Video: Parasitic Worms, Pt. 1

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Video: Parasitic Worms, Pt. 1


It’s important to realize that infections not commonly seen today may become major issues if a disaster throws you off the grid. Knowing which disease-causing organisms exist in your area, even if they are not common problems today, will be important to keep your loved ones healthy.

The word “parasite” comes from the Greek word Parastos, meaning “someone that eats at someone else’s table”. When we think of parasites, none give us the creeps more than the thought of having worms.

In this video, Joe Alton MD discusses some of the basics of parasitic worm infections, including what to expect in terms of symptoms, and much more. Part 1 of a 2 part series.

To watch, click below:

Wishing you the best of  health in good times or bad,

Joe Alton MD

Fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kit and medical supplies at Our products are all eligible to be covered under health and flexible savings accounts.

Get your family medically prepared.  You’ll be glad you did!

Sulfonamides (Sulfa Drugs) in Survival

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Sulfonamides (Sulfa Drugs) in Survival


The availability of antibiotics to the family medic in survival and other austere settings may prevent the unnecessary deaths of loved ones due to infection. When help is not on the way, the average citizen will find these drugs to be important tools in the medical woodshed.

You might think that Penicillin family drugs were the first to be used by the general public, but another popular family of antibiotics called sulfonamides, or sulfa drugs, were actually on the market even earlier. Indeed, it has been called “the first miracle drug”. Sulfonamides deserve credit for saving tens of thousands of lives during World War Two. It was so widely used that many soldiers’ first aid kits came with the drug in pill or powder form. Medics were told to pour it into any open wound.

Sulfonamides were first identified to have antibacterial action by a German scientist named Gerhard Domagk, who evaluated certain dyes for possible medical uses. He found a red dye produced by Bayer (yes, that Bayer) that apparently eliminated bacterial infections in mice. This became “Prontosil”, credited as the first broad-spectrum antibiotic. Interestingly, it didn’t show a lot of antibacterial action in test tubes; Prontosil’s effect was much more noticeable on a live subject.

Another interesting tidbit about Sulfa drugs is that the active ingredient had been used by the dye industry for decades, so no patent could be obtained. Bayer had to share the ingredient with anyone who wanted to use it, eliminating the potential for big profits. This led to many different variations, some of which were “snake oil” that contained toxic ingredients. One such elixir killed a hundred people in 1937, leading to the enactment of the first serious oversight of pharmaceuticals, the Federal Food, Drug, and Cosmetic Act of 1938.


Sulfonamides act to inhibit an enzyme involved in folate synthesis, an important aspect of bacterial DNA production. This family of drugs is bacteriostatic; that is, they don’t directly kill the bacteria, but inhibit growth and multiplication. If bacteria are unable to multiply, they can’t sustain the population needed to damage the body.

A commonly used sulfonamide is the combination drug sulfamethoxazole 400 or 800mg and trimethoprim 80 or 160 mg, known by the brand names Bactrim or Septra in the U.S. In Great Britain, it is called Co-Trimoxazole (Cotrim). A veterinary equivalent is known as Fish-Sulfa or Bird-Sulfa.

ASIDE: Different antibiotics (or other drugs) may be combined into one product. Usually, this is done because the two work together to have a stronger effect against an infection or other condition than they would if used alone. This is called “synergism”.


Broad-spectrum Sulfamethoxazole/Trimethoprim is effective in the treatment of many infections, including:

· Some upper and lower respiratory infections (chronic bronchitis and pneumonia)
· Kidney and bladder infections
· Ear infections in children
· Cholera
· Intestinal infections caused by E. coli and Shigella bacteria (a cause of dysentery)
· Skin and wound infections, including MRSA
· Traveler’s diarrhea
· Acne

Of course, as an antibiotic, no sulfonamide has any effect on viruses or viral illnesses.


The usual dosage in adults is sulfamethoxazole 800-mg/Trimethoprim 160mg twice a day for most of the above conditions for 10 days (5 days for traveler’s diarrhea).

The recommended dose for pediatric patients with urinary tract infections or acute otitis media (ear infection) is 40 mg/ kg sulfamethoxazole and 8mg/kg trimethoprim per 24 hours, given in two divided doses every 12 hours, for 10 days. 1 kilogram equals 2.2 pounds. This medication should not be used in infants 2 months old or younger.

In rat studies, the use of this drug was seen to cause birth defects; therefore, it is not used during pregnancy.
Another sulfa drug, Sulfadiazine, is combined with Silver to make Silvadene, a cream useful for aiding the healing process in skin wounds and burns. Cover completely twice a day.

Sulfamethoxazole/Trimethoprim and other Sulfonamides are well known to cause allergic reactions in some individuals. These reactions to sulfa drugs are almost as common as Penicillin allergies, and usually manifest as rashes, hives, and/or nausea and vomiting. Worse reactions, however, can cause blood disorders as well as severe skin, liver, and pancreatic damage. Those with conditions relating to these organs should avoid the drug.

Although an allergy to Sulfa drugs may be common, it is not the same allergy as to Penicillin. Those allergic to Penicillin can take Sulfa drugs, although it’s possible to be allergic to both.

Sulfonamides and other antibiotics aren’t candy, and they must be used wisely and only when absolutely necessary. In normal times, seek out qualified medical professionals before you consider their use.

Joe Alton MD

Learn more about Sulfa Drugs and other survival antibiotics in the Book Excellence Award winner in Medicine, The Survival Medicine Handbook: The Essential Guide for when Medical Help is Not on the Way, available on Amazon or this website.

What Are Pathogens?

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What Are Pathogens?


An infection is defined as the invasion of the body by microscopic organisms. A pathogen is any agent that can cause a disease, but the term is usually used to describe a microbe. Microscopic germs cause injury to tissues in a number of ways, often by producing toxic substances that damage the cells.

Before we give every micro-organism a bad name, it’s important to know that they are not all pathogenic. In fact, some are beneficial or even necessary for human life, such as many intestinal bacteria.

Pathogens are often carried by “vectors”, from the Latin word vectus, “one who carries”. These are humans, animals, or microbes that carry and transmit a pathogen to others. A vector does not have to be ill to carry a disease: A mosquito, for example, carries the organism that causes malaria in humans but doesn’t experience the disease.

Another example of a disease vector was a domestic servant known as “Typhoid Mary”. She carried Typhoid fever to many people at homes where she worked without feeling sick herself. The elimination of a vector from the environment (terminating Mary’s employment, for example) usually ends the outbreak of disease.


There are a number of different pathogens that cause infectious disease. Perhaps the one we hear most about is bacteria.  By the way, the word bacteria is the plural form. A single one is called a bacterium.

Bacteria were among the first life forms on Earth and are present everywhere from the soil to the bottom of the ocean to the inside of your body. They may even exist on Mars. If you took the entire population of bacteria on the planet, they would probably have a mass about equal to the entire plant and animal population combined. 

Bacteria have a number of shapes, ranging from spheres to rods to spirals. When bacteria reach a certain size, they reproduce by splitting in two, a process called binary fission.

Many bacteria are good guys. Some, however, are pathogens and cause infectious diseases, including cholera, syphilis, anthrax, leprosy, and bubonic plague. The most common fatal bacterial diseases affect the lungs, with tuberculosis alone killing about 2 million people a year, mostly in underdeveloped countries.

There are many different types of bacteria. Most bacteria don’t need to enter the host’s cells to reproduce, they do just fine in, for example, your blood. A subgroup of bacteria called Rickettsia, however, does depend on entry, growth, and reproduction within a host cell.

Rickettsiae are the cause of typhus, Rocky Mountain spotted fever, and a number of other infectious diseases. Rickettsia do not, however, cause rickets, a deformity of long bones in young children which is a result of vitamin D deficiency.

Although many bacteria have become resistant, they can usually be killed with antibiotics. Different bacteria are sensitive to different antibiotics.


Viruses are microscopic pathogens that, unlike most bacteria, can reproduce only inside the living cells of other organisms. Viral particles without a host are known as “virions”, and only act as a living organism when they enter a host cell. Indeed, they stretch the definition of life itself. Viruses can infect all types of hosts, from animals and plants all the way down to bacteria.

Examples of common human diseases caused by viruses include the common cold, influenza, chickenpox, rabies, hepatitis, herpes, Ebola, and Zika.

Viruses can be spread by:

•            Mosquitoes and other vectors

•            Airborne droplets in coughs or sneezes

•            Contact with blood or other bodily fluids

•            Ingestion of contaminated food or water

A normal immune system can often kill the infecting virus. However, some viruses evade these immune responses and result in chronic infections, such as HIV or Hepatitis C. There are antiviral drugs, but it’s important to know that antibiotics have no effect.


Protozoa are one-celled microbes, a step up on the scale as they exhibit animal-like behavior, such as the ability to move. Many have a tail-like appendage called a flagella that they whip around for locomotion. They are restricted to moist or aquatic environments. Therefore, transmission is mostly by drinking contaminated water, although some are transmitted by animal vectors.

Protozoa cause infectious diseases in humans such as malaria, giardia, some dysenteries, sleeping sickness, and amoebiasis. A common vaginal infection is caused by a protozoan called trichomonas.

Protozoa are usually susceptible to treatment with certain antibiotics, such as metronidazole (also known as Fish-Zole in its veterinary equivalent).


A fungus (plural form: fungi) is a microorganism family that consists of such yeasts and molds. Fungal infections most commonly affect skin and mucous membranes like the oral cavity and vagina, but can invade other areas. Fungus affecting the toes is known as tinea pedis, or “athlete’s foot”. “Ringworm” is another type of fungal infection. Severe internal fungal infections can occur in individuals with weakened immune systems. Anti-fungal medications exist in topical or oral form, like miconazole or clotrimazole.

These are just some of the hazards that you’ll face if you take responsibility for the medical well-being of others in times of trouble. Learn about them, get some training and skills, and you’ll keep it together, even if everything else falls apart.

Joe Alton MD

VIDEO: All About Tick Bites

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VIDEO: All About Tick Bites


Backcountry hikes are a great way to commune with nature, but not by encountering bears, cougars, or an irritable moose. In Spring and Summer, we also have to worry about insects like mosquitoes and ticks. Insects like ticks are agents that transmit some pretty serious infections to the unprotected and unwary. In this video, Joe Alton MD discusses everything you need to know about tick bites: Identification, protection, tick removal, and much more.

To watch, click below:

Wishing you the best of health in good times or  bad,

Joe Alton MD

Joe Alton, MD

Fill those holes in your medical supplies by checking out our entire line of medical kits and supplies at!

E. Coli Contamination

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E. Coli Contamination


Romaine Lettuce

Romaine Lettuce

The Centers for Disease Control and Prevention reports that food poisoning from romaine lettuce harboring the bacteria E. Coli spread recently to 29 states and sent at least 150 people to the hospital. The areas involved include all parts of the country from Florida to North Dakota to California, and new cases are making it the worst E. Coli outbreak nationally since 5 people died and 200 were hospitalized in 2006.

Although E. Coli is a common inhabitant of the intestinal tract, some strains, especially O157:H7,  produce a toxin known as “Shiga” that causes bloody diarrhea, nausea and vomiting, dehydration, and other symptoms. Victims range from 1 to 88 years old, and a number are experiencing kidney failure, which has killed one person so far. Several E. Coli varieties are common causes of urinary tract infections.

E. Coli

E. Coli

Sources of Shiga-toxin producing E. Coli may include:

·       Contaminated water (even swimming in it may cause infection)

·       Undercooked ground beef

·       Unpasteurized milk or juice

·       Cheese made from raw milk

·       Raw fruits, vegetables, and sprouts

·       Contact with animals and their enclosures

·       Feces of those infected

After the organism enters the system, it usually takes several days for symptoms to appear. Unlike many infections, E. Coli tends not to cause high fevers, but the abdominal pain, diarrhea, and vomiting can be severe. Dehydration can cause decreased urine production, dark urine, weakness, and fatigue.

Rehydration is the main treatment

Rehydration is the main treatment

Re-hydration support during the illness will help support the victim for the 6-8 days it takes most to get over the infection. Antibiotics are rarely indicated, as it usually goes away by itself; it is even thought that taking anti-diarrheal medicines may slow the recovery process by preventing the elimination of the organism through bowel movements. Dairy products or items with high fat content or fiber can make your symptoms worse.

If it occurs, kidney damage will begin to become apparent after the first week.

Simply avoiding bagged lettuce at the grocery store is not enough, as many of those made ill ate the lettuce in salads served in restaurants. It is not yet known where in the chain from farm to consumer that the contamination with the bacteria took place. A farm in Yuma, Arizona may be involved.

Prevention involves avoiding poorly prepared food and water.  Use different cutting boards for raw fruits and vegetables than you would for raw meat.  

The most important factor in preventing E. Coli outbreaks is strict diligence applied to washing hands before cooking, after caring for animals and their environments, and diapering infants or otherwise disposing of human waste. 

Eating salads is a healthy option for most, but always be sure to make yours with freshly-washed hands and vegetables.

Joe Alton MD

Dr. Alton

Dr. Alton

Find out more about E. Coli contamination and 150 other medical issues when the ambulance may not be just around the corner! Check out a copy of the award-winning Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the way, available at Amazon or at Also, be sure to find a medical kit that will help keep your people healthy in good times or bad: Check out

The Third Edition

The Third Edition

Video: Getting Rid of Rodents

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VIDEO: Getting Rid of Rodents in Good Times or Bad

not a very welcome guest

not a very welcome guest

Every year, a percentage of our food supply is contaminated by the dropping and urine of rats and mice. It’s bad enough in normal times, but it can be a disaster off the grid. Rodents also carry diseases that can affect the health of your group members at a time when modern medicine may not be available. Therefore, it makes sense to eliminate your unwanted guests!

In this video, which follows up on a previous video on rodent-proofing a home, Joe Alton MD tells you what to do if you already have an issue with rat and mice infestation. Various ways to tell that you’ve got visitors and methods to get rid of them are discussed in some detail.

To watch, click below:

Wishing you the best of health in good times or bad,

Joe and Amy Alton

Joe and Amy Alton

Joe and Amy Alton

Learn a lot about over 150 medical issues in the 700 page Book Excellence Award winner in Medicine, The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way.

And don’t forget to fill those holes in your medical supplies with kits and items from Nurse Amy’s entire line at

Survival Medicine Hour: The Flu Hits The Hosts, Antibiotic Use, More

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Antibiotics not helpful against the flu

Antibiotics not helpful against the flu

Joe and Amy Alton, aka Dr. Bones and Nurse Amy, come down with the flu after their successful appearance at the SHOT show in Nevada, just one of 47 states reporting widespread outbreaks of influenza. Find out how hard it is to escape becoming a victim, even if you walk around with hand sanitizer in your pocket all day! Nurse Amy gives her advice for speeding recovery and Dr. Bones talks about the anti-viral drug Tamiflu and how it works to shorten the duration and severity of the illness.

It's good to have antibiotics, even fish versions, in your medical storage, but how to use them wisely in survival?

It’s good to have antibiotics, even fish versions, in your medical storage, but how to use them wisely in survival?

Also, Dr. Alton was the first physician to write about the use of fish and bird antibiotics as a survival tool, but this stuff isn’t candy, and has to be used wisely if at all. Having a supply, however, may avoid the preventable deaths from infected cuts and other minor ailments that could become big trouble in hard times. Some general advice regarding appropriate usage is given, and a useful antibiotic called  metronidazole (Flagyl, Fish-Zole) is spotlighted.

All this and more in the latest Survival Medicine Hour with Joe Alton MD and Amy Alton ARNP!

To listen in, click below:

Follow us on Twitter @preppershow, FB at Doom and Bloom(tm), and YouTube at DrBones NurseAmy Channel!

Joe and Amy Alton

Amy and Joe Alton

Amy and Joe Alton

Learn more about respiratory infections, anti-viral drugs, and antibiotics in the award-winning Third Edition of The Survival Medicine Handbook, The Essential Guide for When Medical Help is Not on the Way.


