BOOK 4

INFECTIONS

CHAPTER 8

RESPIRATORY INFECTIONS

M ost of us cannot completely escape the odd respiratory infection, even with today's advanced medical technology. In a severe disaster, it would be very simple for your entire town to contract colds, sinusitis, influenza, or even pneumonia if the sanitary protocol wasn't strictly followed. Any one of 200 viruses can cause the common cold. The viruses that cause influenza to belong to the influenza A, B, and C categories (mostly A). Flu pandemics have claimed the lives of more than 100 million people throughout history.

Most influenza-related deaths are not brought on by the virus but rather by bacterial pneumonia, a secondary infection that attacks an already compromised immune system.

Most viral particles that cause respiratory illnesses typically propagate them. Many organisms that do so can survive for up to 48 hours on everyday home items like doorknobs and kitchen worktops. When someone sneezes, contagious virus particles can quickly move 4-6 feet.

Upper and lower respiratory infections are the two main categories of respiratory problems. Anything above the vocal cords (larynx) is the upper respiratory tract. The diagnosis will frequently be connected to the damaged upper respiratory system component. This is how it goes:

       nose—rhinitis

       throat—pharyngitis

       epiglottis—epiglottitis

       tonsils—tonsillitis

       sinuses—sinusitis

       voice box—laryngitis

       ear canal—otitis

The lower windpipe, the airways (together referred to as "bronchi"), and the lungs themselves make up the lower respiratory tract. In wealthy nations, respiratory infections like bronchitis and pneumonia are the most prevalent source of infectious diseases.

 

Typical N95 mask

Fever, coughing, sore throat, runny nose, nasal congestion, headaches, and sneezing are some common cold signs. Lower respiratory infections, such as pneumonia and some types of bronchitis, can cause symptoms like coughing up phlegm and having a "productive" cough, high fever, shortness of breath, weakness, and exhaustion. Symptoms of most respiratory infections appear 1-3 days after exposure to the causing organism. If upper, they should last 7–10 days; if lower, they should last a little longer.

 

Colds vs. Influenza

It's important to recognize the distinctions between the common cold and influenza when making a diagnosis. Although the symptoms are similar, they vary in severity and frequency.

 

To determine what you're most likely dealing with, check out the list below:

Symptoms

Cold

Influenza

Fever

Rare, Low

Common, High

Headache

Rare

Common

Nasal congestion

Common

Occasional

Sore throat

Common

Occasional

Cough

Mild

Severe

Aches and pains

Common

Severe

Fatigue

Mild

Severe

 

If used within the first 48 hours following the onset of symptoms, antiviral drugs like oseltamivir (TamifluTM) can lessen the duration of influenza infection. Antivirals have less of a therapeutic impact after the initial 48 hours.

For colds, focus your treatment on the affected area, such as painful throat lozenges for pharyngitis or nasal congestion medication for runny noses. Ibuprofen or acetaminophen will reduce fevers and muscle aches. Additionally, regular hydration and steam inhalation provide some symptomatic relief. We describe many natural therapies in the following chapter of this book, which are also helpful in relieving symptoms.

Although viruses typically cause upper respiratory infections, a bacterium known as beta Streptococcus can also cause some sore throats (strep throat). These patients are suitable for antibiotics because they frequently have tiny white spots on the tonsils, back of the throat, or both. Amoxicillin (veterinary equivalent: Fish Mox) or Keflex (Fish Flex) are among the medications of choice for individuals who are not allergic to penicillin medications. Drugs from the erythromycin (Fish Mycin) family are beneficial for people who are allergic to penicillin.

However, antibiotics or other antibacterial treatments for upper respiratory infections are typically not advised. Since antibiotics have been abused to address these issues, certain organisms have resisted the more widely used medications. Some older antibiotics are now practically worthless for treating numerous diseases due to resistance.

The most frequent infectious disease-related cause of death in developed nations is lower respiratory infections like pneumonia. Bacteria or viruses may bring these on. Many doctors use antibiotics more frequently to treat these infections because they are dangerous. However, since viruses typically cause bronchitis, antibiotics won't help. If a lower respiratory infection doesn't go better after many days of treatment with the typical drugs for upper respiratory infections, antibiotics could be necessary.

