just don't understand Wikipedia formatting adequately..... His note is floating below this comment, but should be under the "Reference" headline above.

35.22.83.2 (talk) 22:54, 9 April 2015 (UTC)

Your treatment of NOLS seems reasonable to me. I removed the refs tags; they tell the interpreter that the contents should be placed after the Reflist template at the end of the article. If you want to display the link in-line, e.g., on a talk page, they should not be used. Walter Siegmund (talk) 15:17, 10 April 2015 (UTC)