strep infection from river water??

Ok - kind of a strange topic, but I can’t get an answer from my doctor. I was paddling two Saturday’s ago, and went for a “swim” - in doing so I got some water in my ears which sort of sloshed around there that whole day/evening. By Monday, I started getting symptoms - aches, sore throat, fever. I ended up running a fever for 6 days straight, and I’m now on my second round of antibiotics. My doc started me on antibiotics without a strep test (due to the holiday), but that’s what the diagnosis is. Now one week later, and I still have a thick white cheese like substance growing all over my tonsils and the back of my throat (lovely, huh?). I work from a home office, so I am not typically exposed to things like sick kids or sick coworkers. Anyone know if I could’ve gotten this infection from the river water? Or could the water in my ears made my sinus cavities a more hospitable environment for some nasty bacteria to set up and have a party? Or was it more likely just a weird coincidence?

river swims
Based on my experiences and what I’ve heard anecdotally from others, river water is suspect as a contributing factor in illness. Dysentery, giardiasis…

Swimmers ear can develop from water staying in your ears. Some folks always carry a bottle of rubbing alcohol which I think can be mixed with hydrogen peroxide to administer via dropper after a day on the river. A good preventative practice if you know you’ll be rolling or swimming or when you get back home and can’t get the water out of your ears.

I’m an open boater and got knocked out of my boat in an eddy couple weeks ago on the Quabog in MA. I was in and out pretty quick but had a sore throat and a headache for three days following that. The river quality was class B maybe C, yeah it was downstream of a sewage treatment plant. Unable to say with certainty why the sore throat, but I suspect the river played a role along with stress levels, strength of immune system, diet, sleep…

All sorts of nasties out there and due to the Bush administration’s undermining and reversing of the Clean Water Act controls polluters will be allowed to negatively effect the quality of our waters.

Doctor didn’t do a strep culture?
My doctor always did strep cultures to tell. Doesn’t seem likely it’s waterborn contracted- NIH website says saliva and “nasal discharge” from infected person and some reports of contaminated food. sounds like the bacteria needs a pretty gross warm slimy environment to survive. You weren’t paddling in nasal discharge again were you?

Bacterial and Viral Infections
In California the local health officials strongly discourage surfing within 72 hours of a heavy rain that brings run-off into the ocean, surfers get all kinds of bacterial infections and viral infections. I do not know how long strep bacteria survive in a cold water environment but many bacteria just become dormant until they find a warm host. Some surfers have died from viral infections that affect the heart after surfing in run-off. Ear infections, sinus infections, respiratory infections and GI problems are common. If you are boating in any area that has sewage discharge or run-off from streets or areas where homeless people camp, or farm animals you can get the kinds of symptoms you are talking about.

Wearing nose plugs if you know you are going to be upside down and rinsing out your nose and ears with saline solution helps a bit. The saline nose spray you buy at a pharmacy is stabilized with a mild antibacterial. I would not put rubbing alcohol in my ears, very dilute hydrogen peroxide is OK.

Ears, nose, and throat are all connected
That’s why there are “ENT” specialist doctors.

I would bet that river swim is exactly where you picked up the bacteria.

Lots of possibilities
Precautions to take:

  1. Squirt alcohol into your ears right after paddling. A mixture of isopropol alcohol, small amount of vinegar, and a tad of glycerine is best.

  2. Irrigate your sinuses with mild salt water. There are various ways of doing this including using an attachment on a water pik on the lowest possible setting.

  3. Clean/irrigate your ears with a syringe of warm water while you shower. You can get syringes for this purpose. Mostly this removes wax that keeps polluted water in your ears.

    Always wear nose plugs anytime you are in doubtful water and might overturn. And keep your mouth shut.

    There is no practical way to guard against giardia. Even a small amount of water in your mouth or nose can contain enough giardia cysts to cause significant problems.

    E Coli is present in a lot of streams and rivers but there has to be a pretty high concentration to cause problems.

    Mostly, don’t paddle in flood conditions. High rainfall amounts increase flows in rivers (fun) but they also cause mixing of sewage and rainwater dumped into the stream because many communities have not updated their drainage systems.

Paddle_ Lupe
you paddling in a suburban area? Or near a city? Hopefully the rivers up here are realatively clean. seems like a water borne problem. Hope ya get better soon.

Bummer. Could be waterborne, but
did you eat at a fast food place or other restaurant on your outing? Since you don’t have much exposure to germs (due to working at home and not having kids)you’re more suseptable to nasties.

Hope you’re better soon.

think we are about to see what drinking
untreated water can do. With what is rapidly becoming the worst natural disaster in recorded history in Asia, death toll is approaching 600,000 and expected to possibly double only because of the contaminated water supply. Typhoid, Malaria, Colera, Dysentery, Encephalitis, Hepatitis, and many more water born deseases are expected to take there toll.