Even with regular therapy, the patients at risk will gradually appear to have worsening shortness of breath or thicker phlegm.

Upper and lower respiratory infections are distinct from asthma, a disorder in which exposure to a substance causes the airways to tighten like a spasm. As a result, I start breathing loudly (wheezing). Asthma can develop as an allergic reaction or be linked to certain respiratory illnesses, like infantile "croup." Different medications, such as airway "openers" and epinephrine, which are not often used to treat colds or the flu, are used to treat asthma.

To stop people with respiratory diseases from infecting others, practicing good respiratory hygiene is crucial. This not only benefits you and your family, but it also exemplifies societal responsibility. Utilize the following procedures to stop the spread of respiratory infections.

Those that are ill:

       Use tissues to cover your mouth and nose before properly discarding the tissues.

       If you cough frequently, wear a mask. The ill person should wear a mask, even if others care for them (healthcare personnel should use N95 masks).

       If possible, stay at least 4 feet away from other people (the average distance droplets will spread).

       Caregivers:

·           Wash your hands thoroughly both before and after contact. Hands should be cleaned with alcohol-based hand sanitizers or washed with soap and warm water for 15 seconds.

       Use a suitable disinfectant to wipe down all potentially contaminated surfaces, such as kitchen counters or doorknobs (dilute bleach solution will do).

       If the sick person has a high fever, isolate him or her in a designated quarantine location.

When treating the patient, always wear gloves. Avoid self-medicating, especially with antibiotics, unless access to proper medical treatment is impossible.

Many of the tactics above and remedies will effectively treat respiratory infections, but what if a catastrophic disaster prevents access to or the production of modern pharmaceuticals? In that case, we need to look no further than our backyard and, if we were savvy in our planning, our medicinal garden. We must consider organic compounds that could improve the body's immunological response and relieve various respiratory problems.

Regular consumption of antioxidants like vitamin C, vitamin e, and others is thought to lessen the frequency and severity of respiratory infections. Numerous research supports its value, even though just one study found a reduction in the annual length of respiratory virus-related symptoms by one day. Despite this, any strategy for storing food for survival should include antioxidant support for the immune system.

Most natural medicines treat specific symptoms, including fever or nasal congestion. The immune system is said to be stimulated by several alternative treatments for different respiratory illnesses. Think about the subsequent essential oils:

       Geranium

       Clove Bud

       Tea tree

       Lavender

You would practice a technique known as direct inhalation therapy to use these oils. On the palm of your hand, apply two or three drops. Rub your hands together to warm the oil, and then put your hands near your mouth and nose. Take three to five slow, deep breaths. Repeat the exercise after two minutes while remaining calm and breathing properly. Remove any extra oil from the chest and throat by wiping.

Many herbs can be consumed as tea and may be beneficial. Elderberry, Echinacea, licorice root, chamomile , goldenseal, peppermint, and ginseng are well-known remedies for general respiratory support. Fresh cinnamon, garlic and onion oil, and cayenne pepper in powder form have all been reported to have antibacterial properties. Other alternatives include lemon, apple cider vinegar, and raw, unprocessed honey. These ingredients are frequently added to one of the aforementioned herbal teas.

There are several effective therapies for certain cold and flu symptoms and general ones. For example, take into account herbal drinks created from the following herbs to treat fever:

       Echinacea

       Licorice root

       Yarrow

       Fennel

       Catnip

       Lemon balm

Salicin, the active component of aspirin, is known to be found in the underbark of willow, poplar, and aspen trees. Remove the outer bark in multiple strips, then use the green underbark to prepare a tea. It ought to reduce fever in the same way as aspirin does.

Consider utilizing direct inhalation therapy (described above) or salves with the following essential oils to treat the congestion that most respiratory illnesses cause:

       Eucalyptus

       Rosemary

       Anise

       Peppermint

       Tea tree

       Pine

       Thyme

Steam is a different inhalation technique that can deliver the herbs above or even conventional pharmaceuticals. Inhaling steam is helpful for many respiratory conditions and is simple to do. Simply add a few drops of essential oil to some steaming water, then lower your face into the steam to breathe it in. To focus the steam, wrap a towel around your head.