Survival Medicine Hour: Sleep Deprivation, Flagyl in Survival, Eye Injuries, Face Masks, More

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Survival Medicine Hour #372

sleep deprivation

sleep deprivation

Sleep deprivation is part and parcel of any post-apocalyptic setting, and you’d better know how to recognize it and deal with the issue in times of trouble. We discuss diagnosis, treatment, and use of natural remedies to help your anxious and depressed people stay work-efficient.

Eye Injuries

Eye Injuries

Plus, eye injury questions from a Survival Podcast listener, and a discussion of how to recognize and treat pneumonia off the grid, and a discussion of the basics of the use of face masks in the survival sick room.

Also, a discussion of the popular antibiotic Metronidazole, also known as Flagyl, and its possible uses as the fish antibiotic Fish-Zole in long-term survival settings.

All this and more in the latest survival medicine hour with Joe and Amy Alton, aka Dr. Bones and Nurse Amy!

To listen in, click below:

Wishing you the best of health in good times or bad,

Joe and Amy Alton

The Altons

The Altons

Fill those holes in your medical supplies with kits and individual items from Nurse Amy’s store at! #1 Top Supplier at!

Just some of our kits

Just some of our kits

Diseases Caused By Food And Water Contamination

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Even healthy-looking fruit can contain contaminants

Even healthy-looking fruit can contain contaminants

The primary necessity for survival is the availability of air. Once you have air to breathe, water, food, and shelter become the next requirements for your continued existence on the planet; that is, clean water and properly prepared food.

Even in normal times, there are many instances where an outbreak of infectious disease occurs due to water of poor quality. Ingesting food that was incompletely cooked caused the deaths of medieval kings in medieval times and may even have sparked the Ebola epidemic in 2014.

Epidemics caused by organisms that cause severe diarrhea and dehydration have been a part of the human experience since before recorded history. If severe enough, dehydration can cause hypovolemic shock, organ failure, and death. Indeed, during the Civil War, more deaths were attributed to dehydration from infectious diseases than from bullets or shrapnel.

More soldiers died from infectious disease than from bullets or shrapnel in the Civil War

More soldiers died from infectious disease than from bullets or shrapnel in the Civil War

Off the grid, water used for drinking or cooking can be contaminated by anything from floods to a dead opossum upstream from your camp. This can have dire implications for those living where there is no access to large amounts of IV hydration.

Therefore, it stands to reason that the preparation of food and the disinfection of drinking water should be under supervision. In survival, this responsibility should fall to the community medic; it is the medic that will (after the patient, of course) be most impacted by failure to maintain good sanitation.

Many diseases have disastrous intestinal consequences leading to dehydration. They include:

Cholera: Caused by the marine and freshwater bacterium Vibrio cholera, Cholera has been the cause of many deaths in both the distant and recent past. It may, once again, be an issue in the uncertain future.

Cholera toxins produce a rapid onset of diarrhea and vomiting within a few hours to 2 days of infection. Victims often complain of leg cramps. The body water loss with untreated cholera is associated with a sixty per cent death rate. Aggressive efforts to rehydrate the patient, however, drops the death rate to only one per cent. Antibiotic therapy with doxycycline or tetracycline seems to shorten the duration of illness.

This is the bowel movement of someone with Cholera

This is the bowel movement of someone with Cholera

Typhus: A complex of diseases caused by bacteria in the Rickettsia family, Typhus is transmitted by fleas and ticks to humans in unsanitary surroundings, and is mentioned here due to its frequent confusion with “Typh-oid” fever, a disease caused by contaminated, undercooked food.

Although it rarely causes severe diarrhea, Typhus can cause significant dehydration due to high fevers and other flu-like symptoms. Five to nine days after infection, a rash begins on the torso and spreads to the extremities, sparing the face, palm, and soles. Doxycycline is the drug of choice for this disease.

Typhoid: Infection with the bacteria Salmonella typhi is called “Typh-oid fever”, because it is often confused with Typhus. Contamination with Salmonella in food occurs more often than with any other bacteria in the United States.

In Typhoid fever, there is a gradual onset of high fevers over the course of several days. Abdominal pain, intestinal hemorrhage, weakness, headaches, constipation, and bloody diarrhea may occur. A number of people develop a spotty, rose-colored rash. Ciprofloxacin is the antibiotic of choice but most victims improve with rehydration therapy.

Dysentery: An intestinal inflammation in the large intestine that presents with fever, abdominal pain, and severe bloody or watery mucus diarrhea. Symptoms usually begin one to three days after exposure. Dysentery, a major cause of death among Civil War soldiers, is a classic example of a disease that can be prevented with strict hand hygiene after bowel movements.


Shigella dysenteriae

The most common form of dysentery in North America and Europe is caused by the bacteria Shigella and is called “bacillary dysentery”.  It is spread through contaminated food and water, and crowded unsanitary conditions. Ciprofloxacin and Sulfa drugs, in conjunction with oral rehydration, are effective therapies.

Another type is caused by an organism you may have read about in science class: the amoeba, a protozoan known as Entamoeba histolytica. Amoebic dysentery is more commonly seen in warmer climates. Metronidazole is the antibiotic of choice.

Traveler’s Diarrhea: An inflammation of the small intestine most commonly caused by the Bacterium Escherichia coli (E. coli). Most strains of this bacteria are normal inhabitants of the human intestinal tract, but one (E. coli O157:H7) produces a toxin (the “Shiga” toxin) that can cause severe “food poisoning”. The Shiga toxin has even been classified as a bioterror agent.

In this illness, sudden onset of watery diarrhea, often with blood, develops within one to three days of exposure accompanied by fever, gas, and abdominal cramping. Rapid rehydration and treatment with antibiotics such as Azithromycin and Ciprofloxacin is helpful. The CDC no longer recommends taking antibiotics in advance of a journey, but does suggest that Pepto-Bismol or Kaopectate (Bismuth Subsalicylate), two tablets four times a day, may decrease the likelihood of Traveler’s Diarrhea.

Campylobacter: The second most common cause of foodborne illness in the U.S. after Salmonella, this bacteria resides in the intestinal tract of chickens and causes sickness when meat is undercooked or improperly processed. It’s thought that a significant percentage of retail poultry products contain colonies of one variety, Campylobacter Jejuni. It is characterized as bloody diarrhea, fever, nausea, and cramping which begins two to five days after exposure. Although controversial, Erythromycin may decrease the duration of illness if taken early.

Trichinosis: Trichinosis is caused by the parasitic roundworm Trichinella in undercooked meat, mostly from domesticated pigs. Trichinosis causes diarrhea and other intestinal symptoms, usually starting one to two days after exposure. Fever, headache, itchiness, muscle pains, and swelling around the eyes occur up to 2 weeks later. Recovery is usually slow, even with treatment with the anti-helminthic (anti-worm) drugs Mebendazole and Albendazole (Albenza).

Giardia Lamblia

Giardia Lamblia

Giardiasis: The most common disease-causing parasite in the world is the protozoa Giardia lamblia. It has even been found in backcountry waters in many national parks in the U.S. Symptoms may present as early as one day after exposure, although it more commonly presents in one to two weeks. Patients complain of watery diarrhea, abdominal cramping, violent (often called “projectile”) vomiting, and gas. Metronidazole is the drug of choice in conjunction with oral rehydration.

There are many other pathogens that can cause life-threatening dehydration if untreated. Although we have mentioned common antibiotic treatments where applicable, most of the above will resolve on their own over time with strict attention to oral (or intravenous) rehydration. Many antibiotics (Cipro is an example) are associated with adverse effects that can be worse than the illness they’re designed to treat, so use judiciously.

It should be noted that some of these illnesses may be mimicked by viruses that are completely unaffected by antibiotics, such as Norovirus. Norovirus has been implicated in many of the outbreaks you read about on cruise ships.

Air, food, water, and shelter is necessary for survival. Bad air, food, water, and shelter leads to the next requirement, and that is medical supplies. Have a good medical kit and know how to use all its components. If you can accomplish this goal, you’ll be an effective medic if things go South.

Joe Alton MD

Joe Alton MD

Joe Alton MD

Find out more about infectious disease and 150 other survival medical topics in the award-winning “Survival Medicine Handbook“, now in its 700-page Third Edition. Plus, fill those holes in your medical supplies with kits and individual items from Nurse Amy’s store at

Why Are Flu Vaccines Sometimes Ineffective?

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Why Are Flu Vaccines Sometimes Ineffective?

flu vaccine

flu vaccine

The Centers for Disease Control and Prevention (CDC) are reporting that 36 states are in the midst of widespread influenza outbreaks. It appears that this flu season might be a bad one, but why? And will the usual vaccines be effective in preventing you for getting the flu this winter?

You might think that, okay, I got the vaccine, so I can’t get the flu this winter. You might be surprised to know, however, that the CDC shoots for about 40-60% vaccine effectiveness in preventing the illness, not the 100% you expected. In fact, last year’s vaccine was 42% successful (less against H3N2), on the low end of the CDC’s target, but in 2014-2015, the prevention rate from the flu vaccine was about 19%.

(Note: This is neither an anti-vaccine nor pro-vaccine article. It is simply a discussion as to why influenza vaccines seem to be less effective in preventing disease in recent years.)

Influenza vaccines produced in a particular year are derived from certain proteins found in last year’s virus. The CDC makes a determination about what virus they expect to be dominant in the coming year, and companies base their production on those predictions. If you have the material from last-year’s flu, why are vaccines sometimes so ineffective in achieving their purpose? Mainly because of two concepts we’ll discuss today: Antigenic Drift and Antigenic Shift.

Antigenic Drift: Viruses are notorious for their ability to mutate, but fortunately their mutations rarely make a major change in their genetic makeup. When the changes are so small that the current virus going around is essentially the same as the previous one, it is called antigenic drift. In this circumstance, vaccines are more effective; that is, they reach the CDC goal of 40-60% prevention rate because they are fighting essentially the same virus.

mutations caused Ebola to be transmissible from bats to humans in West Africa

mutations caused Ebola to be transmissible from bats to humans in West Africa

Antigenic Shift: Sometimes, a virus undergoes a major mutation or two viruses combine to make a significant change in the nature of a virus. For example: If the Ebola virus primarily lives in fruit bats in Africa, some mutation along the way made it able to live in human beings. Perhaps another mutation made it more easily passed along to other humans in bodily secretions. These significant changes in the genetic makeup are called antigenic shifts. With antigenic shifts, all bets are off with regards to predicting the success of a vaccine in preventing disease. To take an extreme example, if the Ebola virus mutated to make it easily transmissible via airborne droplets, we’d be in a lot of trouble.

Classifying Influenza Viruses

The dominant virus causing this year’s influenza cases in the H3N2 Type A virus. Influenza viruses are classified according to the proteins that exist on their surface. These are called Hemagglutinins (HA) and Neuraminidases (NA). There are more and more different HA and NA subtypes discovered every year. The Swine flu, for example, is H1 N1.

Why is flu vaccine less effective against influenza A(H3N2) viruses?

The journal Proceedings of the National Academy of Sciences suggests that last year’s vaccine’s ineffectiveness occurred as a result of an antigenic shift in the H3N2 virus. Indeed, the flu vaccine seems to be generally less effective against influenza A(H3N2) that other viruses. Why? This from the CDC:

“While all influenza viruses undergo frequent genetic changes, the changes that have occurred in influenza A(H3N2) viruses have more frequently resulted in differences between the virus components of the flu vaccine and circulating influenza viruses (i.e., antigenic change) compared with influenza A(H1N1) and influenza B viruses. That means that between the time when the composition of the flu vaccine is recommended and the flu vaccine is delivered, H3N2 viruses are more likely than H1N1 or influenza B viruses to have changed in ways that could impact how well the flu vaccine works.”

In other words, H3N2 tends to develop mutations more often and faster than other common influenza viruses.

The CDC goes on to say: “Growth in eggs is part of the production process for most seasonal flu vaccines. While all influenza viruses undergo changes when they are grown in eggs, changes in influenza A(H3N2) viruses tend to be more likely to result in antigenic changes compared with changes in other influenza viruses. These so-called “egg-adapted changes” are present in vaccine viruses recommended for use in vaccine production and may reduce their potential effectiveness against circulating influenza viruses.”

Therefore, the flu vaccine as currently produced is less effective in its purpose than we would like. More research is necessary to produce a vaccine that we can depend on to prevent the disease, and to make it safer for those opting to take it.



In the meantime, ask your physician for an anti-viral med (not an antibiotic!) that may decrease the duration and severity of the disease, such as oseltamivir (Tamiflu) or zanamivir (Relenza). As these drugs are more effective in the first 48 hours of symptoms, you should have these on hand, just in case your doctor isn’t able to see you quickly. I recently received an official CDC health advisory emphasizing the increased importance this year of these medications due to the issues related to the H3N2 virus. It also stated that early treatment may decrease the risk of hospitalization.

Joe Alton MD

Dr. Alton

Dr. Alton

Find out more about influenza and 150 other medical topics in the award-winning Third Edition of “The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way”

Hepatitis in Survival Settings

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There are various infectious diseases that may confront the caregiver in off-grid settings. These can affect various organs of the body, one of which is the liver.

Although your skin is the largest organ you have, the liver is the largest organ that resides inside the body. It is located on the right side of your abdomen just under the lowest rib.

The liver is susceptible to damage from drugs and alcohol, as well as inflammation from certain viruses, a condition known as “hepatitis”. If the liver is diseased, it can become enlarged and tender. This compromises its ability to perform functions like helping your body eliminate toxins, digest food, store energy, and more.

There are various types of hepatitis, listed as A, B, C, D, and E. Each has its own characteristics, but many symptoms are similar. Some types are related to poor hygiene, others from poorly prepared food or contaminated water, and some are even transmitted sexually, but all cause liver dysfunction and scarring. Symptoms can range from none at all (but still contagious) to life-threatening, and may include:

  • Loss of appetite
  • Nausea and vomiting
  • Diarrhea
  • fever
  • Dark-colored urine and pale greyish bowel movements
  • Stomach pain
  • Itching
  • Muscle and joint aches
  • Fatigue
  • General ill feeling (also called “malaise”)
jaundiced eyes

jaundiced eyes

Although sufferers may experience several of the above symptoms, the hallmark of hepatitis is jaundice, a yellowing of skin and eyes that occurs due to an excess of a yellowish substance called “bilirubin” in your system. Bilirubin is formed by the breakdown of old red blood cells in the liver. A healthy liver eliminates bilirubin as part of this process.

jaundiced skin

jaundiced skin(wiki)


Hepatitis A virus is caused by oral-fecal contamination; it can be gotten, for example, by drinking water that has particles from the bowel movements of infected individuals. It’s begins as a flu-like syndrome, then quickly manifests many of the symptoms mentioned above 2 to 6 weeks after exposure. It can also be transmitted sexually.

In survival, failing to properly purify water can cause an epidemic of Hepatitis A. In normal times, a restaurant employee who doesn’t wash his hands after using the bathroom can pass the disease along to customers.

Hepatitis A usually gets better without treatment after a few weeks. Interestingly, children rarely get symptoms, while 80% of adults do. In areas at risk, a vaccine is available.


Hepatitis B can be spread by exposure to infected blood products, semen, and vaginal fluids. Symptoms are usually indistinguishable from Hepatitis A.

ascites from chronic liver disease

ascites from chronic liver disease

Hepatitis B. however, may cause scarring in the liver that leads to a chronic condition known as “cirrhosis”.  In cirrhosis, the functioning cells of the liver are replaced by non-functioning nodules. Cirrhosis may also be caused by long-term alcohol or drug abuse. Besides jaundice, the condition can lead to “ascites”, an accumulation of fluid that causes swelling of the abdomen, swollen legs, and other symptoms.


