Did the chicken get undercooked or did someone just not wash their hands? Either way someone on the trip just exploded. No big deal, right? Sure, modern medicine has a lot of great options that can help us through this, but in a wilderness setting this gets tricky fast. In a wilderness setting, quarantine and management of a viral outbreak require a combination of individual and collective efforts to prevent the spread of disease. There are some serious issues to consider when you do have an illness outbreak.

• You may not know what disease someone has and the mechanism for transmission may be unclear.

• One or two people experiencing physical weakness on the trip may be easy to deal with, but if the whole group cannot effectively make it down the river the situation will turn into an emergency quickly.

• We often only carry a limited amount of medication into the wilderness and if everyone get’s sick there isn’t enough to go around.

• Being sick on a wilderness trip is unpleasant especially when you’re already in an uncomfortable setting. New participants can be particularly turned off to the experience and may not wish to come back.

Prevention is always a better option so making sure you have an illness prevention plan in mind should always be the first option. Frequent hand washing, a food storage plan, exercising increased caution with human waste, and water filtration are all strong points to consider for in your illness prevention plan. Small things like packing a thermometer, sanitizing wipes, hand sanitizer, and gloves are all little things you can do to help prevent illness. So, what happens when illness does break out? Here are some best practices for managing a viral outbreak in a wilderness setting:

How to manage patients when illness strikes you paddle team.

Isolation and quarantine: If a person shows symptoms of a viral illness, they should be isolated from others and advised to stay in their tent or designated area until they are no longer contagious. This may require one person who is not ill to manage their boat and help them get down the river. This person should always assume everything is infected on that boat and take precautions to prevent illness. This will also include isolating that persona’s personal gear and reevaluating how boats are rigged to make sure any equipment the sick person has in also quarantined.

Personal hygiene: Encourage individuals to practice good personal hygiene, including frequent hand washing with soap and water or using hand sanitizer, covering their mouth and nose when coughing or sneezing, and avoiding close contact with others.

Group management: Limit group size and encourage physical distancing, such as staying at least six feet apart, to reduce the risk of transmission. Avoid activities that involve close contact or shared equipment, such as communal meals or shared gear. This may include keeping more distance on the water as well between quarantined boats.

Waste management: Properly contain and dispose of human waste to minimize the risk of pathogen transmission and water pollution. This can be achieved by using wag bags or other designated toilet facilities, and properly disposing of all waste in designated areas. Consider adding a few extra wag bags so that if anyone becomes ill has their own personal toilet accommodations, thus reducing the likelihood of the spread of illness.

Food preparation: Encourage individuals to prepare their own food and avoid shared meals, or have designated individuals prepare food for the group using proper hygiene practices. If designated individuals who are not ill are preparing food, then they can pass food off to quarantined individuals by setting it down and walking away. If you have a non-sick party assisting a boat with ill individuals then have that person assist with cleanup of the dishes of the sick party using strict sanitation guidelines.

Monitoring: Encourage individuals to self-monitor for symptoms and to report any changes to their health status to the trip leader or other designated individual. If a designated individual is selected to assist with the ill parties, then that person should be monitoring the sick individuals for changes in symptoms.

Emergency response: Have a plan in place for responding to a potential outbreak, including evacuation procedures, medical support, and reporting to local health authorities.

• Evacuation: If the outbreak becomes severe, consider evacuating the group to a more secure and hygienic location where medical attention and support can be accessed. This may require a satellite communication device or cell phone communication or someone heading down river ahead to an emergency egress point to summon help. Even if you don’t have an exact location getting an emergency response rolling can help save lives or further costly medical complications. If medical evacuation is required then there is an array of option available to prepared parties. You can find more information in our medical evacuation article.

• Monitoring: Even if it doesn’t seem that bad initially, the trip leader or designated individual should monitor the individual for symptoms and assess their condition regularly. If their condition worsens, they should escalate the situation and consider evacuation.

• Reporting: If possible, the trip leader or designated individual should report suspected virus cases to the local health authorities and follow their guidance for handling the outbreak. If there is a viral outbreak such as something like norovirus it may be helpful to other parties travelling don river. If needed managing agencies can post warnings or quarantine camps that may have viral or other health hazards.

Managing illness in the outdoors doesn’t require a team of highly trained doctors on the trip, though the more medical knowledge on the trip the better. Even if you do not possess advanced wilderness medical training you can still follow some good common sense safety practices to make sure you have an illness free trip on the river.