INFECTIONS - Medicine for Mountaineering and Other Wilderness Activities - page 322

leased when the eggs hatch spread throughout the body via the bloodstream and localize in
muscles.
If infestation is heavy, penetration of the intestinal wall by the larvae one to four days
after ingestion produces nausea, vomiting, abdominal cramps, and diarrhea that resemble
food poisoning. The migration of the larvae to the muscles seven days after ingestion pro-
duces fever, chills, muscular weakness, a skin rash, and swelling of the face and tissues
around the eyes. Headache may be severe.
The diagnosis is based upon the onset of characteristic symptoms following the inges-
tion of poorly cooked wild game or improperly prepared pork or pork products such as
salami.Askintestisavailable.Ifthe Trichinella parasiteisdiscoveredearly,intheintestin-
alphase,albendazolecanbeeffectiveineliminatingtheintestinalwormsandlarvae.There
is no specific treatment for late-stage trichinosis. Symptomatic treatment consists of rest,
mildormoderateanalgesics,andsedativestopromoterestfulsleep.Prednisonemaybebe-
neficial in the early stages of the disease. All pork must be thoroughly cooked. In addition,
freezing at 0°F (−18°C) for twenty-four hours or 5°F (−15°C) for twenty days usually kills
all trichinae.
More information is available at www.cdc.gov/ncidod/dpd/parasites/trichinosis/de-
fault.htm .

ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)
Acquiredimmunodeficiencysyndromeistheresultofasusceptibilitytounusualinfections
and malignant tumors caused by a defect in the immune system. The disease results from
thedestructionofnormallymphocytesbythehumanimmunodeficiencyvirus(HIV).Since
its identification in 1981, the disease has spread worldwide. Over two-thirds of HIV cases,
and over 80 percent of deaths, occur in sub-Saharan Africa.

Significant Febrile Illnesses Likely to Be Encountered by Mountaineers
and Adventure Travelers

Table 22-2

FEVER WITH MACULES 1
AND PAPULES 2

FEVER WITH
PETECHIAE 3

FEVER WITHOUT RASH

Rocky Mountain spotted
fever

Rocky Mountain spotted fever Typhoid fever

Dengue fever Dengue fever Malaria

Typhoid fever Malaria Infectious mononucleosis

Lyme disease Meningococcal disease Plague

Infectious mononucleosis Relapsing fever