Hepatitis C can cause acute or chronic infection, and is seen most often in older individuals. It may be contracted by intravenous drug use, transfusion, and unsafe sexual practices. A percentage of these patients will progress to cirrhosis over time and, sometimes, complete liver failure. A vaccine is now actively promoted by the government that may protect infected individuals from future damage.


The hepatitis D virus is unusual because seems to only occur in those with an active Hepatitis B infection. In tandem, the two viruses cause a significant “superinfection”.


Hepatitis E is typically an acute infection that is sometimes associated with eating poorly cooked pork or wild game. It is self-limited, which means that it gets better without treatment after several weeks. Some types of hepatitis E virus are spread by oral-fecal contamination similar to Hepatitis A.


Make the patient comfortable by encouraging rest, encouraging rest and hydration, and giving antihistamines like diphenhydramine for itching. There are limitations about can be done in an austere setting regarding this condition. The anti-viral and immune drugs used for this condition will simply be unavailable.

Wash your hands!

Wash your hands!

The austere medic can, however, practice good preventive medicine by encouraging the following policies:

  • Wash hands after using the bathroom and before preparing food
  • Wash dishes with soap in hot water
  • Avoid eating or drinking anything that may not be properly cooked or filtered
  • Make sure children don’t put objects in their mouths
  • Use condoms to avoid sexual transmission
  • Don’t share personal items, if at all possible, like toothbrushes or razors with infected persons

Some natural substances may encourage good liver health and were used in the past to treat those with hepatitis. Avoiding fatty foods and alcohol Increase, taking zinc supplements, and staying hydrated may help.

There is little hard data proving their effectiveness, but they may be your only options in a survival setting. They include:

  • Milk Thistle
  • Artichoke
  • Dandelion
  • Turmeric
  • Licorice
  • Red Clover
  • Green Tea

Although viral diseases are difficult to treat off the grid, a focus on prevention will help make sure your people have the least chance of getting hepatitis.

Joe Alton MD

Dr. Alton

Dr. Alton

Learn more about hepatitis and 150 other medical topics in the 700 page third edition of the 2017 Book Excellence Award winner in medicine, The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way,

7 Serious Infections from Contaminated Food and Water

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7 Serious Infections from Contaminated Food and Water

Just Hanging Out (and I mean just hanging out)

Just Hanging Out (and I mean just hanging out)


Recently, I watched a few episodes of “Naked and Afraid“, a series that puts two individuals in extreme environments with few supplies and, for some reason, no clothes. In this program, many of the participants come down with various infections; some of which cause bowel disturbances. Life then becomes, well, even more miserable than walking around for three weeks naked in the jungle.

Epidemics characterized by diarrhea and dehydration have been a part of the human experience since before recorded history. Cholera is an example of one particularly dangerous infection that was epidemic in the past. It and other bacterial diseases, many of which are now rare, may once again become a problem in the uncertain future.

Off the grid, water quality is questionable and may lead to misfortune if not properly purified. Using bad water to cook food in a remote setting can also lead to major problems that manifest as diarrhea, and later, dehydration. When dehydration is not treated, deaths may occur.

typical bacteria

typical bacteria

Many diseases with diarrhea as the main symptom are caused by poor sanitation. These including the following:

Cholera: Caused by CTX, a toxin produced by the marine and freshwater bacterium Vibrio cholera. Cholera toxins produce a rapid onset of diarrhea and vomiting within a few hours to 2 days of infection. This was a major issue in Haiti after the earthquake there several years ago.

The diarrhea caused by cholera looks like water after rice has been cooked in it. In addition, victims complain of nausea, leg cramps, and other symptoms. The body water loss with cholera is so severe that it is associated with a sixty per cent death rate if untreated. Aggressive efforts to rehydrate the patient, however, drops the death rate to only one per cent. Antibiotic therapy with doxycycline or tetracycline seems to shorten the duration of illness.

typhus rash (

typhus rash (

Typhoid (and Typhus): Salmonella typhi is a bacterium of the Enterobacteriaceae family that is found in contaminated and undercooked food. The illness it causes is called “typh-oid fever” because it often confused with Typhus.

Typhus is a complex of diseases caused by bacteria in the Rickettsia family that is transmitted, not by contaminated food and water, but by fleas and ticks in unsanitary surroundings. Although it rarely causes severe diarrhea, Typhus can cause severe dehydration due to high fevers and other flu-like symptoms. Five to nine days after infection, a rash begins on the torso and spreads to the extremities, sparing the face, palm, and soles. Doxycycline is the drug of choice for this disease.

Typhoid rash

Typhoid rash (

Contamination with Salmonella in food (leading to typhoid fever) occurs more often than with any other bacteria in the United States, with a major outbreak in turkey meat causing more than 100 hospitalizations in 2011. In Typhoid fever, there is a gradual onset of high fevers over the course of several days. Abdominal pain, intestinal hemorrhage, weakness, headaches, and bloody diarrhea may occur. A number of people develop a spotty, rose-colored rash, hence the confusion with typhus. Ciprofloxacin  is the antibiotic of choice, but most victims improve just with rehydration therapy.

Dysentery: Caused by a number of different pathogens (disease-causing organisms), dysentery is an inflammation of the large intestine that presents with fever, abdominal pain, and severe bloody or watery diarrhea. Symptoms usually begin one to three days after exposure. Dysentery was a major cause of death among Civil War soldiers. It is a classic example of a disease that can be simply prevented with strict hand hygiene after bowel movements.

civil war hospital

civil war hospital

The most common form of dysentery in North America and Europe is caused by the bacteria Shigella and is called “bacillary dysentery”.  It is spread through contaminated food and water in crowded unsanitary conditions. Ciprofloxacin and Sulfa drugs, in conjunction with oral rehydration, are effective therapies.

Another type of dysentery is caused by an organism you may have read about in science class: the amoeba, a protozoan known as Entamoeba histolytica. Amoebic dysentery is more commonly seen in warmer climates. Metronidazole is the antibiotic of choice.

Traveler’s Diarrhea: An inflammation of the small intestine most commonly caused by the Bacterium Escherichia coli, commonly known as E. coli. Most strains of this bacteria are normal inhabitants of the human intestinal tract, but one (E. coli O157:H7) produces a toxin (the “Shiga” toxin) that can cause severe food poisoning. The Shiga toxin is so potentially dangerous that it has been classified as a bioterror agent.

In this illness, sudden onset of watery diarrhea, often with blood, develops within one to three days of exposure accompanied by fever, gas, and abdominal cramping. Rapid rehydration and treatment with antibiotics such as Azithromycin and Ciprofloxacin is helpful. The CDC no longer recommends taking antibiotics in advance of a journey, however, but does suggest that Pepto-Bismol or Kaopectate (Bismuth Subsalicylate), two tablets four times a day, may decrease the likelihood of Traveler’s Diarrhea.

Campylobacter: The second most common cause of foodborne illness in the U.S. after Salmonella, this bacterium resides in the intestinal tract of chickens and causes sickness when meat is undercooked or improperly processed. It’s thought that a significant percentage of retail poultry products contain colonies of one particular variety, Campylobacter jejuni. Symptoms include bloody diarrhea, fever, nausea, and cramping which begins two to five days after exposure. Although controversial, Erythromycin may decrease the duration of illness if taken early.

Trichinosis: Trichinosis is Caused by the parasitic roundworm Trichinella in undercooked meat, mostly from domesticated pigs. Trichinosis causes diarrhea and other intestinal symptoms one to two days after exposure. Fever, headache, itchiness, muscle pains, and swelling around the eyes occur as much as 2 weeks later. Recovery is usually slow, even with treatment with the anti-helminthic drugs Mebendazole and Albendazole (Albenza).

beautiful but could harbor giardia

beautiful, but could harbor giardia

Giardiasis: The most common disease-causing parasite in the world is the protozoa Giardia lamblia. It has even been found in backcountry waters in many national parks in the U.S. Symptoms may present as early as one day after exposure, although it more commonly presents in one to two weeks. Patients complain of watery diarrhea, abdominal cramping, violent (often called “projectile”) vomiting, and gas. Metronidazole is the drug of choice in conjunction with oral rehydration.

There are many other pathogens that can cause diarrheal disease and dehydration if untreated. Although we have listed antibiotics in this article (many of which you can read about in this website), most of the above will resolve on their own over time with strict attention to oral (or intravenous) rehydration. Without hydration support, however, the situation may become life-threatening in some cases.

An important point is that some of these illnesses may be mimicked by viruses that are unaffected by antibiotics, such as norovirus, so employ them only when absolutely necessary. The U.S. is in the midst of an epidemic of antibiotic resistance that is partly due to overuse in humans. You might be surprised when I say “partly”; close to 80% of antibiotics in the U.S. are given, not to humans, but to food-producing livestock.

recipients of most antibiotics

recipients of most antibiotics

If you see post-apocalyptic disaster movies, you’ll see a lot of gunfights at the OK corral. Certainly, this may occur in the aftermath of a major catastrophe. The most deaths will occur, however, due to failure to assure that water is clean, food is prepared properly, and human waste is safely disposed. The medic for a survival group must understand this and enforce good sanitary practices. If he/she is successful, the group will have a better chance of staying healthy even in the worst of situations.

Joe Alton MD

Joe Alton MD

Joe Alton MD


Find out more about infectious disease and much more with the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and supplies at

a small first aid kit with items shown such as a tourniquet, gauze, mini compression dressings, ace, scissors and more

Motorcycle and hiking first aid kit

7 Antiseptics For Your Medical Kit

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Betadine is a Iodophor-type antiseptic

I’ve often said that, in a major disaster, we may be thrown back to a bygone era where modern medicine is not an option. Indeed, we can expect civil war-era statistics with regards to major abdominal and chest trauma outcomes, but we will still be ahead of our ancestors even if we’re thrown off the grid. That’s because of modern knowledge of antisepsic techniques.

The word antiseptic comes from the greek words anti (against) and septikos (putrid or rotten).  Antiseptics are substances with antimicrobial properties applied to living tissue to reduce the possibility of infection. Antiseptics, it should be noted, are not antibiotics. Antibiotics are meant to destroy bacteria within the body. Antiseptics are also different from disinfectants, which destroy germs found on non-living objects. All of these are important supplies for the survival medic.

Infected wound

We have a number of videos on this website that discuss antibiotics and what your options are in a survival scenario. If you haven’t been here before, use the search engine and you’ll find there are more than you think. We haven’t, however, talked a lot about antiseptics. Let’s discuss the most popular types on the market that might be candidates for your survival medical kit.

Iodophors: Iodophors like Betadine contain iodine, a substance that can also be used to purify water, but is combined with a solubilizing agent, povidone, which makes it, unlike pure iodine, relatively nonirritating and nontoxic to living tissue. Iodophors work against a broad array of microorganisms and don’t need to be heavily diluted. I will admit that I do dilute my Betadine if I use it on open wounds for regular dressing changes.  Iodophors are effective in killing microbes within just a few minutes.


Chlorhexidine Gluconate: This substance, perhaps better known by its brand name “Hibiclens”, is helpful  against many types of germs, although it’s not very effective against fungal infections. It’s relatively long-lasting, however, compared to some other antiseptics. For this reason, Hibiclens is popular as a way to prepare areas for surgery and for healthcare providers to scrub their hands before patient encounters.

Alcohol: Ethyl Alcohol (also called ethanol) is another tried and true antiseptic product. It, along with isopropyl alcohol, kills many different types of microbes and is fact acting and inexpensive. The problem is that alcohol has a drying effect on skin, the oral cavity, and vagina. It has a tendency to inhibit the development of new cells, so use it for an initial wound cleaning but not for regular care.

Benzalkonium Chloride: BZK is a mild antiseptic and is easily tolerated by most people. One of the most popular first aid wipes or sprays, some say that it has a special effect against the rabies virus, but there’s little hard data supporting this claim.

Hydrogen Peroxide: Hydrogen peroxide is used to clean wounds and reacts with blood to form an impressive foam. This is because blood and most cells contain an enzyme called catalase. Catalase reacts with hydrogen peroxide, converting it into oxygen and water. This effect makes it popular for household first aid in common mishaps like abrasions, but not a great candidate for regular dressing changes due to its drying effect on new cells. It can be used as a mouth rinse in the oral cavity, however, making it a candidate for a survival dental kit.

PCMX (Parachlorometaxylenol or chloro-xylenol for short): Available in more brand names than you can count, this substance is effective against most germs. It’s less potent, though, than chlorhexidine and iodophors, although the antiseptic effect lasts longer. PCMX can be irritating, so don’t use it on mucous membranes like the oral cavity and vagina.

Bleach and baking soda added to just-boiled water in the right proportions can make an effective antiseptic solution

Bleach: Bleach can be found as either a sodium hypochlorite (Clorox) solution or can be improvised with calcium hypochlorite granules, also known as “Pool Shock”. Used more as a disinfectant than an antiseptic, bleach in very dilute solutions (0.5% or less) can make Dakin’s solution, a time-honored method to clean wounds. Be sure to watch our recent two-part video on this website that shows you how to make it easily and affordably.

I’m sure you know of more products that can serve as antiseptics for your survival sick room. Armed with these items, your chances of succeeding when everything else fails, at least as a medic, go up exponentially. Be sure to get the supplies and knowledge that will save lives in times of trouble.

Joe Alton MD

Joe Alton MD

Find out more about stopping hemorrhage and 150 other medical topics in the survival mindset with the 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way. And don’t forget to fill those holes in your medical supplies by checking out Nurse Amy’s entire line of kits and supplies at!

Video: Using Plants for Natural Mosquito Control

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Video: Natural Mosquito Control

mosquitoes can be vectors of various diseases

Summer is upon us, and mosquitoes are part and parcel of warm weather just about everywhere. Of course, you can use DEET or other chemicals to ward off bites and the diseases that can be transmitted by them, but you could put together a garden as well that would repel the nasty critters. Nurse Amy Alton takes a turn in front of the camera this time to talk about some plants that you might consider for your garden that will repel mosquitoes. Preventing diseases like Malaria, Zika, Chikungunya, West Nile, and others is a great way for a homestead medic to avoid problems in good times or bad!

To watch, click below:

Wishing you the best of health in normal and not-so-normal times.

Amy Alton, ARNP

Amy Alton ARNP


Find out more about medical issues on remote homesteads or other off-grid settings in our 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available at Amazon; and don’t forget to fill those holes in your medical storage by checking out Nurse Amy’s entire line of kits and supplies at…

Survival Medicine Hour: Black Scout, Pt. 2, Azithromycin, Sick Room Set-Ups

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Setting up a sick room

In this episode of The Survival Medicine Hour with Joe Alton, MD and Amy Alton, ARNP (aka Dr. Bones and Nurse Amy), we welcome back Jack of Black Scout Survival’s popular YouTube channel, who discusses a wide range of topics in part 2 of his interview with Amy.

Plus, Joe Alton, MD examines Azithromycin as a survival antibiotic. Thomas Labs has released a new bird drug, Bird-Zithro. Is Bird-Zithro a possible candidate for treating sick birds in your aviary after a disaster? Find out all you need to know about this important drug.

bird zithro 30 count azithromycin

Azithromycin for sick birds

Lastly, when an infectious disease epidemic comes to your town, would you be able to set up an effective sick room that will help the infected recover while keeping the healthy from getting sick? Joe and Amy go over what factors will make for an effective area to deal with infectious disease off the grid.

All this and more on The Survival Medicine Hour with Dr. Bones and Nurse Amy. To listen in, click below:

Follow us on Twitter @preppershow                YouTube: DrBones NurseAmy Channel                  Facebook: Doom and Bloom


Wishing you the best of health in good times or bad,


Joe and Amy Alton


Dr. Bones and Nurse Amy

Don’t forget to get a copy of the new 700 page third edition of The Survival Medicine Handbook: The essential guide for when medical help is not on the way, available at Amazon or at

Video: Sulfa Drugs in Survival

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Add medicines to your medical kit

Without antibiotics in your medical kit, there will be deaths in survival scenarios that could have been prevented. Using certain veterinary equivalents may be an answer as to how to obtain them. This video discusses the family of antibiotics known as “Sulfonamides”: How they work, What they’re good for, How to use them wisely, and more. Remember that antibiotics aren’t candy, and should be used only when absolutely necessary. We’re in the midst of an epidemic of antibiotic resistance in this country (mostly due to their use in livestock!). Companion video to a recent article.