Herbal teas made from the following relieve congestion:

       Licorice root

       Peppermint

       Anise

       Cayenne pepper

       Sage

       Stinging nettle

       Dandelion

Add honey and drink 3–4 times a day as necessary. Fourteen teaspoons of fresh horseradish taken orally three times a day help to expand airways. Both conventional and alternative healers employ plain sterile saline solution, administered either nasally or in a "neti pot."

Use salves containing the following essential oils for cold-related aches and pains:

       St. John’s wort

       Eucalyptus

       Peppermint

       Rosemary

       Camphor

       Lavender

       Arnica (dilute)

Teas made from the following are thought to relieve muscle aches:

       Passionflower

       Chamomile

       Valerian root

       Willow underbark

       Ginger

       Feverfew

       Rosemary

sip warm tea with raw honey 3 times a day.

Traditional treatments for the occasional sore throat include ginger, Tilden flower, sage teas, honey, and garlic "syrups." They should be warmed up and combined with honey and sometimes lemon several times a day. Warm salt water gargles will also provide relief. To lessen unpleasant swallowing, licorice root and honey lozenges are very beneficial.

Although the herbs discussed in this book have all been proven beneficial, it's vital to remember that each person's response to a given herbal product is unique. Additionally, several variables, like rainfall, the state of the soil, and the time of harvest, may affect essential oil quality.

 

THE PROTECTIVE MASKS GUIDE

 

Infectious infections have always been a common occurrence throughout human history. It has been known since the Middle Ages that some illnesses can spread from person to person through the air or by touching human fluids. As a result, medical staff members have worn masks to limit exposure.

This makes sense for reasons other than self-interest: There won't be many people with medical training available to help a group or community in a survival crisis. Only two doctors were present for every 100,000 people in the nations where the 2014 Ebola pandemic occurred. As a result, the doctor is a useful asset. It would be unfair to those who depend on them if they fell ill.

In the past century, the basic surgical mask hasn't undergone many alterations in terms of look. You've probably seen pictures of people wearing them in epidemic-affected areas. If you have the flu or a cold and are going out in public, it is considered socially appropriate to wear them in Asia. Face masks also serve as a helpful reminder for individuals to avoid touching their mouths and noses, a common way for germs to spread.

You should include enough masks (and gloves) in your medical storage if you will be caring for your family in circumstances when access to contemporary medical treatment is impossible. Without these things, you and the rest of the family could contract an infectious disease.

Standard "medical masks" come in various protection levels depending on the fit and barrier quality; three-ply masks, which are the most popular, are more "breathable" than six-ply masks, which are probably more of a barrier. To create a barrier against infectious droplets, a tight fit is essential.

The N95 respirator mask is an improvement over the standard mask. A family of disposable respirators known as N95 masks has an efficiency rating of at least 95% against particles larger than 0.5 microns. While they are helpful against a variety of pollutants, they are not completely protective. N99 masks (99%) and N100 masks (99.7%) are higher-level masks, although they are more expensive. The N stands for non-oil-resistant; other options include the R95 and P95 masks, mostly used in industrial and agricultural settings.

Many of these masks contain an "exhalation valve" square or round in the middle, which aids breathing. However, they do not protect against gases like chlorine and do not shield the eyes. You would require a "gas mask" for this, albeit even these do not shield the wearer from contamination by toxins that are absorbed via the skin.

So what would be a sensible course of action? Standard and N95 masks are required as part of your medical supplies. Because the masks should be thrown away after usage because they will become contaminated, I would advise purchasing a large quantity of each. Face shields and hoods should be fitted in cases of particularly lethal infections like Ebola.

There are no set rules regarding what people wear in the sick room. For those who are ill, I advise using the usual masks to stop the spread of illness through coughing and sneezing (which can send air droplets several feet). Give the carers the N95 masks. You will provide the greatest level of protection to individuals who are most vulnerable to exposure in this way. Always remember that protecting yourself and the group's healthy members comes first. Contagious individuals should be kept apart, and every aspect of cleanliness should be carefully observed. Other precautions include having sufficient masks, gloves, aprons, eye protection, and antiseptics.

