The Problem with Zebras

"When you hear hoof beats, think horses, not zebras."

That was one of the gems that Dr. Steve shared in his off-grid medicine course.  It's something taught to all students in medical school.  And what is means is this:  Common things happen commonly.  The child in the waiting room is more likely to have an ear infection than appendicitis.  The young adult is more likely to have type-2 diabetes than a gunshot. 

We naturally gravitate toward the sensationalized rather the common.  If we decide to learn something new, it has to be something cool, different, unique.  Quick and easy would be really good, too.  Macho survivalists want to learn how to DIY an appendectomy on themselves, sans anesthesia.  But learning to satisfy the essentials of good nutrition to stay healthy in the first place?  Leave that to the grannies. They want to be able to stitch up that GSW or finish off an amputation or place a tourniquet (and argue about which tourniquet is best).  They want to be able to treat the rare injuries, the zebras, that likely aren't even once in a lifetime or once in a family's lifetime, but can't manage the common problems (the horses).  They don't know which OTC meds are best for which conditions or when to suture and which wounds must be left open.

Spending money on stuff is easier than learning a new skill. The acquisition of that box of ammo, bottle of fish antibiotics, or solar rechargeable penlight provides an immediate reward of having accomplished something.  And with online shopping, you receive that reward twice--once when you purchase, and again when it arrives.

Learning a new skill takes time. It's not glamorous or sensational.  On top of that, the macho guys are even ridiculing your choices, which makes it harder.  They're sure the hoof beats coming are zebras, and it's silly to waste time preparing for horses, mules, or donkeys.  So you just have to put your head down and plow on.

Which brings us back to the problem with zebras.  For a very long time the US, figuratively, has been a nation of horses treated by horse doctors, horse doctors that have been trained to treat only horses.  Not zebras.  Even though zebras bear some physical resemblance, there are significant differences.  Because the zebras carry some vastly different diseases.  And those diseases have symptoms and presentations that are quite similar to those for horses, but the treatments may be totally different.  The horse doctors might have read about these zebra diseases, but they have never seen them.  Most American doctors have never seen even one case of the following:

• diphtheria
• tetanus
• rabies
• scabies
• mumps
• German measles
• cholera
• yellow fever
• typhus
• tularemia
• plague
• anthrax
• botulism
• measles (though this is changing with increasing numbers of people who are not immunized)

When American doctors hear hoof beats, they think horses. Scabies gets diagnosed as psoriasis.  Improperly diagnosed rabies patients are given steroids for pain and sent home.  Is it influenza, or anthrax?  The symptoms are very similar. What about plague or tularemia?  Even with experience, these can be hard to differentiate.  Without experience? You probably don't want to go there.

Unfortunately, many of those hoof beats in the distance are in fact coming from zebras.  Most physicians in US have never seen the actual zebras making a comeback and crossing our borders.  Measles is only the beginning.  Lots of other communicable diseases are on their way.   We currently have the problem of physicians unable to identify more exotic diseases now, while the technology is available to help them.  What happens when our society collapses?  They will not have their technology to help them diagnose anything.

Now, there are a few horse doctors who hear the hoof beats of zebras in the distance.  Some of them teach off-grid medicine to preppers.  Some write books or blogs.  No one physician covers everything, so it's best to acquire at least two or three different sources--hard copies.  Make sure you're prepared to deal with the ailments common to horses.  That's what you'll see the most of.  But it would also be wise to have the means of dealing with communicable diseases, parasites, and infectious diseases of third world countries, as well as bioweapons.  Zebras can be heard in the distance.

Links to related posts:
Cholera
Rabies
Scabies
Tularemia 
Typhus
Armageddon Medicine  
Survival and Austere Medicine, 3rd Edition  
The Survival Medicine Handbook 

For further reading:
https://www.deseretnews.com/article/900041016/utahn-dies-from-rabies-a-first-since-1944.html
https://www.healthline.com/health/psoriasis/psoriasis-vs-scabies

 © 2019, PrepSchoolDaily.blogspot.com  04.23.24

Rabies--Can Anything Be Done?

Disclaimer.  I am not a licensed health practitioner.  This is just another post on an item you might wish to have available if needed so that a physician can treat you and your family as best as possible.  No medication, including those available over the counter, should be taken without consulting a physician.  Information shared here is for educational and entertainment purposes only.  It is not medical advice nor a substitute for licensed medical care.  A qualified, licensed physician or other medical provider should be consulted before beginning any herbal or conventional treatment.

One of the things I love most about writing this blog is that I learn so much.

Predictably, there was quite a bit that I didn't know about rabies.  It's not like it's a common occurrence, or even uncommon.  Every responsible dog owner has their dogs vaccinated against rabies.  Bats carry rabies.  Don't approach a dog, or any other animal, acting strangely, and particularly one that is excessively salivating. I think that covers what the average person knows about rabies.