To watch the video, click below:

Wishing you the best of health in good times or bad,


Joe and Amy Alton


The Altons

Hey, get supplies for your medical kit, plus a copy of the latest edition of The Survival Medicine Handbook (also available at amazon), at Nurse Amy’s store on this website!


(slider image for this article courtesy of

Setting Up A Survival Sick Room

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A hospital tent

In normal times, we have the luxury of modern medical facilities that can isolate a sick patient from healthy people. In a survival scenario, however, most organized medical care will no longer exist, placing the average citizen into the position of medic for his/her family or community.  

Although we may be thrown back to the 19th century medically by a disaster, we have the benefit of knowing about infections and hygiene.  The knowledge of how contagious diseases are spread and how to sterilize supplies give us a major advantage over medical personnel of bygone eras.

Using this knowledge, it should be possible for a medically prepared person to put together a “sick room” or “hospital tent” that will minimize the chance of infectious disease running rampant through the community. The cornerstone of care is to deal effectively and humanely with the sick while keeping the healthy from becoming infected.

In the face of a looming catastrophe, you must first make the decision to either stay in place or get out of Dodge. If you’re staying in place, choose a room where the sick will be cared for. That room should be separate from common areas, like the kitchen. It must have good ventilation and light, and preferably, a door or other physical barrier to the rest of the retreat.

If the wiser choice is to leave the area, shelter is an issue that may be addressed with, for example, tents. Choose a tent as the sick room and place it on the periphery of the camp. Again, good ventilation is important to allow air circulation.

With sick rooms in a retreat or camp, it is important to designate them before a disaster occurs. For groups where a number of people are living together, procrastinating will cause someone to lose their room or tent for “the greater good”. This invariably breeds resentment at a time when everyone needs to pull together.

Sometimes, you may find that there isn’t a spare room or tent to assign as a sick room. If you only have a common area to work with, raise a makeshift barrier, such as a sheet of plastic, to separate the sick from the healthy. Even if you have a dedicated sick room, keep group members with injuries separate from those with infectious diseases such as influenza. Although wounds will sometimes become infected, they won’t likely be as contagious as epidemic illnesses.

tent joe's kids

The injured should be separate from the infected, if possible

A sick room in a retreat with air conditioning won’t qualify as decent ventilation when the power’s down. In this case, air ducts are actually more a danger than a benefit. Microbes passing through the air ducts in the sick room to other areas may present a risk for transmission of disease. Cover with duct tape. Keep windows or tent flaps open, however, except in particularly bad weather. Screening may be necessary in areas with lots of insects, or netting provided over the beds.

Furnishings should be minimal, with a work surface, an exam area, and bed spaces. In mild weather, some of these bed space can be outside, as long as shade is provided via a canopy or other means. Hard surfaces are preferable to fabric upholstery, as cloth can harbor disease-causing organisms. Even bedding might best be covered in plastic. The more areas that can be disinfected easily, the better.

It’s important to have a way to eliminate waste products of bedridden patients, even if it’s just a 5-gallon bucket and some bleach. Containers with lids should be made available to put used sick room items that need cleaning.


Keep a basin with soap and water at the entrance to the sick room

A station should be set up near the entrance of the sick room or hospital tent for caregivers’ masks, gloves, gowns, aprons, and other personal protection items (have a good supply of these items). You’ll should also have a basin with water, soap, or other disinfectant. Thermometers should be dipped in alcohol.

Many consider medical supplies to consist of gauze, tourniquets, and battle dressings, but you must also dedicate sets of sheets, towels, pillows, and other items to be used in the sick room. Keep these items separate from the bedding, bathing, and eating materials of the healthy members of your family or group.

Having a lot of these may seem like overkill to you, but there can never be enough dedicated medical supplies. Expect to care for more people that you’ve planned for. There will always be additions that weren’t planned, and medical items will be expended much faster than you’d expect.

Cleaning supplies should also be considered medical preparedness items. You’ll want to clean the sick room thoroughly on a daily basis. Hard surfaces should be regularly cleaned with soap and water, or use other disinfectants such as a 1:10 bleach solution. Don’t forget to disinfect the doorknobs, tables, sinks, toilets, counters, and even toys.

Wash bed sheets and towels frequently; boil them if you have no other way to clean them. As these items may carry disease-causing organisms, wash your hands after use. The same goes for plates, cups, etc. Any equipment brought into the sick room should stay there.

One additional item that will be important to your sick room patients: Give them a whistle or other noisemaker that will allow them to alert you when they need help. This will decrease anxiety and give them confidence that you will know when they are in distress.

The duties of a medic involve more than how to control bleeding or splint an orthopedic injury. Medical problems involving infectious disease may take a heavy toll on your people if the sick aren’t isolated from the healthy. Knowing how to put together an effective sick room will go a long way towards helping the sick get healthy and the healthy stay that way.


Joe Alton, MD


Joe Alton MD

Find out more about dealing with infectious disease in times of trouble in our 700 page Third Edition of the Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available at Amazon or on this website.

The Survival medicine handbook Third Edition 2016

The Survival Medicine Handbook 2017 Third Edition

Survival Medicine Hour: Sulfa Drugs, Uva Ursi, Quicklime, More

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Sulfa Drugs

In this episode of the Survival Medicine Hour, Joe Alton, MD (Dr. Bones) and Amy Alton, ARNP (Nurse Amy) examine Sulfa drug antibiotics as an option in survival settings. One of the first antibiotics, sulfa has been credited with saving the lives of tens of thousands in WWII, including Winston Churchill himself, and still has applications today in good or bad times.

Also, the herb Uva Ursi may have some use in urinary tract infections, one of the medical issues that sulfa drugs are effective for. Find out more about this herb in Nurse Amy’s segment on natural remedies.

Uva ursi

Uva Ursi

Plus, Dr. Bones discusses what disasters are most responsible for the most deaths in the U.S. over the last 40 years. The answers will definitely surprise you! Plus, some guidelines on disposal of dead bodies in post-apocalyptic times.

All this and more on the latest Survival Medicine Hour with Joe and Amy Alton!

To Listen in, click below:


Wishing you the best of health in good times or bad,

Joe and Amy Alton

joe and amy radio

The Altons

Please follow us on Twitter @ Preppershow, and don’t forget to check out Nurse Amy’s entire line of medical kits at!

Survival Medicine Hour: Disaster Deaths, Antibiotics, XStat, More

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In this episode of The Survival Medicine Hour, Joe and Amy Alton, aka Dr. Bones and Nurse Amy, discuss an antibiotic called Clavamox that’s used in dogs and cats as a possible survival med. Also know as Augmentin, is it exactly the same as the human drug, as  Dr. Alton found was the case years ago with certain fish and bird antibiotics? You might be surprised.

Also, the military may be getting taken for a ride with the expensive prescription product XSTAT, a syringe of hemostatic sponges used for severe hemorrhages. Sounds good, but does it work and what’s behind the recommendations for the government to add this item to military supplies? And does it have any application for survival medics?


XSTAT hemostatic syringe

Plus, do dead bodies from natural disasters cause epidemics? Amy and Joe explore this possibility and compare it to Ebola in 2014 and other events. Lastly, a young man wants to take his 6 month old son and wife to Belize, currently under a Zika warning from the CDC. What is Dr. Bones’ opinion?

To listen in, click below:


Wishing you the best of health in good times or bad,


Joe and Amy Alton

joe and amy radio

Dr. Bones and Nurse Amy

Why The Disparity In Zika Affected Newborns?

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zika virus

Zika Virus under the microscope

Zika virus hasn’t been on the front page much lately, but case numbers continue to rise in many countries. The World Health Organization stated recently that Zika infection has been documented in 75 countries throughout the globe.

One of the many unusual aspects of Zika virus is that Brazil has, far and away, the most cases of babies born with birth defects. The most prominent of these is microcephaly, a condition where the brain fails to grow normally, causing a striking appearance where the head is much smaller than normal. Brazil has about 2000 cases of this abnormality, while Colombia has the second highest with only 57; the U.S. is third with 31 cases, including miscarriages. Within Brazil itself, the Northeastern part of the country has the highest number of infants affected by the debilitating effects of the virus.

The American Society of Tropical Medicine, in its annual meeting in Atlanta, discussed this disparity, which has fueled a hotbed of speculation about the disparity.

A  Brazilian health official, Pedro Fernando da Costa Vasconcelos, suggests that vaccination against  Yellow Fever, a virus in the same family as Zika, may be a factor. In Northeastern Brazil, few receive this vaccine compared to other parts of the country. It’s possible, he says, that the vaccine may give some cross-protection against Zika.

A number of other theories exist, including effects on humans by certain pesticides used in the epidemic zone and, perhaps, contaminated lots of vaccines. However, no hard data has, as yet, implicated these and other possibilities as part of the equation.

Another factor may be the growing tendency of women to terminate their pregnancies in the face of a diagnosis of Zika infection. Still another, according to Albert Ko, a Yale professor, relates to the difficulty tracking numbers of abortions for this reason and the fact that many never know they had the infection at all. Zika has no symptoms whatsoever in 80% of patients. The rest experience fever, joint aches, rashes, and eye redness.


Microcephalic Infant

What is obvious, however, is that there are wide variations in the percentage of Zika infections to birth defects. Puerto Rico recently reported its first case of microcephaly in a newborn, but has catalogued  more than 30,000 people infected with Zika.

Professor Ko says that a new large-scale study will follow thousands of pregnant women with Zika diagnoses. Genetics, prior viral infections, and even the mosquitoes that transmit the virus will be evaluated. It’s possible that, with this information, a more definitive picture of factor involved in Zika-related birth abnormalities will emerge.

An issue not commonly considered is what effect Zika infection may have long-term in apparently unaffected infants. Will they reach normal milestones like walking and talking at the appropriate time? Down the road, will they perform adequately in school? It will take years to find out.

Meanwhile, cases continue to accumulate, mostly travel related. A total of close to 36,000 cases have been documented by the Centers for Disease Control and Prevention (CDC) in the United States and the U.S. territory of Puerto Rico. New cases are still being reported in Florida by the Department of Health, which says that 1,165 total cases (153 in pregnant women) exist in the state as of November 11, 2016. Of these, 225 were transmitted by local mosquitoes.

Some good news: A vaccine called Zika Purified Inactivated Virus, or ZPIV, seems to be showing promise in research conducted, and human trials have begun at the Walter Reed Army Institute of Research. In addition, Dr. Michael Diamond of the University of Washington has identified an antibody that might protect the unborn fetus against the effects of the Zika virus on nervous tissue. Research is ongoing on these and other fronts in the battle against what has become a worldwide epidemic.

Joe Alton, MD


Dr. Alton

 Find out more about the Zika Virus in Joe Alton, MD’s book “The Zika Virus Handbook“, available at



Zika: 10 Things to Worry/Relax About

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Aedes Albopictus Mosquito

Zika virus has been in the news since the beginning of the year, and there’s a lot of information out there; some of it is reassuring and some, well, not so much. Here’s some things you should know that will make you worry/not worry about this infectious disease that’s been reported worldwide. 


Worrisome: Reported cases of Zika in the U.S. and its territories will soon hit 20,000. The number of Zika cases IN THE U.S. and its territories reported to CDC’s Arbonet (ARthropod-BOrne virus) national registry has risen to almost 19,000. With some researchers suggesting infection in one quarter of the population of Puerto Rico before the end of 2016, 20,000 cases might be a gross underestimation.

Reassuring: While the Zika epidemic rages in Puerto Rico, the continental U.S has reported a total of 2,964 cases of mostly travel-related Zika virus illness (out of a population of 320 million).  South Florida is the only area in the continental U.S. where local mosquitoes are confirmed by authorities to have spread the disease (about 50 cases).

The number of U.S. Zika cases are updated weekly by the CDC at



Worrisome: The actual number of Zika cases is probably close to 5 times the number of reported cases. Zika virus causes relatively mild symptoms like rashes, fevers, joint pains, and reddened eyes, and even then in only 20% of cases. 80% have no symptoms whatsoever, which means that the actual number of cases is probably 5 times greater. This doesn’t count people who wouldn’t go to the doctor for a mild fever or a rash, so it might be even more.

Reassuring: Even if case totals are, in fact, much higher than reported, the virus leaves the bloodstream after a week or so in most people. It can, however, last for months in seminal fluid or, perhaps, the eyes. Once you have recovered from the acute infection, you receive immunity from the antibodies produced by your immune system. Future pregnancies won’t be affected.



Worrisome: Zika is a bona fide pandemic. A pandemic is a widespread occurrence of a disease not normally seen in a place that spreads across different regions. Zika has now been identified in close to 70 countries and has been referred to as a pandemic by the National Institute of Health since at least January 2016.

Reassuring: Despite concerns raised by many health officials, athletes and tourists returning from the Olympic Games don’t seem to have sparked significant new outbreaks in their home countries.


microcephalic infant



Worrisome: Newborns with Zika infections can have multiple abnormalities, not just microcephaly. Microcephaly is a condition where a small brain leads to poor head growth. Beside this, however, other evidence of brain damage, deformed joints, and vision or hearing impairment may occur.

Reassuring: The percentage of abnormal newborns in Zika-infected mothers isn’t as high as you think. Statistics for the rate of birth abnormalities in newborns have ranged from 1% to 13% in Brazil and 1% in the previous outbreak in Polynesia in 2013-4, according to a CDC report released last May. There are no numbers that say a Zika-infected mother’s chances are very high of having a baby with microcephaly or other defects.



Worrisome: We can’t say for sure that Zika-infected babies born looking normal will be unaffected by the virus. Zika is shown in lab studies to kill brain and other nerve cells. What if the number of cells damaged is not enough to make the baby appear abnormal at birth but enough to cause delays in milestones like walking or talking? What if these infants end up having learning disabilities once they’re old enough to go to school? We won’t know for years.

Reassuring: Although our research into the effects of Zika virus is in its infancy, no hard evidence exists that a baby from an infected mother will have later developmental deficits.



Worrisome: Zika virus may be passed through from human to human through seminal fluid, vaginal secretions, blood, and now, tears. Researchers are finding more and more ways that Zika might be transmissible from human to human. A study from Washington University in St. Louis reports that tears of mice carried parts of the Zika virus.

Reassuring:  The vast majority of Zika infections are still transmitted by mosquitoes. Sensible actions like the use of mosquito repellents, the wearing of long sleeves/pants, and drainage of nearby standing water are still the best way to prevent an infection.



Worrisome: There is more than one strain of Zika, and there may have been mutations. Zika, like many viruses, exists in different subtypes (at least two) that could mutate from time to time. This fact might explain why a virus originally identified in 1947 only started causing community-wide outbreaks in 2007, and no reported cases of abnormal babies before 2013. A mutation that increased the severity of effect on humans (at least, newborn ones) may have occurred.

Reassuring: It’s possible that Zika just had never been exposed to such large populations without natural immunity. Researchers haven’t yet reported if the strain spreading rapidly in Singapore is the same one as that in Brazil.



Worrisome: There may already be more than one locally-transmitted outbreak in the U.S. Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor’s College of Medicine, suspects that there may be more areas of local Zika transmission than just the one in Miami. The Guardian reports that he said, “…I think there’s not just Zika transmission going on in Miami, it’s going on all up and down the Gulf Coast and in Arizona, it’s just that nobody’s looking.” The CDC, although it stops short of predicting an epidemic of Zika, believes clusters of cases may still appear in warm-weather states.