 

THE EFFECTIVE SICKROOM

 

Normally, we have the luxury of state-of-the-art medical facilities and cutting-edge methods to keep sick patients away from healthy individuals. Most of these benefits will become extinct if we find ourselves cut off from society due to a tragedy, and we will be forced to deal with medicine much like it was in the eighteenth century.

However, we have the advantage of understanding sterilization and how contagious diseases are spread, giving us an advantage over our ancestors. The medically prepared should be able to construct a "sick room" or "hospital tent" using this knowledge. This will lessen the possibility of infectious diseases spreading rapidly.

Whether you are at home or on the path, you should have a plan in place for a place where the sick and injured can receive care. Establish a sick room in your home if you plan to remain there. It should be at one end of the home, have a door that can be closed, and have one or two windows to enable light and ventilation. Pick a hospital tent in the wilderness, and set it up outside your camp. Making a plan before a huge calamity is crucial since, if you don't, you'll inevitably have to eject someone from their room or tent. As a result, at a moment when everyone must work together to survive, you might expect resentment.

To separate the sick from the healthy, you'll need to create a temporary wall, like a plastic sheet, if you don't have a spare room or tent. Even if you have a separate sick room, it can be a good idea to put this over the door for extra security. If possible, keep individuals with injuries apart from those with contagious illnesses like the flu or pneumonia.

In a power outage, air-conditioning ducts will be practically ineffective and could seriously endanger the rest of your group. Wrap them up. To reduce the concentration of airborne infections, keep windows or vent flaps open unless it is exceptionally bad outside.

The room should have only a work surface, an exam area, and beds. Avoid touching any carpets or sofas with cloth surfaces since they can contain germs. It could be best to wrap even the bedding for contagious people in plastic. The more surfaces that can be quickly cleaned or sanitized, the better. (Try doing it on a carpet every day!) Even if all you have is a 5-gallon pail of bleach solution, you should have a mechanism to remove waste from your bedridden patients. Provide closed containers for discarded sick room supplies.

It would be highly beneficial to have a station with masks, gloves, gowns, and disinfectants next to the tent or room entry. You'll need towels that the caregiver should only use, along with a basin with water, soap, or another disinfectant. Those with infectious illnesses should only be cared for by one individual.

Purchase plenty of masks, gloves, and gowns. Gowns can be bought commercially, can be constructed of plastic coveralls, or even can be full-body aprons. Gauze, tourniquets, and war dressings are frequently considered part of a medical supply kit, but you also need sets of linens, towels, pillows, and other goods specifically for the sick room. Keep these items apart from the beds, toiletries, and food that the healthy family members use.

Cleaning products ought to be included in the list of medical preparedness supplies. Everyday cleaning of the sickroom is required. Use disinfectants, soap, and water to clean surfaces that might be contaminated. Bleach diluted 1:10 in water would work well for this. Doorknobs, tables, sinks, toilets, counters, and toys must be cleaned and sanitized. Bed linens and towels should be washed frequently; if necessary, boil them. After handling patient bedding or clothing, immediately wash your hands or otherwise disinfect them. The same holds for other items used to care for the patient, such as dishes and cups. Anything brought into the sick room for medical purposes should remain there.

For sick room patients, it's also crucial to provide them with a noisemaker of some kind so they can let you know when they need assistance. They will feel less anxious and more confident, which you will notice if they are in difficulty due to this.

 

FOOD-BORNE AND WATER-BORNE ILLNESS

 

Drinking water and eating food are now much safer than before, thanks to modern water treatment and disinfection methods. In the past, contaminated water was the cause of several fatalities. Today, epidemics of infectious diseases continue to occur in impoverished nations. Therefore, it stands to reason that sanitary problems will likely arise following a disaster.

