I was planning a backpacking trip to IR and encountered this forum, which is a truly wonderful resource; thanks to everyone for sharing all of your insights.
One of the items that concerned me was the endemic nature of Echinococcus granulosus (the "hydatid tapeworm") in all inland lakes (and possibly surrounding Lake Superior water) on Isle Royale. For those who aren't aware, worms aren't the risk for humans - the risk is that we would stand in for moose, and have (potentially lethal) cysts form in our organs (particularly the liver, but also potentially elsewhere) if we ingest the eggs (which are found in wolf feces and, via rain runoff, are known to contaminate all inland water on Isle Royale, and quite possibly surrounding Lake Superior water, though probably at a much lower rate. It's worth noting that although the wolf population on IR has greatly diminished, foxes are known carrion feeders and while they may or may not be immune to E. granulosus - it's debated - it's probably safer to assume that they can, and that E. granulosus prevalence on the island has not diminished despite the recent decline in the wolf population.)
Although these tapeworms exist elsewhere in the United States, their concentration appears to be many orders of magnitude higher on Isle Royale vis-a-vis the Boundary Waters and other areas with the same fauna (at least to the extent I've been able to tell from a review of online sources - it doesn't seem anyone is all that concerned about echinococcosis elsewhere in the lower 48, at least from a backpacking / backcountry standpoint. Please correct me if I'm wrong; I may just have not looked far enough! I did see a few mentions of certain parts of Idaho / Montana / Utah / California / New Mexico / Arizona, but they didn't seem to be as extensive as Isle Royale and seemed to be more of a threat for sheep farmers and their dogs.)
As such, there have been several threads in the past regarding the need to use water filters (and not just UV sterilization or chemical treatment) to make water on Isle Royale safe to drink.
In the process of researching, I came across a very extensive (286-page) document on echinococcosis from the World Health Organization (WHO) that I hadn't seen cited on any of the tapeworm-related threads here. (https://www.medbox.org/preview/5255e18b ... cc/doc.pdf) It contained a lot of information on disinfection protocols that I thought was important. One of the most important aspects that I haven't seen anyone mention:
The document goes on to recommend wearing gloves/protective equipment in the first place, and subsequent thorough hand-washing with soap and water (among other measures for decontamination of clothing, surfaces, etc.) I don't know about y'all, but when I'm backpacking, I typically use hand sanitizer (i.e. a concentrated solution of ethanol, isopropyl alcohol, or similar) to clean my hands, since it's more convenient than carrying soap and treating water to wash hands as well as drink. If "5 to 60 minutes" of exposure to ethanol concentrations similar to those in Purell didn't kill the eggs, then simply dabbing a little on your hands is the biowarfare equivalent of a band-aid on a sucking chest wound - it's not going to do any good.Echinococcus and Taenia eggs are highly resistant to numerous chemicals (22). For example, eggs of T. pisiformis survived for 3 weeks in 10% formalin, eggs of E. granulosus retained viability in ethanol (50%, 70%, 95%) after 5 min to 60 min exposure (19, 24, 26), but only a few survived in glutaraldehyde (5% and 10%) (27). Most of the commercial disinfectants with activity against viruses and bacteria are ineffective against Echinococcus eggs (see below).
So it appears that hand sanitizer would be completely ineffective against tapeworm eggs that have come to reside on your hands. In other words, even if you properly treat water that you drink, you could still contract echinococcosis if you have eggs on your hands (from contaminated soil, water, or elsewhere). This is not a theoretical concern; the document notes that in addition to transmission through drinking water, other transmission mechanisms include:
Another research study, "Hydatid disease in children," noted risks associated with swimming or other exposure to contaminated bodies of water: (https://www.sciencedirect.com/science/a ... 6X14001169):"Handling infected definitive hosts, egg-containing faeces or egg-contaminated plants or soil followed by direct hand to mouth transfer."
Anyway, I just thought this is something people should be aware of - I know that previous posts have mentioned not eating unwashed wild blueberries (the document recommends preferably boiling them), but it was news to me (after several days of reading/researching) that hand sanitizer wouldn't kill any residual baddies that might be left on my hands after swimming, tripping and hand-planting on the trail (I'm particularly good at this), attempting to domesticate a wolf and bring it back on the seaplane... etc.The diagnostic armamentarium has to be supplemented by clinical examination and a meticulously taken history. History of bathing and swimming in pond water, which is usually contaminated with animal excreta, should be noted. Male children tend to participate in more outdoor activities and games compared to girls in villages and thus have a greater chance of coming into contact with water, soil and feces contaminated with Taenia eggs. Male preponderance has been reported in other studies...
(That last one, to be clear, was a joke. Wolf domestication is not recommended and there are probably more severe risks involved than echinococcosis. As a separate note, and more to the point, these eggs can survive for a very long time on surfaces (including canid hair and, I would speculate, human skin) at normal humidity levels, so there's also the potential for transmission via your clothes, boots, backpack/other gear, and so on after you leave the island, unless they're all properly sanitized via desiccation with dry heat and/or high temperature washing / autoclaving.)
Obviously, it's an individual choice of how much risk you're comfortable taking, and I don't mean to be an alarmist - as Laurence Gonzales puts it in his book Deep Survival (https://amzn.to/2AcsEcs), if you never take any risks, you'll never do anything fun or worthwhile. I am aware that tens of thousands of people visit Isle Royale each year, a number which vastly exceeds the cumulative known echinococcosis cases in the lower 48 over the past several decades (it is in fact extraordinarily rare for non-indigenous, i.e. not Native American, U.S. residents to contract it domestically). I haven't done any math, but back of the envelope, one is probably far more likely to die or suffer severe disability traveling to Isle Royale than from contracting echinococcosis from Isle Royale, assuming you aren't intentionally stupid (i.e. you don't start munching on wolf feces).
But given the long-term incubation period (often asymptomatic for decades until you wake up one day and it's suddenly a big problem - potentially anaphylactic shock), invasive treatment required (excision surgery on the liver, brain, or wherever else cysts form, and/or chemotherapy), and potentially severe consequences vis-a-vis more well-known backcountry waterborne threats like Giardia or Cryptosporidium, or even vector-borne threats like Lyme disease from black-legged deer ticks, I felt like this was important information to share - clearly the base rate of contracting it on IR is substantially higher than it would be anywhere else in the wilderness, and as such there are unique considerations that must be taken into account for trips to Isle Royale compared to other backcountry adventures.
I hope this is helpful background. It took quite a while for me to type this (and, probably, for you to read it) but everyone has been so generous sharing their insights here that I wanted to do the same... maximum effort. I have never visited Isle Royale, nor talked to anyone who has, nor am I a microbiology expert nor a professional scientist, but I do have a brief background in scientific lab research and work as a research analyst in the finance/investing world - so interpreting and synthesizing information is what I do for a living. I think my conclusions here are directionally accurate for our purposes although there are undoubtedly some aspects I've misunderstood or not completely captured. Regardless, I recommend you review the appropriate portions of the linked documents yourself for further important information and context.
Best wishes from Texas!