Reassuring: Future local outbreaks are likely to be minor in the U.S.  A number of states, like Louisiana and other Gulf and East coast states, are recovering from floods dues to storms and Hurricane Hermine. Cases of Zika virus, however, don’t seem to be arising out of standing water there that would be excellent breeding grounds for mosquitoes. Cities, like Houston, with low-income areas that harbor abandoned buildings and trash, also provide possible sites for the next generation of mosquitoes; Zika virus doesn’t seem to have taken hold there either.

dead bees

dead bees



Worrisome: Aerial Spraying with chemical pesticides like Naled may affect honeybees and even humans. Use of pesticides that are neurotoxic might have ill effects on important pollinators like bees, or even human beings. It might be safer to use methods that kill mosquito larvae instead.

Reassuring: Aerial spraying is an effective way to eliminate large populations of adult mosquitoes quickly and rarely affects humans. Naled is a shorter acting pesticide than some others, and when used correctly (before sunrise or after sunset), is unlikely to cause major damage to pollinators, which mostly forage during daylight hours. The recent bee die-off after spraying in Dorchester County, S.C., was due to spraying which occurred at 8 a.m.


Singapore’s next for Zika (image: pixabay)



Worrisome: A new local Zika outbreak is spreading throughout Singapore in Asia. The location is important because Singapore is an important financial hub for the region. Travel-related cases already have been reported in Malaysia and the Philippines from returning travelers. Given the widespread commercial travel to Singapore, where 300 cases have been reported in 10 days, the entirety of Asia may be affected in the near future.

Reassuring: Here in the U.S., the coming fall and winter seasons will decrease mosquito populations significantly throughout most of the country. USA Today reported in July that Brazil was recording fewer cases of Zika as the Southern Hemisphere entered its “winter”.


So, it’s your choice: You can decide either to go look for your worry beads or, instead, cover your eyes with your hat and order another pinacolada. Just don’t forget the mosquito repellent.


Joe Alton, MD




Survival Medicine Hour: Hurricanes, Zika Update, Bee Deaths

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zika virus

Zika Virus

In this episode of the Doom and Bloom Survival Medicine Hour with Joe Alton, MD and Amy Alton, ARNP, a Florida landfall occurs for a hurricane for the first time in more than a decade. Were you ready? What should you do to prepare for the next one? Plus, Dr. Bones discusses new tragedies for the native bee population in the U.S. What will be the straw that break’s the bee’s, I mean, camel’s back? With every third bite of food you put in your mouth coming as a result of some bee pollinating a plant, you should be invested in this topic!

storm surge

A hurricane’s storm surge

Plus, we haven’t talked about Zika for a while, but that’s not because there hasn’t been a lot of news about it. Nurse Amy and Dr. Bones follow the globetrotting pandemic to a new outbreak in Singapore, talk about outbreaks that might not be reported due to lack of testing, and the effects that could occur on zika-infected newborns that are born looking perfectly normal.


More bad news for bees

All this and more on the latest Survival Medicine Hour with Dr. Bones and Nurse Amy!

To listen in, click below:

Wishing you the best of health in good times or bad,

Joe and Amy Alton


The Altons

New Bad Outcomes For Zika Newborns?

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arthrogryposis clubfoot

arthrogryposis (deformed joints)

As we continue to learn more about the effects of Zika on the newborn, a new series of abnormalities are making clear the implications of infection for pregnant women.


Zika is a member of the Flavivirus family that includes Yellow Fever, West Nile, and other mosquito-borne illness. The main concern is Zika’s predilection for attacking brain cells, causing some infected fetuses to have poor brain development and head size. The condition, known as microcephaly, can cause lifelong disabilities costing millions of dollars in care over a lifetime.


Now, a new study from researchers in Brazil suggests that Zika causes damage to other nerve cells as well. Seven babies born with microcephaly were studied. Six of these were found to also have a rare condition called “arthrogryposis”.


Usually seen in only one of 3000 births, arthrogryposis causes multiple malformed, stiff joints. The abnormalities may be caused, not by damage to the joints themselves, but by weak nerves that don’t allow passion flexion and extension during the pregnancy. The joint then becomes fixed and deformed, a condition known as a “contracture”.


Damage to the nerves that control vision and hearing are also thought to occur as a result of Zika infection in the womb.


The news comes as the 25th case of locally-transmitted Zika infection is reported in South Florida, where warm weather allows a robust population of Aedes mosquitoes, the species most associated with transmission of the disease. State health officials also announced 14 new cases of travel-related Zika, bringing the total in Florida to 382, of which 57 are pregnant women.


Aerial spraying of an area north of Downtown Miami is the latest effort on the part of the state of Florida to combat spread. Storm drains are also being targeted as possible hotspots for mosquito breeding activity. Although the insecticide Naled appears to be lowering the mosquito count in traps set in the neighborhood, it is also a possible danger to honeybees and other natural pollinators.


A separate local case was reported further north in Palm Beach County, but it’s uncertain at present whether it represents the beginning of a second outbreak.


In other news, a baby born in Texas has died from Zika-related complications, including microcephaly.


Despite the concern of health officials about the virus, a recent WaPo-ABC News poll finds that less than half of Floridians and Texans consider themselves worried about Zika. Apathy may stem from the fact that the acute illness itself is mild, with only 20 per cent reporting symptoms such as fever, joint pain, rashes, and sometimes, red eyes. Another factor may be that Zika is mostly a major issue only for pregnant women or couples that are considering pregnancy.


Protecting against mosquitoes is just common sense. In addition to Zika, West Nile virus, Yellow Fever, Dengue fever, and other diseases are risky. Wearing light-colored, long pants and sleeves while outside and using mosquito repellent is good policy.


EPA-approved products contain DEET, picaridin, or oil of lemon eucalyptus. When using mosquito repellent, don’t forget to:

  • Only use small amounts, but reapply if you’re sweating heavily, swimming, or outside for extended periods.
  • If you’re using sunscreen and mosquito repellent, apply the sunscreen first. Wait 20 minutes before applying mosquito repellent.
  • Avoid spraying near eyes and mouth; spray on your hands and apply. Do the same for children.
  • Avoid applying on cuts or areas of skin inflammation.
  • Wash the repellent off treated skin once you’ve gone inside; especially, wash your hands before touching food.


DEET, the most common ingredient, should not be used in infants 2 months old or younger.

Joe Alton, MD


Joe Alton, MD

Going to the Olympics? 5 Risks To Plan for

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zika virus

Zika under the microscope

Every day, more news about Rio’s woes regarding the upcoming Olympics is published online. It’s become clear that going to the games, as an athlete or a spectator, just might be hazardous to your health.



The dangers include a raging Zika epidemic, water contamination, air pollution, and security concerns. Despite the calls to cancel the Olympics for these reasons, Brazil and the International Olympic Committee say the show must go on. What precautions, then, should be taken by the competitors and tourists to stay safe and healthy?






As the CDC learns more about the Zika virus, obviously a mutated version of the original, there are more and more concerns: More species of mosquitoes that might carry it, more types of sexually activity that could spread it, and the unknown long-term developmental effects on infected infants, even those that are born appearing normal.

Athletes and tourists should:

• Stay indoors whenever possible
• Use mosquito repellent whenever outside or in any areas without screens.
• Avoid areas with standing water
• Wear long pants and sleeves
• Treat clothing with permethrin, a long-lasting pesticide
• Use pesticide-treated bed netting if not staying in air-conditioned hotels
• Use condoms (standard issue for this year’s athletes) or abstain from sex



Zika virus isn’t the only infection that visitors to Brazil should be concerned about. Malaria, Yellow Fever, Hepatitis A and B, Dengue, and Typhoid fever are some of the other diseases found in the region. Some of these are spread by mosquitoes, others by food and water contamination, and some by sexual activity.

Vaccines exist for a number of these issues, such as Hepatitis and Yellow Fever. Others can be prevented by medications, such as malaria. Every athlete and visitor To Brazil should contact their physician to see what precautions are appropriate for the trip.


dirty water
The waters of Guanabara Bay and other venues for sailors, kayakers, canoers, and open-water swimmers in the Rio Olympics are notoriously filthy due to raw sewage that is constantly released into them. Bacterial and viral counts performed by researchers, including a study commissioned by the Associated Press, found quantities that might be considered a natural disaster in the U.S. The adjective used for the amount of viruses was “astronomical”.

The old saying “Don’t drink the water” goes double, no, triple for your trip to the Rio Games. It’s thought that drinking just three teaspoons of the water has a 99 per cent chance of causing an infection. Dr. Valerie Harwood of the Department of Integrative Biology at the University of South Florida, goes as far to say “Don’t put your head under water.”

Among the germs is rotavirus, the most common cause of gastroenteritis. In last year’s Junior Rowing Championships, a dozen U.S. team members got sick.

This year’s team will be protected with a newly-designed anti-microbial training suit. If you’re just an average tourist at the beach, however, even wet sand has high levels of microbes.

Drink only bottled water and, if you’re going into the water, put that bottle in a plastic bag first. The outside of the bottle could become contaminated if it becomes wet. Have hand sanitizers available and wash wet clothing. Don’t forget to use bottled water when brushing your teeth. Ask for your drinks with “no ice”.


The air quality in Rio isn’t as bad as it was in the Beijing Summer Games, but it’s unacceptable by U.S. standards and much worse than any other Olympics. Particulate matter from the many vehicles in the city is often at dangerously high levels, and responsible for more deaths there than the water.

When you’re not in an air-conditioned building, you might consider wearing a face mask to avoid the pollutants. If you’re a Westerner, you might not be accustomed to this practice, but it’s common in many Asian countries.


A striking scene recently greeted arrivals to Rio’s airport: A group of law enforcement officers with a sign that read “Welcome to Hell, whoever comes to Rio De Janeiro will not be safe.” Indeed, Rio de Janeiro is a hotbed of crime, with entire favelas (low-income neighborhoods) completely under the control of organized gangs. Brazil’s financial woes have caused funding problems for local police, although the city says that it’s added much more security for the Games.

Despite this, be situationally aware. That means keeping an eye on unusual activity or individuals not acting normally. You might consider carrying a small flashlight; some have a strobe function that emits a bright flashing light which might discourage the opportunistic criminal. In any case, have a plan of action in case of trouble.

The CDC recommends, among other things, that you:

• Avoid travel at night
• Keep your hotel room locked
• Don’t wear fine jewelry
• Avoid risky areas
• Always travel with a companion
• Carry copies, but not originals, of important documents when you travel outside

Still going to the Olympics? Some might say that you’ll never have to prove your courage in any other way, but with a few precautions, you can stay healthy and safe.



Joe Alton, MD


Dr. Alton


We’re learning more about Zika virus every day. Check out Joe Alton, MD’s book “The Zika Virus Handbook” for the important information you need to keep your family healthy

CDC Expands Zika Guidelines

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zika virus

CDC: Females can transmit Zika

In a recent update, the Centers for Disease Control and Prevention now state that Zika virus is transmissible through any type of sexual activity that involves exposure to genital secretions. Previously thought to be sexually transmitted by males to their partners, a recent case in New York City showed that the infection could be passed from a female to a male.

Zika virus carries a risk of severe birth abnormalities in a fetus when infection occurs during a pregnancy. Chief among these is microcephaly, a condition where head growth is decreased as a result of damage to brain tissue. The virus is responsible for at least 1600 abnormal newborns in Brazil and 12 in the United States.

The significance of the new findings regarding sexual transmission is that the population at risk for spreading Zika has now increased considerably. In a revamp of its official recommendations, the CDC now advises against unprotected sex with any person, male or female, who has traveled to or lives in an area with Zika. This includes female-female through vaginal secretions as well as male-male through seminal fluid.

The CDC also released new data that suggests Zika may exist in a pregnant woman for longer than the week or so previously thought. Testing should be performed up to two weeks from exposure or the appearance of symptoms. The CDC stated, “”Expanding the use of the Zika-specific test could provide more women with Zika virus infection a definite diagnosis and help direct medical evaluation and care.”

The CDC also recommended testing all pregnant women in at-risk areas or with possible Zika exposure. These include Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) and IgM antibody studies. Previously only available at the National Institute of Health, CDC, and certain state labs, Zika tests are now more widely available through state and commercial labs.

Acute Zika virus infection causes mild symptoms (fever, rash, joint aches, red eyes) in 20 per cent of cases, but 80 per cent show no symptoms at all. While this fact may appear comforting to some, it means that there is the possibility that an asymptomatic pregnant woman may not learn she was infected until her fetus is found to be abnormal on obstetric ultrasound. Often, serial ultrasounds over time are needed; confirmation of an abnormal head growth pattern may not occur until late in the pregnancy.

Official CDC recommendations for those planning to get pregnant in the near future are as follows: “Women who have Zika virus disease should wait at least 8 weeks after symptom onset to attempt conception, and men with Zika virus disease should wait at least 6 months after symptom onset to attempt conception.” The longer period for men reflects that ability of the virus to remain active in seminal fluid for three months or more.

Zika virus is also thought to be transmissible through blood transfusions and even menstrual blood. A case in Utah where a family caregiver contracted the infection suggests that handling bodily fluids, such as blood, urine, or feces might be a risk factor.


Aedes mosquito

Despite this, the grand majority of infections occur due to bites from infected mosquitoes. Controlling mosquito populations by draining standing water and other methods is considered the most effective way of decreasing Zika cases in an area. Individuals should wear loose, light-colored clothing and use mosquito repellent whenever outside in at-risk areas.

Expect CDC guidelines regarding Zika virus infection to change as more is known about the Zika virus.

Joe Alton, MD


Joe Alton



Survival Medicine Hour: Snakebite, Bee Sting, Heat Waves, Zika in the US?

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bee stinger in a sting wound

In this episode of the Survival Medicine Hour with Joe Alton, MD (Dr. Bones) and Amy Alton, ARNP (Nurse Amy) tackles a bunch of topics. First, new cases of Zika in Florida may not be related to travel outside the country. Until now, all cases were from people who returned from the epidemic zone in the Caribbean and Latin America. Puerto Rico now has 4000 cases, almost all locally transmitted, and the CDC thinks we’ll have some clusters of local cases in the continental U.S. as well.

snakebite ankle with bruising

snakebite wound

Also, summer is here and a murderous heat wave has gripped the Nation’s East, Midwest, and Southwest, causing at least 6 deaths and cause the heat index to feel like 100 degrees or more in locations that are used to much milder weather. Heat stroke is a major risk and you need to know how to identify and treat it.

heat dome reuse

the “heat dome”

Plus, out in the woods you’ll encounter a lot of critters. Last week, we talked about bites and attacks from warm furry ones, this weeks it’s snakes and bees/wasps. Learn all the latest about how to deal with a snakebite when modern medical help is not available, plus how to use an epi-pen to treat severe allergic reactions like anaphylactic shock.

All this and more on the latest Survival Medicine Hour with Joe and Amy Alton! To listen in, click below:

Wishing you the best of health in good times or bad,

Joe and Amy Alton


The Altons


Zika Virus: What We Don’t Know (A Lot)

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zika virus

NIH electron microscope: Zika Virus

Despite the World Health Organization and the Centers for Disease Control and Prevention downplaying any effect on the coming Summer Olympics in Brazil, Zika virus continues to mystify many researchers. The viral disease, mild or asymptomatic in most cases, can attack brain and other nerve cells in fetuses, leading to major failures in growth and development, such as microcephaly.

Certainly, the major concern with Zika virus is its effect on the unborn fetus. But now, new cases are leading some to question what we really know about the virus. Rare, at least at present, they suggest that more people may be at risk than originally thought.

The CDC reports that in New York City a woman who contracted Zika during a trip to the epidemic zone has infected her male partner through sexual intercourse. Previously, Zika was seen as a purely male-to-female or male-to-male transmission. Now it’s possible that vaginal fluids might have the same ability as semen to spread the virus. If a female can transmit it to a male (or another female?), it widens the population at risk significantly.

For example, a woman travels to Brazil, gets Zika and transmits it, through vaginal secretions, to her partner when she arrives home. Her partner has sex with others and transmits it through, say, seminal fluid.