Any unsterilized water or food that has not been thoroughly cleansed and prepared could put the health of an entire neighborhood in danger. You will be responsible as the medic for ensuring that the water is safe to drink and that the areas where food is prepared are clean.

Sterilizing Water

Floods, interruptions in the water supply, and several other unforeseen circumstances can taint the water. A dead raccoon can contain harmful bacteria upstream from where you get your water supply.

The purest alpine brook might include protozoa, a type of parasite that can spread sickness. An organism that damages you once it establishes a home in your body is known as a parasite. Giardia and Entamoeba parasites are frequent disease-causing agents; they can infect trekkers in the most remote wilderness areas.

If the water is hazy when you start, it is because it contains a lot of minute trash particles. On the market, numerous top-notch commercial filters in a range of sizes handle this. An alternative method for creating your own particulate filter is to use a piece of 4-inch-wide PVC pipe and insert two or three layers of gravel, sand, zeolite, or activated charcoal, separating each layer by pieces of fabric or cotton. Run hazy water through it to see clear water come out the other side once it has been cleaned and is ready to use.

This kind of filter will remove particulate matter whether it contains activated charcoal or not, but it won't eliminate germs and other diseases. It's crucial to have a variety of options for sanitizing water to get rid of microbes, such as the following:

1. Boiling: Use a heat source to bring your water to a rolling boil. Some bacteria might endure extreme heat, but they are uncommon. Even more comprehensive would be to use a pressure cooker.

• Chlorine A 3–8 percent solution of sodium hypochlorite is found in household bleach, sold for use in washing clothes. Bleach has a strong history of successfully eradicating bacteria, and 8–10 drops in a gallon of water will suffice. You probably won't taste any different if you're used to drinking city-treated water.

• Iodine tincture (2 percent). Per gallon of water, add 12 to 16 drops. For this, an eyedropper is helpful. Before drinking water sanitized with bleach or iodine, you should wait 30 minutes.

Ultraviolet radiation The sun will render microorganisms inert. It only takes 6 to 8 hours in direct sunlight (best on a reflective surface). Fill your transparent gallon bottle to the top, then give it a good 20-second shake. The oxygen released from the water molecules will aid the process, enhancing the flavor.

 

STERILIZING FOOD

 

Anyone who has consumed food that has been out too long likely has had an experience where they later regretted it. The key to disease prevention is thoroughly cleaning surfaces used to prepare meals.

A surface for preparing meals is your hands. Before making your dinner, properly wash your hands. Before utilizing them, other surfaces used for food preparation, such as worktops, cutting boards, plates, and cutlery, should also be washed with water and soap or a weak bleach solution. Even though not all germs are killed by soap, it does assist in removing them from surfaces.

Before eating, wash your fruits and veggies under running water. Food made from plants cultivated in soil may include disease-causing microorganisms, and that's before fertilizers like manure are added. If the fruit has a rind, you are not protected; the organisms on the rind will get on your hand and spread to the fruit after you peel it.

The fluids from raw meat are infamous for contaminating food. Meats should be prepared separately from your produce. Make sure that meat reaches the proper safe temperature and stays there consistently until cooked, depending on the type of meat. To be sure of this, use a meat thermometer. The safe cooking temperature for various types of meat is listed below.

Beef:

145 degrees

Pork:

150 degrees

Lamb:

160 degrees

Poultry:

165 degrees

Ground meats:

160 degrees

Sauces and gravy:

165 degrees

Soups with meat:

165 degrees

Fish:

145 degrees

 

DIARRHEAL DISEASE AND DEHYDRATION

 

An increase in infectious diseases, none of which will be more prevalent than diarrhea, is likely to result from deteriorating sanitation and hygiene. An increased frequency of loose bowel movements is referred to as diarrhea. Three liquid stools in a row are cause for concern and alert you to the possibility of dehydration. Water loss from the body is dehydration. If severe, it may result in several chemical imbalances that are potentially fatal.

