McLaughlin Joseph B, Gessner Bradford D, Bailey Ann Marie
Division of Public Health, Alaska Department of Health and Social Services, Anchorage, AK.
Wilderness Environ Med. 2005 Summer;16(2):92-6. doi: 10.1580/1080-6032(2005)16[92:goamct]2.0.co;2.
To determine the burden of and risk factors for diarrheal illness among mountaineers climbing Denali during the spring of 2002.
We conducted a retrospective cohort study of all willing and available climbers who returned to base camp from June 11 to 14, 2002. We used a questionnaire that addressed illness status, demographics, and potential risk factors for illness. A case of diarrhea was defined as self-reported diarrhea (loose stool) in a Denali climber who did not have diarrhea before arrival at base camp.
Thirty-eight (29%) of the 132 climbers who were interviewed reported experiencing diarrhea at some point on the mountain. Spending 8 or more days at the 17 200-foot high camp; being a member of a climbing party in which at least 1 other person also had diarrhea, especially if tent occupancy was 3 or more; and not receiving education about disease risk-reduction techniques among climbers who were on a guided expedition were associated with increased risk of illness.
To prevent infectious diarrheal outbreaks among mountaineers climbing Denali (and other highly trafficked alpine routes), we recommend that park staff provide climbers with detailed information related to minimizing disease risk and develop more effective strategies for preventing climbers from depositing fecal material directly into snow along the route, such as establishing and enforcing firmer penalties for noncompliance with existing human waste disposal regulations and requiring the use of personal stool-hauling devices.
确定2002年春季攀登迪纳利峰的登山者中腹泻疾病的负担及风险因素。
我们对2002年6月11日至14日返回大本营的所有愿意且可参与的登山者进行了一项回顾性队列研究。我们使用了一份调查问卷,内容涉及疾病状况、人口统计学信息以及疾病的潜在风险因素。腹泻病例定义为迪纳利峰登山者自我报告的腹泻(稀便),且在抵达大本营之前没有腹泻症状。
在接受访谈的132名登山者中,38人(29%)报告在山上的某个时候经历过腹泻。在海拔17200英尺的营地停留8天或更长时间;所在登山团队中至少有1名其他人员也出现腹泻,特别是如果帐篷居住人数为3人或更多;以及在有向导带领的探险登山者中未接受疾病风险降低技术教育,这些情况都与患病风险增加有关。
为预防攀登迪纳利峰(以及其他高流量山区路线)的登山者中传染性腹泻疫情的爆发,我们建议公园工作人员向登山者提供与尽量降低疾病风险相关的详细信息,并制定更有效的策略,以防止登山者直接在沿途将粪便排入雪中,例如对违反现有人类粪便处理规定的行为制定并实施更严厉的处罚措施,以及要求使用个人粪便搬运设备。