It’s thought that Zika virus exists in seminal fluid for 2 months or more, but what if it lasts longer? Ebola virus lasts 6 months or more there. Is six months long enough to avoid sex or use protection?

In Utah, an elderly man dies of complications due to Zika virus. Was there some other medical issue that made it a fatal event? The CDC reported that he had 100,000 times more “viral load” than normal. Did he get a particularly bad strain? How many strains are there?

Now, Fox News reports that a family caregiver is found to have been infected. How did it happen? Exposure to blood? Airborne droplets? Contact with urine or feces? No one really knows.

Does this now mean that we have to treat the virus as contagious by casual contact between humans, as opposed to requiring an infected mosquito bite or intimate relations? Should we, then, revamp our contagion protocols for medical professionals?

All this may seem to be major overkill to you. Zika doesn’t even cause symptoms in 80% of cases, and most infected babies are still born without microcephaly. The fact that it’s a “silent” infection in many, however, might be most concerning.


A pregnant woman with an asymptomatic Zika infection won’t know her fetus is affected until ultrasounds tests reveal poor growth of the fetal head or other signs of damage. An asymptomatic male or female won’t know bodily fluids are contaminated.

Another question: Are there long-term effects of Zika virus on the development of otherwise normal-appearing babies? We won’t know until milestones, like walking and talking, are delayed or fail to be reached. That might take years to determine.

Zika is not Ebola. People aren’t dropping dead in the streets, so a calm, reasoned approach to this virus is important. We have much to learn about Zika virus. Funds are needed to study it; we can’t allow politics to “infect” the Zika debate. Politicians should let the researchers do their job to make sure that this mysterious disease doesn’t become a medical crisis in the U.S., now or in the future.

Due to lack of funding, it may be too late to avoid the complications of Zika Virus in the U.S. this summer. If we’re smart, though, we’ll facilitate the research needed to truly understand it and its short- and long-term effects.

Joe Alton, MD


Joe Alton, MD

Find out all you need to know about the Zika virus in Joe Alton’s book “The Zika Virus Handbook”, available at Amazon.

Survival Medicine Hour: Expert Charley Hogwood, Cinnamon, Antibiotics, Alligators

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Charley Hogwood, Survival Group expert

In this topic-packed episode of the Survival Medicine Hour with Joe Alton, MD and Amy Alton, ARNP, survival group expert and author Charley Hogwood joins us to talk about survival group dynamics as well a number of other issues that may affect your chances for survival in the uncertain future. Also, Nurse Amy talks about one of her favorite herbs, Cinnamon, and its medical uses and Dr. Alton discusses an unusual subject, driven by recent news: Alligator attacks, what to do and some common-sense prevention strategies. He also brings you up to date with the Zika epidemic ramping up in Puerto Rico, and the 3 infants born with Zika-related deformities in the United States. Finally, Dr. Alton discusses antibiotics while answering a question from a listener of the popular Survival Podcast with Jack Spirko. Dr. Alton serves as the medical expert on Jack’s Expert Council.

alligator above water

image by

Plus, doctors say 1 in 5 trauma victims’ death are preventable. Dr. Bones and Nurse Amy discuss why and what could be done to increase your chances of surviving a mass casualty incident.

To listen in, click below:


Wishing you the best of health in good times or bad,

Joe and Amy Alton

joe and amy radio

Dr. Bones and Nurse Amy

Zika Update: More Cases In U.S., More Woes In Brazil

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aedes albopictus

The U.S. now has three newborns with Zika-related birth defects, according to the Centers for Disease Control and Prevention.

Puerto Rico now has 1,700 confirmed cases of Zika, almost 200 of which are in pregnant women. The warm-weather U.S. territory is in the midst of an epidemic of the mosquito-borne illness. The numbers don’t take into account that 80 per cent of infections are without symptoms, a fact that suggests that the actual number of cases is at least five times higher. Evaluations of blood banks in the island has found that more than one per cent of all units donated carry evidence of the Zika virus.

Although 750 cases has been identified in the continental U.S. and Hawaii, all appear related to travel in the epidemic zone. More than 200 pregnant women are being monitored for signs of fetal damage. The CDC has yet to find a case that they are confident was locally transmitted. They consider the risks of a U.S. epidemic to be very low.



The CDC is counting a range of abnormalities in its study on the effect of the virus. Chief among them is microcephaly, where the baby’s skull fails to grow normally, probably as a result of defects in brain development. Also seen are calcium deposits, excess fluid in the brain, and abnormal eye development.  It is thought that 1-15 per cent of Zika-infected newborns will come out with some type of problem.

In an effort to increase preparedness levels, the CDC has assembled teams of experts that it will send to various high-risk states, especially when the first expected local cases are found. Also, the teams plan to assist efforts to control mosquito populations in the affected areas. Lab tests for Zika virus, previously available only through state labs, are now available in various commercial labs, such as Quest Diagnostics and Labcorp.


Aedes Aegypti life cycle

The Zika virus, along with the often-more serious Dengue fever virus, is spread by Aedes mosquitoes. Both Aedes Aegypti and its cousin, the Asian Tiger Mosquito, Aedes Albopictus, are thought to be able to spread the virus. These mosquitoes have now been identified in 44 states, up from 12 in previous surveys. The same mosquitoes are known to transmit Yellow Fever and the West Nile virus.

In the meantime, the World Health Organization has closed ranks with the International Olympic Committee in saying that it considers Zika a low risk for causing problems in the upcoming Summer Games. Previously, it had sounded alarms regarding Rio de Janeiro, the host city. Rio has the second highest number of Zika cases in Brazil. The Games start August 5th.

More than 250 medical professional of all stripes, including myself, have signed a petition recommending cancellation or transfer of the Summer Olympics to another venue. At present, this forms a minority opinion, although many countries are warning against travel to the Zika epidemic zone, especially for women who are pregnant or considering pregnancy and their partners. Canadian professor Amir Attaran of the University of Ottawa was invited to sit in on WHO’s Zika hearings, but the invitation was then rescinded when he refused to sign a confidentiality agreement.


Brazil: Zika epicenter

As if Brazil wasn’t having enough problems with Zika virus, the acting governor of Rio de Janeiro state has declared a state of “financial disaster“.  Governor Francisco Dornelles announced the measure to allow Rio to adopt extraordinary measures to pay mounting costs related to the Summer Olympics. Brazil is in the midst of a major economic recession.

Dornelles’ spokesman said that the decision was made because of lower-than-expected revenues from taxes and oil royalties. He said: “The financial crisis has brought several difficulties in essential public services and it could cause the total collapse of public security, health care, education, urban mobility and environmental management,”.

Rio’s situation is so bad that two of its hospitals were taken over by the government to pay medical personnel. Some police stations are so strapped for funds that they have asked for donations of basic items like toilet paper. Public workers and retirees have suffered months-long delays in receiving their money. Major Olympic projects, like the metro line being built to carry tourists to venues, are well behind schedule.

So, ask yourself this question: Is it worth it to have half a million tourists from 180 countries travel to the epicenter of a major epidemic for a sports event?


Joe Alton, MD


Joe Alton, MD

Hey, find out everything you need to know about Zika Virus with Dr. Alton’s new book: The Zika Virus Handbook.

High Resolution Front Cover_6093961

Announcing The NEW Third Edition Survival Medicine Handbook

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The Survival medicine handbook Third Edition 2016

The Survival Medicine Handbook 2016 Third Edition

Well, we’ve returned from an awesome week in the great state of Oregon and got to look at the final proof of the Third Edition, which arrived while we were away. It looks good on review, so we hit the publish button and it’s now available at Amazon.


For those who don’t know us, the third edition of The Survival Medicine Handbook is not your standard first aid book: Unlike other medical books (even some outdoor and “survival” medicine books), it assumes that a disaster, natural or man-made, has removed all access to hospitals or doctors for the foreseeable future; you, the average person, are now the highest medical resource left to your family.  It’s also for the family that lives or is traveling in rural areas where the ambulance is more than a few minutes away, or where there isn’t cell phone service.


To let you know what’s in the book, most of the topics are below. Every chapter has been revised to some extent. We’ve greatly increased the content on hemorrhagic wounds, adding chapters on active shooters, tourniquets, gunshot and knife wounds, discussions of ballistic trauma and body armor, and even the medic under fire. Food/water contamination, pandemic diseases, rodent issues, and disease-causing microbes also added as individual discussions. The section on respiratory infections is completely reworked as is the section on physical exams. Additional natural disaster preparedness topics include blizzards, avalanches, survival when lost at sea, mudslides, and more. Nurse Amy has added a lot of material to the medical supplies section, plus how to sterilize supplies, choosing a medic bag, and more. Soft tissue wound care and patient transport have been expanded. As always, we discuss alternative remedies wherever they may be helpful.
Here are just some of the over 150 topics (175 illustrations) covered in our 670 page book:



We hope you’ll consider the Third Edition of the Survival Medicine Handbook for your library.


Joe and Amy Alton


Joe Alton, MD and Amy Alton, ARNP


Zika News and Video

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The first birth in the continental U.S. with Zika-related birth abnormalities occurred in a hospital in Hackensack, NJ. The baby reportedly has microcephaly, a condition where the head fails to grow normally, inhibiting normal brain growth.

While mentally challenged, most of these babies are otherwise healthy. Many will require lifelong care, which has been estimated by President Obama to cost 10 million dollars over the life of the child.

The mother had traveled to the U.S. from Honduras to seek better medical care. As of yet, local cases of Zika have not been proven beyond reasonable doubt. However, consider this scenario: the mother of the baby has Zika virus, is bitten by a mosquito, and the mosquito transmits the virus to American citizens during her stay.


Luckily, Zika virus is thought to only stay in the blood for a week or so. This limits the window in which a mosquito can pass the virus from  one human to the next. It does appear, however, to spend much more time in other bodily fluids such as semen. Sexual transmission is believed to be the most likely way for a human to pass it to another human.

The CDC reported May 20th that at least 279 pregnant women in the United States and U.S. territories like Puerto Rico have documented evidence of Zika virus. This is a spike from last week’s report. Many hundreds more Americans citizens, non-pregnant, have been found to have had the infection. As only 20% of patients develop symptoms, actual numbers are probably several times higher.

Still, these are cases in which the victim has traveled from the epidemic zone in South America or had sexual activity with someone who has. No epidemic is expected in the United States, although small clusters of locally-transmitted cases in warm-weather states like Florida and Texas may occur, as well as in major populations centers like New York City during the summer.

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Here’s my recent video on the book I’ve written on Zika virus, The Zika Virus Handbook, pretty much all you need to know explained in plain English. No-nonsense, non-panic, it’s the only book, as far as I can tell, written by a doctor who delivered his share of babies during his career and who writes about medical preparedness.

To watch, click below:

Wishing you the best in good times or bad,


Joe Alton, MDblaze tv 2

Survival Medicine Hour: Jack Spirko 2, Zika Triples, Dental Issues

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jack small

Jack Spirko and Joe Alton, MD

Jack Spirko of The Survival Podcast returns to complete his interview with Dr. Bones on the latest Survival Medicine Hour with Joe and Amy Alton. Also, an introduction to dental preparedness, plus what items you might consider for your survival dental kit.

Many of our readers and listeners are surprised to hear us talking about dental issues. Indeed, few who are otherwise medically prepared seem to devote much time to dental health. Poor dental health, however, can cause issues that affect the work efficiency of members of your group in survival settings. When your people are not at 100% effectiveness, your chances for survival decrease.

History tells us that problems with teeth take up a significant portion of the medic’s patient load. In the Vietnam War, medical personnel noted that fully half of those who reported to daily sick call came with dental complaints.  In a long-term survival situation, you certainly will find yourself as dentist as well as nurse or doctor.

Plus, cases of Zika Virus more than triple among pregnant women in the U.S. Still no locally transmitted cases, but the CDC predicts they’ll arrive in the heat of summer, when mosquitoes are out in force. All this and more in this episode of the Survival Medicine Hour.

To listen in, click below:


Wishing you the best of heath in good times OR bad,



Joe Alton, MD and Amy Alton, ARNP

Amy Alton Everglades Close up 400 x 600


Check out Nurse Amy’s entire line of medical kits, from her bleeding control kit to the Stomp Supreme, at her store at

Survival Medicine Hour: Zika Death, Reporters and Prepper Events, More

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Disasters happen, whether reporters believe it or not

The U.S, records its first Zika death in an elderly man from Puerto Rico, where 700 cases have been confirmed and thousands more suspected. The mainland U.S. hasn’t been immune either: 93 cases so far in Florida and 77 in New York (no subtropical climate but still a home for the Aedes mosquito). They explore how politics is infecting the Zika debate over funding, and holding up appropriations for mosquito control just as warm weather is arriving in the U.S, Their new book “The Zika Virus Handbook” is an all-you-need-to-know about Zika virus, and now available at It’s the only book (far as we can tell) on the subject written by a physician.

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Zika Virus Handbook

The Atlanta Journal Constitution reports that prepper events, like the ones Dr. Bones and Nurse Amy are speaking at as of this writing are in “the business of fear”. If that’s the case, are car insurance salespeople also in the business of fear? How about health insurance plan and Obamacare? Our hosts discuss how insurance takes many forms, and tangible items like food and medical supplies might just be another form of it. Also, is it fear or common sense that drives a small percentage of the population to take measures to be prepared for disasters? Who are the crazy ones, “preppers” or the general population who scramble to the supermarket and empty shelves in a frenzy before a big storm? You decide.


All this and more on the latest episode of The Survival Medicine Hour with Joe Alton, MD and Amy Alton, ARNP.


To listen in, click below:


Wishing you the best of health in good times or bad,


Joe and Amy Alton, aka Dr. Bones and Nurse Amy


Survival Medicine Hour: New Normal, Zika Handbook, More

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Joe and Amy Alton announce their latest book, “The Zika Virus Handbook“! It’s the first book on everything you need to know about the infection written by an MD. It’s concise at 138 pages, but still way more information than the other books on Amazon. You’ll find out how to identify, prevent, and treat the disease, all about the mosquito that transmits it, and every measure you can take to protect your family. You’ll also hear about what our government is doing about it, plus some alternative theories about why so many cases are occurring on this side of the Atlantic. Zika’s this year’s pandemic, and with warm weather approaching, you should know about it.

Also, are people who prepare for disasters normal? Are “normal” people who don’t prepare for disasters normal? Well, in the New Normal, they might be, but normal sure doesn’t mean “sane”. Dr. Bones and Nurse Amy discuss the difference between “normal” and “sane” and why it’s even more important, given recent events, for people to wake up and get together knowledge and supplies that might help in times of trouble.


17-year Cicada

Also, it’s time for the 17 year cicadas to come out! Will it be a plague of biblical proportions, and do you have anything to worry about? All this and more on the Survival Medicine Hour with Doom and Bloom’s Joe Alton, MD, and Amy Alton, ARNP.

To lIsten in, click below:

Wishing you the best of health in good times or bad,


Joe and Amy Alton



The Zika Virus Handbook

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Warm weather is on the way, and the Centers for Disease Control and Prevention state that we can expect more case of Zika virus in the United States this summer. Indeed, the Aedes mosquito which transmits the virus seems to have expanded its range to include 30 U.S. states, up from 12 in the last survey. The Aedes mosquito (Aedes is Greek for “unpleasant”) is now found as far North as New York.


Until now, Zika cases have all be traced to those who have traveled to the epidemic zone in South and Central America, with a number also identified in Puerto Rico and other Caribbean countries. The CDC, however, believes that there will be locally-transmitted clusters of Zika in various areas in the U.S.


We keep a close eye on pandemic diseases, and it looks like Zika virus is the one to watch out for this year. As such, we have researched everything that the average citizen should know about it: How to identify it, how to prevent it, and what the treatment options are.