Human cases of rabies are rare in the US, with generally only two to three occurrences per year, most of which are contracted overseas.  However, more than 50,000 people worldwide die from rabies each year, and most of these cases are due to bites from unvaccinated dogs.  In developed countries, wildlife exposure is the most common cause of rabies deaths.  Of course, there are the idiots, like the couple in Utah who bought a home with bats.  And enjoyed handling the bats!!  The husband died in 2018 and his wife had to receive the rabies shots.  Both said they had never been bitten.

With modern medicine still available to us, any encounter with a bat warrants receiving the rabies vaccination.  The most insignificant of scratches can be fatal.  (Indeed, the Utah family of the man who died said they had not been bitten or scratched, only that the bats had licked their fingers.  And that they often found the bats in bed with them.)  And that's why over 50 students in two Utah schools were sent to receive the preventative rabies vaccinations just from having the bats in their classrooms.

Vaccination is required by law (and common sense) for veterinarians and veterinarian office workers.  It is recommended for cave explorers and those traveling to rabies-endemic regions.  Pre-exposure immunization is over $500 and is usually not covered by insurance.

That's a hefty price tag, but it may be worth considering.  I know I am, at least for my daughters who handle all the animals.

At the very least, make sure your pets are vaccinated for their protection and especially for yours.

However, post-collapse these vaccines are not going to be available and interactions with animals, especially wild animals, may increase.  The first thing that is going to have to happen is that loose or wild dogs, pets that were abandoned or dumped by their owners, are going to get rounded up and euthanized or shot.  It will be sad, but it will have to happen to protect the community.  Because those vaccines eventually wear off and domestic dogs will have rabies again.

So what can we do?

As mentioned above and like most people know, strange behavior and excessive salivation are signs of rabies.  In addition, nocturnal animals will appear during the day, and most will show aggressive behavior.  Rabies is most commonly spread by raccoons, skunks, bats, opossums, coyotes, foxes, and dogs.  According to Dr. Joseph Alton, author of The Survival Medicine Handbook, there has never been a documented case of rabies transmission to humans in the US from cows, squirrels, rabbits, rats, sheep or horses.

If there is any concern that an animal has rabies, that animal should be isolated and observed, if possible for at least a week.  A biting animal with rabies usually dies within 5 to 7 days.  Any unvaccinated pet or animal whose vaccination has lapsed that has been bitten or otherwise attacked by another animal should be isolated for at least seven to eight weeks, during which time signs usually appear, though sometimes rabies symptoms can take up to two years to manifest.

In people, signs of rabies usually appear one to three months after initial exposure, but again, may take up to two years to appear.  The first course of action whenever someone has been bitten or scratched by an animal suspected of having rabies (and any bat contact at all) is to seek medical attention and the life-saving prophylactic rabies vaccines, currently a course of five shots over a two-week period.

Unfortunately, that will likely not be an option post-collapse.

Is there anything that can be done?  Actually, yes.  (This is the cool stuff I learned by writing this post today.)

Studies suggest that vigorous scrubbing and irrigation of the wound may reduce the risk of transmission.  While washing and scrubbing with soap is good, benzalkonium chloride is best as it has demonstrated some efficacy against the rabies virus.  Antibacterials, including iodine, have zero efficacy against viruses.  The caregiver must don gloves to protect himself, and then the wound should be irrigated with a syringe and scrubbed vigorously for at least ten minutes to flush out the virus, saliva, debris, and bacteria.  Do not close the wound, but keep it bandaged to prevent infection.

And that's all that can be done.  Early symptoms of rabies include fever, headache, over-sensitivity to light and sound, difficulty swallowing, and (in animals) a fear of water.  Once the sickness has begun, here is no known treatment that can save a person's life.

Links to related posts:
Skin Preps and Washes (including benzalkonium chloride) 
Post Collapse Management of Domestic Animal Bites  
Suturing the Skin 

For further reading:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1058082/
https://www.reliasmedia.com/articles/141247-emergency-management-of-rabies-exposure
https://microbewiki.kenyon.edu/index.php/Antiseptic_efficacy_of_benzalkonium_chloride
http://beansbulletsbandagesandyou.com/bullets/2019/04/27/rabies-prepare-aware/
https://www.cdc.gov/rabies/medical_care/index.html
https://www.aafp.org/afp/2014/0815/p239.pdf
https://www.deseretnews.com/article/900041016/utahn-dies-from-rabies-a-first-since-1944.html
https://www.deseretnews.com/article/865689891/Students-treated-for-rabies-after-bat-exposure-at-Utah-high-schools.html

© 2019, PrepSchoolDaily.blogspot.com  

1 march 2023