Common ailments like diarrhea may go away on their own if you only allow your patient clear drinks and advise them to abstain from solid food for 12 hours. However, the following signs and symptoms that may appear along with diarrhea could indicate a more serious condition:

       A fever that is at least 101 degrees

       Moderate to severe dehydration

       Blood or mucus in the stool

       Black or grey-white stool

       Severe vomiting

       Major abdominal distension and pain

       Diarrhea lasting longer than three days

These signs and symptoms could indicate a severe infection, intestinal bleeding, liver malfunction, or surgical problems like appendicitis. The risk that the affected person won't be able to control his or her fluid balance will also rise due to these symptoms.

Since the dawn of history, there have been outbreaks brought on by germs that produce diarrhea. One extremely dangerous illness that was widespread in the past and might be again in the hazy future is cholera. Abdominal pain and a lot of watery diarrhea are symptoms of this infection.

Another extremely severe sickness brought on by tainted food or drink is typhoid fever. Like cholera, it is marked by painful, bloody diarrhea, and throughout history, it has been the source of deadly outbreaks. Typhoid fever often rises every day, and after a week or more, you might see a blotchy rash and nosebleeds on their own. From there, the patient's condition gets worse.

Dehydration is the final result of untreated diarrheal disease and the most common cause of mortality. The average adult needs 2-3 liters of fluid daily to maintain balance since the body is 75% water by weight. Children are more susceptible to dehydration than adults are: Every year, 4 million children in developing nations pass away from causes such as diarrheal dehydration and other causes.

Rehydration

Dehydration is treated by fluid replacement. The first line of treatment is oral rehydration, but if it is unsuccessful, it may be necessary to inject fluid intravenously, which calls for specialized tools and knowledge. Give your tiny patient amounts of clear fluids to start every time. Water, clear broth, gelatin, Gatorade, and Pedialyte are a few examples of clear fluids that are simpler for the body to absorb.

Commercial oral rehydration packets are available, but you may make your own fairly quickly at home: To 1 liter of water, add the following:

       6–8 teaspoons of sugar (sucrose)

       One teaspoon of salt (sodium chloride)

       ½ teaspoon of salt substitute (potassium chloride)

       A pinch of baking soda (sodium bicarbonate)

       For children, use 2 liters of water.

Juices, puddings, and thin cereals like grits or cream of wheat can be added to the diet as the patient demonstrates a capacity to handle these liquids. Given that some people are lactose intolerant, it is advisable to avoid milk. Giving solid patient food is possible once they can consume thin cereals.

The BRAT diet is a well-liked method for rehydrating quickly after dehydration in kids. The following foods are part of this diet:

       Bananas

       Rice

       Applesauce

       Toast (plain or crackers)

The fact that these foods are bland and well-tolerated is a benefit of this tactic. Additionally, they reduce intestinal motility, which slows down water loss by reducing how quickly food and fluids travel through your body.

Naturally, some medications can be helpful. Diarrhea can be treated with Pepto-Bismol and Imodium (loperamide). Although they don't treat infections, they will reduce the frequency of bowel motions and help you save water. These medications are available over-the-counter and are simple to get. They can be taken as tablets and last for years if stored properly.

ZofranTM is an effective antiemetic medication for vomiting (ondansetron). Typically, doctors won't hesitate to write this prescription, especially for individuals leaving the country. Of course, acetaminophen or ibuprofen are effective for treating fevers. More water is lost when the fever is greater. Therefore, anything that lowers fever will benefit someone's level of hydration.

It has been claimed that a variety of natural compounds are beneficial in certain circumstances. These are some examples of herbal remedies:

       Blackberry leaf

       Raspberry leaf

       Peppermint

Every two to three hours, have a cup of the tea you made with the leaves.

It is believed that consuming one teaspoon of raw honey and half a clove of smashed garlic four times per day will have an antimicrobial impact in some cases of diarrhea. Abdominal cramps can often be relieved with ginger tea, an age-old remedy.

You can attempt antibiotics or antiparasitic medications as a last option to treat dehydration from diarrhea (particularly if there is also a high fever). Use twice-daily doses of ciprofloxacin, doxycycline, and metronidazole until the stools are less watery. Some of these are available without a prescription in the veterinary version (discussed later in this book). The main negative effect of these medications is typically diarrhea; therefore, they should only be taken as a last resort.

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