As an obstetrician in a previous life, Joe Alton, MD is especially interested in a disease that can affect, sometimes disastrously, newborn babies. But it does more than that; Zika has been associated with nervous system disorders, like Guillain-Barre syndrome, that can cause, sometimes permanent, paralysis.



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He’s put it all down on paper in his new book The Zika Virus Handbook. Like his 2014 book on Ebola virus, the book has everything you need to know about the infection, and it’s all written in plain English.


“The Zika Virus Handbook” explains all you need to know about the epidemic in a calm, no-nonsense fashion. The book gives a solid plan of action that can be easily followed in a concise guide. All this from a physician that has decades of experience as an obstetrician, and whose mission is to put a medically prepared person in every family for any disaster. In fact, it’s the only book on Zika written by a physician that’s spent his life caring for pregnancies and who is well-known in the field of disaster and epidemic preparedness.


The book also outlines other pandemic diseases, past and present, and discusses way to control the Aedes mosquito, which transmits the disease through its bite.


Like many pandemic diseases, many controversial theories abound about why Zika has become a threat, and you’ll find these and commentary on their plausibility in “The Zika Virus Handbook”.


There’s no need to panic about Zika virus. The CDC stops short of predicting an epidemic in the U.S. But it’s affected 64 countries so far, and it only makes sense to learn about any disease that could affect your family’s health.


You can find the book at, and be sure to keep an eye on Joe Alton, MD’s website at for regular updates.



Amy Alton, ARNP



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High Resolution Front Cover_6093961 Zika


Zika virus, native to Africa, has crossed the Atlantic and is predicted by the World Health Organization to infect 4 million people in the Western Hemisphere.  It has been linked, more every day, to a number of birth abnormalities, including close to 5000 cases of microcephaly (a smaller than normal head circumference with a corresponding small brain) in Brazil. Researchers also have linked Zika to stillbirths, miscarriages, eye problems and other complications, with problems not only in the first trimester but throughout pregnancy. It is also related to Guillain-Barre syndrome, a condition where a person’s immune system attacks its own nerve cells, and, now, other neurological issues resembling multiple sclerosis.



More Proof for Zika’s Role in Microcephaly and Nerve Disorders



Brazilian researchers reported last week that Zika preferentially targets developing brain cells. They used stem cells to study embryonic brain development in a lab dish, and reported in the journal Science that virus samples taken from a Brazilian patient destroyed the growing nerve cells in a few days. They suspect that’s happening in the womb in pregnant Brazilian women.



Zika’s History



Zika was first identified in monkeys living in Uganda’s Zika forest in 1947. It spread slowly at first, and seemed to be a pretty harmless virus, causing hardly any symptoms at all in most people, as a matter of fact, no symptoms in 80% of those infected. But it started proliferating in 2007  to Asia and the South Pacific; it showed up in Brazil around the time of the World Cup in 2014.  Because hardly anyone in the Americas has immunity to Zika, it’s spread widely since then and has earned the title of pandemic.



The CDC and Zika Virus


Transmitted by the Aedes species of mosquitoes, the Centers for Disease Control and Prevention recently related its concern for the U.S. as warmer weather arrives this spring and summer, and the mosquito population explodes. A recent survey found the Aedes mosquito in 30 US states, up from 12 in past studies. “Aedes”, by the way, is the Greek word for “unpleasant”. Amen, brother.



Sure enough, the more researchers learn about the Zika virus, the scarier it appears to federal health officials, and they’re urging more money for mosquito control and development of vaccines and treatments.



672 cases of Zika virus have been identified in the United States and Puerto Rico (about half there), all of which are tied to persons who have traveled to or have had sexual relations with someone who traveled to the epidemic zone in South America.



With the 2016 Summer Olympics taking place in Brazil, the country with the most cases, the CDC expects a number of U.S. tourists will return with the virus. They predict clusters of locally-transmitted cases, especially in warm weather states like Texas and Florida, but have stopped short of suggesting that it will become an epidemic here. In Puerto Rico, however, the CDC believes that hundreds of thousands of people might become infected.



Zika Prevention and Treatment


Due to its novelty, there is no proven treatment for Zika virus and the first vaccines won’t be tested until at least September. This is past the time when the Aedes mosquito will be most active here, so it’s important to watch out for it. The NIH suggests bed rest, fluids, and acetaminophen to treat the symptoms of acute disease, which will resemble the flu, with the addition of rashes, joint pain, and conjunctivitis (“pink eye”). Aspirin and ibuprofen are discouraged as treatment, as Zika Virus may mimic a related virus, Dengue Fever, which can cause abnormal bleeding (Zika doesn’t). Indeed, Zika virus is related to not only Dengue, but also Yellow Fever and West Nile virus.



The best way to prevent infection is to eliminate areas of standing water that could serve as nurseries for mosquito larvae. As well, citizens are recommended to use mosquito repellents like DEET, Picaridin, IR335, and Lemon Eucalyptus oil (all EPA-approved) whenever outdoors. Travel to the epidemic zone should be avoided, especially for pregnant women and their significant others. Zika’s the first virus to generate a travel warning by the U.S. specifically for those that are expecting. Cases of Zika in travelers have been identified as far away as Russia and China.



GMO Mosquitoes


In a field trial, genetically-engineered male mosquitoes will be released into a test community near Key West, Florida this year. These mosquitoes, known as OX513A, have a gene that prevents their offspring from developing into adults. They will compete with normal males for mating privileges and it is thought that they will significantly decrease the mosquito population in at-risk areas. Local citizens aren’t too happy about the idea, though, and legal action might block the experiment.



Politics and Zika

masks on kids

President Barack Obama has sought about $1.9 billion in emergency money to help fight the Zika epidemic internationally and to prepare in case the virus spreads here, but the request has stalled in the GOP-controlled Congress. Last week, therefore, the administration said it would use $589 million in funds left over from the Ebola outbreak for some of that work. Lucky for the administration and, certainly for us, that Ebola pooped out when it did and left some money. It’s another example of executive action bypassing congress, but I might just agree with this one.



The administration says that it’s laid out a precise plan for dealing with the virus, but members of Congress say that it’s only an outline. Despite this, a bill is expected to pass very soon. Expect more controversy about funding as time goes on.



What You Should Do To Avoid Zika Infection


The most important thing you can do to prevent Zika infections is to make your property inhospitable to mosquitoes. If Zika has been identified in your home town, you will have to take aggressive measures. You can decrease the chance that mosquitoes will want to breed in your backyard by eliminating standing water. Consider these mosquito control methods from the American Mosquito Control Association:



  • Covering rain barrels with a screen or other barrier.
  • Keeping lids on garbage cans.
  • Strictly maintaining disinfection in swimming pools or hot tubs using chlorine or salt. Assure that water is circulating well. Drain completely if not in use. Abandoned swimming pools should be filled in with dirt or sand.
  • Emptying kiddie wading pools.
  • Draining water from tarps, pool covers, or other protective sheeting.
  • Removing buckets, empty flower pots, and other containers that might accumulate water.
  • Frequently changing water in birdbaths, pet dishes, and animal troughs.
  • Unclogging rain gutters that might not be draining well.
  • Repairing any leaky outdoor faucets.
  • Installing or repairing tightly-fitting window and door screens. Use U.S. #16 or #18 mesh.
  • Adding a water feature to a standing pond, such as a waterfall or fountain.
  • Removing debris from ornamental ponds or fountains that might prevent water flow.
  • Installing or repairing tightly-fitting window and door screens.
  • Cutting or mowing areas of tall grass, a favorite place for adult mosquitoes to loiter.
  • Avoiding excessive watering of lawns and plants, especially near the house.
  • Adding topsoil to uneven areas of your yard that might accumulate rain water.
  • Notifying local authorities of nearby properties with areas of undrained storm water that could be an issue. They will probably have equipment that can eliminate the problem.



Note that draining wetlands and natural ponds may be illegal. There are many natural predators of mosquitoes that live there, such as birds, bats, fish, frogs, and other wildlife. Check with your local municipalities for rules and regulations.



So consider long pants and long sleeves if the mosquitoes are thick in your neighborhood this summer. Use your mosquito repellents, and re-apply them often, especially if you’re pregnant or planning to be. Consider mosquito netting, especially if you like the windows open. And think about how important it really is to see personally who wins the pole vault at the Brazilian Summer Olympics. Don’t travel to the epidemic zone unless absolutely necessary.




High Resolution Front Cover_6093961 Zika

Now, for the first time, we’re making a big announcement, our new book “The Zika Virus Handbook: A doctor tells you all you need to know about the pandemic” will be out in the next few days on Amazon and we’re excited about being able to bring this information to our readers and the general public.



The Zika virus is going to be a topic of discussion all summer, and you’re going to want to know what you can do if there are some locally-transmitted cases in your area, as the CDC is now predicting. We talk about Zika’s origins in Africa, its travels to Asia and the Polynesian islands, how it spreads, and all about the nasty little bug that’s transmitting the disease.



We talk about the medical issues that, more and more Zika virus is being linked to, especially birth abnormalities, and nerve conditions that can cause paralysis and other problems. You’ll learn how to identify an active case, how to differentiate it from its relatives like Yellow fever, dengue, west nile, and others. More importantly, you’ll learn how to prevent your property from harboring mosquitoes that put you and your family at risk. We’ll discuss all the different methods that your municipality could use for mosquito control, including pesticides, biological agents, and more.



We also talk about pandemics of the past and present in The Zika Virus Handbook and how to put together an effective epidemic sick room, and a lot more.



A lot of theories as to why these previously minor illnesses have become a big issue on this side of the pond exist, and we even go through a lot of these, and examine them for just how plausible they are. A lot of you remember our Ebola Survival Handbook, and this book is a little like it, although I was pretty mad about our government’s lack of response with this one. I’m a little calmer about this one, and I think, for Zika, we need a calm, no-nonsense approach to dealing with it. I talk about our policy going forward on this epidemic, and what makes the most sense for pregnant women and, really, just about everyone in terms of staying safe and healthy.



I hope you’ll check out the Zika Virus Handbook, we’ll be making announcements when it comes out, and I think you’ll find it a good, concise read.



Joe and Amy Alton, aka Dr. Bones and Nurse Amy


Video: All About Zika Virus

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Zika Virus (ZIKV) is the latest virus to cross the Atlantic and infect large populations in Central and South America, especially Brazil. Over 4000 cases of Microcephaly, a birth defect, have already been reported. The World Health Organization believes up to 4 million cases and 100,000 could become affected before it’s all over (it’s been wrong before, though, as we learned during the Ebola epidemic). In any case, you’ll see a lot about it on the news, so it’s important to know about it. Learn all about Zika virus, with Joe Alton, M.D. in his latest video.

To watch, click below:




Wishing you the best of health in good times or bad,



Joe Alton, MD

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Survival Medicine Hour: Bleeding Control Kit, Herbal Teas, Zika update, more

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Bleeding wound

Would you have the materials and knowledge to stop heavy bleeding if you were confronted with it? In these violent times, you should be prepared to deal with injuries that could be life threatening and have the equipment that might save a life. Hear Amy Alton, ARNP, explain her thinking in designing a compact med kit that deal with hemorrhage that she believes should be in every workplace, classroom, and homestead. Also, Joe Alton, MD, talks about natural remedies when he goes over some herbal teas. Plus: Why does Zika Virus in Brazil cause birth defects, while no major history of the problem seems to occur with Zika virus in its original territory (Africa and Asia)? Is a mutation the cause? All this and more on the latest Survival Medicine Hour with Dr. Bones and Nurse Amy.


To listen in, click below:



Wishing you the best of health in good times or bad,



Joe and Amy Alton


Check out Nurse Amy’s latest kit “The First Aid Bleeding Control Kit” at her store at




Zika Virus A Mutation?

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The Zika virus, the subject of one of our recent articles, is spreading throughout the hemisphere after crossing the Atlantic from Africa. At present, cases have been reported in every country except for Canada and Chile. News articles regarding the tragic consequences it has on pregnancies are  published daily. The Center for Disease Control (CDC) has gone so far as to travel advisories warning pregnant women to stay away from countries with widespread outbreaks, like Brazil.



Interestingly, in Africa, Zika virus is thought to be a mild pest, causing minor illness; in fact, 80% of those infected have no symptoms at all. It is not associated with birth defects like microcephaly where it is traditionally found. Yet, this virus is now becoming an issue that some predict may affect up to 100,000 newborns. It isn’t hard to imagine that this will tax the resources of poor countries that are dealing with it.



Why is a virus that isn’t a big problem in its original territory suddenly causing these heartbreaking deformities? Zika is an equatorial disease spread by mosquitoes, conditions that are present in both Brazil and Africa. Why should it have so different a presentation in one part of the world than another?



It is my opinion that we dealing with a viral “mutation”. Viruses are well-known for their ability to change genetically. These changes, or mutations, may either be insignificant or have major consequences. Luckily, most are the former, and this is the reason why influenza vaccines work to prevent illness. This year’s flu is usually similar to last year’s, and flu vaccines are made from components of last year’s virus. If an influenza virus mutates significantly, it usually causes many more cases and, often, deaths as we have less immunity to it.



Imagine if Ebola, which caused a regional epidemic in West Africa in 2014, had mutated to become easily transmissible through the air? It would have been more challenging to control and could have reached pandemic status.



Despite this, I can find nothing in the news that mentions the possibility that the virus has mutated. If we are to have success in producing treatment or prevention of this viral illness (none exists at present), we will have to take into account the chance that this Zika virus is not the same as the original.



Joe Alton, MD



All About Zika Virus

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One of the scenarios we write about is the “Pandemic”. Although we have had success curing many illnesses with antibiotics, we are still struggling with outbreaks of viral diseases. In 2014, thousands died in West Africa during the Ebola epidemic. In 2015, Chikungunya virus crossed the Atlantic into the Western Hemisphere and infected a million people. This year, Zika virus is the latest pandemic, and the first to generate travel warnings specifically for women that are pregnant or of childbearing age.

A little-known virus of equatorial Africa and Asia, the Zika virus has “jumped the pond” and is wreaking havoc in South America, especially among pregnant women and their newborns. Like its predecessors, it’s a mosquito-borne virus. Citizens of the Americas have little immunity against it.

Most people experience mild flu-like symptoms, but an infected during a pregnancy can yield a newborn with brain damage. In late 2015, it was mainly a Brazilian problem. A congenital abnormality (once called a “birth defect”) called microcephaly started appearing among newborns. Microcephaly presents as an abnormally small head and is associated with mental handicaps; if severe, it may be incompatible with life.

Brazil is a large country with a youthful population; in an average year, it sees about 150 cases of microcephaly. Since the arrival of Zika virus in May 2015, there have been 3,500. Now, cases of the virus are being reported in the United States from Virginia to Arkansas to Hawaii (mostly in returning travelers from South America). In total, 25 countries so far are reporting evidence of the virus.


spanish flu ward
Infectious disease can be endemic, epidemic, or pandemic:



–An Epidemic infectious disease is a community-wide outbreak of an illness that is not always present in an area. Influenza, EnterovirusD68, and Ebola are examples.
–An Endemic infectious disease is one that is normally found and expected in a certain area. Malaria is endemic in many tropical countries.
–A Pandemic occurs when an infectious disease crosses various borders and runs rampant throughout a large region, or even the whole world. The Spanish Flu of 1918 is the classic example. Zika has had outbreaks in Africa, Asia, and now, South America. Cases have been reported in Denmark and Sweden as well.


Zika virus is a member of the Flavivirus family, which contains a number of well-known diseases such as yellow fever, chikungunya, and West Nile virus. Like the others, Zika virus is carried by Aedes mosquitoes, which are the main agent of transmission (human to human transmission can also occur); unlike the others, the virus affects the unborn.

Symptoms of the virus include headache, rash, fever, and conjunctivitis (pink eye). The grand majority of infected people have no signs of the infection whatsoever. This is ominous for a pregnancy, as the mother doesn’t even know she was at risk.



There is no vaccine or treatment available that is effective against Zika virus. Prevention, however, is simple: Don’t travel to the countries where widespread outbreaks are occurring. If you have to go, use sunscreen, long pants and sleeves, plus mosquito repellant or netting. Standing water near your location in affected areas should be drained.

Mosquito control efforts are underway in Brazil and other countries at risk. Besides the usual sprays with pesticides, you might be surprised to know that GMOs (genetically modified organisms) are playing a part.

A male “Franken-mosquito” called OX513A has a gene that kills his offspring. Female mosquitoes only mate once during their lives, so this might have a significant effect. Brazil claims more than a 90% decrease in the population after release. OX513A was also used in the Florida Keys in 2012 (over protests) to combat an outbreak of another Flavivirus, Dengue Fever.




Joe Alton, MD


Learn more about infectious diseases in our 3 category #1 Amazon bestselling book “The Survival Medicine Handbook”, with more than 270 5-star reviews…

FLUAD, The Next Generation Vaccine?

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One thing you can count on seeing every winter is a flu outbreak. Influenza is a viral respiratory illness that has been the cause of worldwide epidemics (“pandemics”). In 1918, the Spanish Flu spread throughout the globe and killed close to 100 million people.

Even non-pandemic influenza can turn deadly in some cases. The Centers for Disease Control and Prevention have limited information on official death counts from flu each year, but it can be anywhere from a few thousand to fifty thousand in the U. S., mostly among those over 65.


So many people get the flu yearly (one in five to one in twenty in recent years) that modern medicine has worked diligently to try and prevent it. This has led to the development of vaccines. Vaccines work by exposing you to the previous year’s virus in the hope that you will develop immunity to this year’s version. Now, the Food and Drug Administration has approved a new type of flu vaccine with a “booster” meant to improve the immune system, especially in the elderly. This new vaccine, called Fluad, claims to translate into better outcomes among older people.



Fluad’s main target is people over 65 years of age. The elderly typically do worst if they get the flu, so much so that influenza has been called the “Old Man’s Friend” because it ends their suffering, and I mean permanently. According to an FDA spokesperson: “Immunizing individuals in this age group is especially important because they bear the greatest burden of severe influenza disease and account for the majority of influenza-related hospitalizations and deaths…”


Fluad contains MF59, a mixture that includes squalene, an oily nutrient produced by the liver but also seen in sharks, certain birds, and amaranth seeds (it also includes some preservatives). When incorporated into vaccines, MF59 increases the number of immune cells that are activated.


From a pandemic standpoint, there’s another benefit: Adding MF59 can help extend vaccine supplies. People might need a lower dose of vaccine, thus allowing more to receive it.


The government actually considered using MF59 when the Swine Flu arrived in the U.S. in 2009. But, although vaccine supplies were short, MF59 wasn’t used due to the expected resistance to the new ingredient.


U.S. government officials have been wary about using MF59 in vaccines because of public suspicion of new ingredients in medical treatments in the U.S. Fluad, however, has been in use in Europe and Canada for close to 20 years; the FDA now declares it to be safe and effective.


Vaccine effectiveness is a big issue, because last year’s vaccine was only around 20% effective in preventing the flu in those who took it. Normally, you want a flu vaccine to be 60% effective or more.


There are two reasons why last year’s vaccine failed, relatively speaking. The formulation may not be effective against a particular virus if the virus mutates or a new virus arrives. Also, if the vaccine doesn’t activate a person’s immune response, it won’t work to produce antibodies against the virus.

Tests show Fluad works at least as well as the vaccines already on the market, and may boost a senior’s protection from H3N2, one of the currently circulating strains of influenza.


(DID YOU KNOW: Type A (the most common) Influenza viruses are categorized by certain proteins on their surface called HA (Hemaglutinins) and NA (Neuraminidases). For example, Swine Flu is H1 N1.)


The CDC recommends that everyone over 6 months of age receive the vaccine. Despite this, only 148 million doses get distributed in the United States, a country with a population of more than 300 million. This is because of concerns on the part of many of adverse reactions. Some believe that reluctance is also due partly to the injection required, so a nasal mist was developed. Unfortunately, shortages are commonly reported.


Another concern is the possibility of  an adverse reaction to something in the vaccine. Ill effects of flu vaccine can be minor or major. Minor problems following a flu shot include pain, redness, and swelling at the site of injection, plus flu-like symptoms. If these occur, they usually last 1 or 2 days.


This doesn’t mean, however, that serious problems can’t occur with vaccines. One in a hundred thousand to a million people may develop a disorder called Guillain-Barre syndrome, which can cause long-term damage to nerves. Children may, rarely, experience seizures due to high fever from a flu shot. Of course, anyone could be allergic to a component of the vaccine, causing a mild to serious reaction. Major reactions seems to occur in one in a million cases.


You won’t find Fluad on pharmacy shelves this year but it should be available next year. Will it decrease flu-related deaths among older citizens in the U.S.? We’ll have to wait until 2016 to find out.


Joe Alton, MD


To find out more about influenza, check out our classic 4 part series of articles, or get a copy of our bestseller The Survival Medicine Handbook, with over 250 5-star reviews.

And, if you’re looking for a Christmas gift for that older child, check out our board game Doom and Bloom’s SURVIVAL!, a great way to have a fun family game night (and think about tough decisions you’d make in a survival scenario). Now with a full set of 8 custom miniatures, our survival medicine DVD, and a SURVIVAL! nylon mini-backpack free with your purchase!


Antibiotic-Resistant Superbugs

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The wise medic will store antibiotics to deal with infections in survival scenarios, but what happens when a bacteria becomes resistant to them? In other words, a “Superbug”?

In the U.S., 2 million people are infected annually with bacteria resistant to standard antibiotic treatment. At least 23,000 of these will die as a result. In an increasingly overburdened health system, resistant microbes are responsible for a huge increase in the cost of caring for the sick.

This article will discuss antibiotics and the epidemic of resistance that has spawned a growing number of superbugs.


Antibiotics are medicines that kill micro-organisms in the body. Amazingly, the first antibiotic, Penicillin, was discovered entirely by accident in 1928 when Alexander Fleming returned to his lab from a vacation. He noticed that a lab dish with a bacterial culture had developed a mold known then as Penicillin Notatum. Around the mold, an area had developed that was clear of bacteria. Further study proved the potent germicidal effect of the compound processed from the mold.

By the 1940s, penicillin was in general use and credited with saving many lives during WWII. Since then, more than 100 different antibiotics have been identified and developed into medicines.

Antibiotic Overuse

The huge success that antibiotics had in eliminating bacterial infections caused them to be used excessively. Liberal employment of antibiotics is a bad idea for several reasons:

  • Overuse fosters the spread of resistant bacteria.
  • Allergic reactions can occur, sometimes severe.
  • Antibiotics given before a diagnosis is confirmed may mask some symptoms and make identifying the illness more difficult.

Antibiotics will kill many bacteria, but they will not be effective against viruses, such as those that cause influenza or the common cold. They are also not meant as anti-fungal agents.



Viruses are largely unaffected by antibiotics


Most will be surprised to hear that almost 80% of the antibiotics used in the U.S. don’t go to people, but to livestock. This is not to treat sick livestock but to make healthy livestock grow faster and get to market sooner. No one knows for sure why antibiotics have this effect, but the gross overuse on food animals is a big reason for the epidemic of resistance seen today.

The Superbug List Grows Longer

The Center for Disease Control and Prevention has compiled a list of close to 20 bacteria that have shown a tendency towards antibiotic resistance. They include various organisms that cause severe diarrheal disease, respiratory issues, wound infections, and even sexually transmitted disease.

The CDC’s list:

  • Clostridium difficile
  • Carbapenem-resistant Enterobacteriaceae (CRE)
  • Drug-resistant Neisseria gonorrhoeae
  • Multidrug-resistant Acinetobacter
  • Drug-resistant Campylobacter
  • Fluconazole-resistant Candida
  • Extended spectrum β-lactamase producing Enterobacteriaceae (ESBLs)
  • Vancomycin-resistant Enterococcus (VRE)
  • Multidrug-resistant Pseudomonas aeruginosa
  • Drug-resistant Non-typhoidal Salmonella
  • Drug-resistant Salmonella Typhi
  • Drug-resistant Shigella
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Drug-resistant Streptococcus pneumoniae
  • Multidrug-resistant tuberculosis
  • Vancomycin-resistant Staphylococcus aureus (VRSA)
  • Erythromycin-resistant Group A Streptococcus
  • Clindamycin-resistant Group B Streptococcus


There have been no effective treatments identified for some of the above microbes, as in the case of multidrug-resistant Tuberculosis. MRSA, Methicillin-Resistant Staph. Aureus, was responsible for more deaths than AIDS in recent years.


Although this is the CDC’s list of superbugs that affect the United States, they aren’t the only ones. A new type of Malaria, a very common parasitic disease of warmer climates, is turning up that is resistant to the standard drugs.


Viruses are “resistant” to antibiotics by nature (in other words, they are unaffected by them) and include Influenza A, Swine Flu, Ebola, Bird Flu, SARS, and Middle East Respiratory Syndrome (MERS). These will be discussed in detail in a future article.


An Effective Strategy


Strategy #1


Many believe that antibiotic-resistant Superbugs listed are exotic diseases that could never affect their community. With the ease of commercial air travel, however, cases of antibiotic-resistant diseases from afar can easily arrive on our shores.


Recently, a case of multi-drug resistant Tuberculosis was identified and then isolated at the high level isolation unit at the National Institute of Health in Maryland. Although we have increased our capacity for handling this type of patient significantly since the arrival of Ebola in the U.S. last year, it wouldn’t take much to overwhelm our facilities.



Therefore, the medic must have a plan to decrease the chances for antibiotic-resistant infections. The main strategy is to hold off on dispensing that precious supply of antibiotics until absolutely necessary, but other strategies include:


  • Establishing good hygiene practices: Everyone should be diligent about washing hands with soap and hot water or hand sanitizers. Good respiratory hygiene includes coughing or sneezing into tissues or the upper arm, but never the bare hands.
  • Supervising sterilization of water, preparation of food, and disposal of human waste and trash. Contaminated water and food will lead to many avoidable deaths in survival scenarios. Make sure that food preparation surfaces (counter tops, etc.) are disinfected frequently.
  • Dedicating personal items: Personal items like towels, linens, utensils, and clothing may be best kept to one person in an epidemic setting.
  • Cleaning all wounds thoroughly and covering with a dressing. Skin is the body’s armor, and any chink in it will expose a person to infection.
  • Social distancing: When a community outbreak has occurred, limiting contact with those outside the family or survival group may be necessary to stay healthy.
  • Keeping a strong immune system: Getting enough rest, eating healthily, and avoiding stress will improve a person’s defenses against disease. Unfortunately, it may be difficult to achieve these goals in times of trouble.
  • Going natural: Allicin, a compound present in garlic, is a natural antibiotic that is thought to have an effect against some resistant bacteria like MRSA. Crush a clove and eat it.



Preventing the spread of infections, especially antibiotic-resistant ones, is important to maintain the viability of a survival community. If you’re the medic, have antibiotics in your storage but use them wisely. If you do, you’ll help prevent not only resistance, but a lot of heartache if things go South.


Joe Alton, MD

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Metronidazole as a Survival Antibiotic

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Antibiotics are an important part of any medical arsenal in tough times. Many infections easily treated today would possibly be life-threatening in an off-grid survival setting. Indeed, if such a thing occurred, you can bet that these drugs would no longer be produced. There would be a lot of otherwise avoidable deaths due to simple cuts that become infected or dehydration from diarrheal disease. We only have to look at mortality statistics from pre-antibiotic times like the Civil War to know that this is true. More soldiers died then from infectious disease that from bullets or shrapnel.



This article is part of a series on antibiotics and their use in survival settings. Today we’ll talk about an antibiotic that would be useful to deal with some organisms that can cause a number of major problems. Metronidazole (aquatic equivalent: Fish-Zole) 250mg is an antibiotic in the Nitroimidazole family that is used primarily to treat infections caused by anaerobic bacteria and protozoa.

“Anaerobes” are bacteria that do not depend on oxygen to live. “Protozoa” have been defined as single-cell organisms with animal-like behavior. Many can propel themselves randomly from place to place by the means of a “flagellum”; a tail-like “hair” they whip around that allows them to move.



Giardia (Protozoal Parasite)

The antibiotic Metronidazole works by blocking some of the functions within bacteria and protozoa, thus resulting in their death. It is better known by the U.S. brand name Flagyl and usually comes in 250mg and 500mg tablets. Metronidazole (Fish-Zole) is used in the treatment of these bacterial diseases:



• Diverticulitis (an intestinal infection seen in older individuals)
• Peritonitis (an inflammation of the abdominal lining due to a ruptured appendix, ruptured cysts, and other causes)
• Certain pneumonias (lung infections)
• Diabetic foot ulcer infections
• Meningitis ( an infection of the spinal cord and brain lining)
• Bone and joint infections
• Colitis due to a bacterial species known as Clostridia (sometimes caused by taking Clindamycin!)
• Endocarditis (a heart infection)
• Bacterial vaginosis (a very common vaginal infection)
• Pelvic inflammatory disease (an infection in women which can lead to abscesses, often in combination with other antibiotics)
• Uterine infections (especially after childbirth and miscarriage)
• Dental infections (sometimes in combination with amoxicillin)
• H. pylori infections (a bacteria that causes peptic ulcers)
• Some skin infections

And those are just the bacterial infections that metronidazole can deal with. It also works with these protozoal infections:

• Amoebiasis: dysentery caused by Entamoeba species (contaminated water/food)
• Giardiasis: infection of the small intestine caused by Giardia Species (contaminated water/food)
• Trichomoniasis: vaginal infection caused by parasite which can be sexually transmitted

Amoebiasis and Giardiasis can be caught from drinking what appears to be the purest mountain stream water, and these infections are seen right here in the Great Smoky Mountains and elsewhere. Never fail to sterilize all water, regardless of the source, before drinking it.

Metronidazole is used in different dosages to treat different illnesses. You’ll find detailed information in our book “The Survival Medicine Handbook” and in other standard medical references such as the Physician’s Desk Reference. You’ll also find this information at or

Here are the dosages and frequency of administration for several common indications:

• Amoebic dysentery: 750 mg orally 3 times daily for 5-10 days. For children, give 35 to 50 mg/kg/day orally in 3 divided doses for 10 days (no more than adult dosage, of course, regardless of weight).

• Anaerobic infections (various): 7.5 mg/kg orally every 6 hours not to exceed 4 grams daily.

• Clostridia infections: 250-500 mg orally 4 times daily or 500-750 orally 3 times daily.

• Giardia: 250 mg orally three times daily for 5 days. For children give 15 mg/kg/day orally in 3 divided doses (no more than adult dosage regardless of weight).

• Helicobacter pylori (ulcer disease): 500-750mg twice daily for several days in combination with other drugs like Prilosec (Omeprazole).

• Pelvic inflammatory disease (PID): 500 mg orally twice daily for 14 days in combination with other drugs, perhaps doxycycline or azithromycin.

• Bacterial Vaginosis: 500mg twice daily for 7 days.

• Vaginal Trichomoniasis: 2 g single dose (4 500mg tablets at once) or 1 g twice total.

All drugs have the potential for side effects, also known as adverse reactions. These are different from allergies, where your body actually mounts an immune response to a drug, such as in a penicillin allergy.

One particular side effect has to do with alcohol: drinking alcohol while on Metronidazole will very likely make you vomit.


Metronidazole should not be used in pregnancy. but can be used in those allergic to Penicillin.

Having antibiotics will give you an additional tool in the medical woodshed that just might, one day, save a life. They’re not toys, however, and should only be used when absolutely necessary.


Joe Alton, MD

joe bleachLearn more about antibiotics and their use in survival settings in our book “The Survival Medicine Handbook“, with over 250 5-star reviews on Amazon.