I think it’s a good idea to research where you paddle and the amount of pollution you are likely to encounter. Even in the remote wilderness area’s of the North you will encouncter mercury in the water from mining runoff. I live in Ohio and unfortunately some rivers even today are little more than open sewers.

a little bit of knowledge can hurt

– Last Updated: Dec-29-04 8:28 AM EST –

I am finding out myself that a little bit of knowledge CAN be a bad thing.

Errors I made this year

Thought you couldn't get strep from river. Wrong, and the ugly reason is coliform bacteria, yeah the nasty stuff in feces. Echhh.

Though using silicone swimmer ear plugs were a good idea. Got some stuck in my ear. Pain, blockage, bacteria. Found out do not stick q-tips in ears, do not remove ear wax, you need it! Do not use undiluted stuff in ears like vinegar,hydrogen peroxide, etc. In fact most GP docs don't know how to undo an ear blockage, only ear nose and throat people. You can puncture your ear drum and have chronic infections. Mine was so bad was seriously dizzy for awhile.

All this casused me to think why do I disdain traditional medical knowledge and often prefer hearing from others who experience these problems, even when I have shared and listened to advice that was also not helpful and even dangerous. I think the reason is a real disconnect in traditional medicine between treating acute problems and learning how to prevent problems by active living and taking care of problems.

Thanks for the replies. Sounds like the consensus is that the river water definitely could have been the culprit. On the other hand, I also stopped at hwy rest areas there and back to use the bathroom, and I did even eat at a fast food restaurant on the way home (kinda rare for me). The river in question is the Mulberry in western Arkansas - it’s in the country, not an urban river at all, but I don’t know how bad runoff is there from area farms.

I’m feeling much better now, but still not 100% better. I have New Year paddling plans that are starting to look sketchy because I don’t want to get out there if my body is still in the middle of fighting this thing off.

This thing has just completely kicked my butt! I’ll get a cold maybe once a year, but this has just been ferocious. I was wearing nose clips when I flipped, but not ear plugs. I hate to wear still more things on the water, but the thought of going through this again definitely means I’ll be trying some of the tips you all offered here to help prevent a reoccurance.

I hope everyone paddles infection-free in the New Year!

Well, I disagree in part.
“Thought you couldn’t get strep from river. Wrong, and the ugly reason is coliform bacteria, yeah the nasty stuff in feces. Echhh.”

Fecal coliform and fecal strep are not the same thing. You can’t get strep from coliform bacteria but both are typically present in polluted water.

“Though using silicone swimmer ear plugs were a good idea. Got some stuck in my ear. Pain, blockage, bacteria.”

Wrong kind of plugs. Use Doc’s Pro Plugs.

“do not remove ear wax, you need it!”

Excess ear wax should be removed. Any ENT will tell you that. But you are right, a q-tip is not the way to do it.

good to hear you’re feeling better.

Dr. Disco, are you a health care professional, as in a medical doctor? I ask this respectfully because I would like some guidelines for ear drops, from you or anyone with such advanced training.

I do remember that it was common practice at a girlscout summer camp, on a pristine, class A, adirondack pond, for all swimmers to receive a couple drops of isopropyl alcohol after swimming. I’m unaware if it was diluted or mixed with other things. As it was a practice extending over the eight years that I attended as a camper and beyond another eight to when I went back as a counselor I am unaware of any harmful affects this may have had. Of the hundreds that received the drops, if there were problems relating to the drops it seems they should have surfaced during that time. However, that is not to say that medical practices should not be put in question, given to review and possibly discontinued. To the best of my knowledge it was used to help dry the ear canal and kill germs.

Questions; Should isopropyl alcohol be diluted? How much? If not diluted is it harmful? Is chorinated water an acceptable dilutent? Is hydrogen peroxide, acceptable or not? What is the purpose of glycerine you suggest? To clarify, you suggest white vinegar, please clarify amounts.

Perhaps you could break this down into ratios. Maybe start with a half or quarter cup of alcohol and use a measuring cup or spoons for other ingredients.

I’m asking this on behalf of those who may not have access to affordable health care at this moment but would appreciate a professional’s opinion. As always, one should use reasoned judgement when gleaning information from the internet. A happy and healthy New Year to all.


Paddling the Fifebrook or Quabog New Years Day

I am not a physician
I have simply sought advice from physicians about ear problems. The following web site should be helpful:

I will look up the formula for ear drops and post it later.

Ear Drops Recipe
The simplest recipe is 50% alcohol, 50% white vinegar. Some people I know dilute the vinegar 50/50. The vinegar is important because infection can result from changes from acidic to basic in the ear canal. Divers (I am a scuba diver as well as a paddler) often put this mixture in their ears before they dive as well as after. I was told that it had to remain in the ear canal for 5 minutes or it wouldn’t be as effective. The original recipe I was given by a biologist friend included a very small amount of glycerine. I don’t know what that is supposed to do and I usually don’t put it in.

Squares with advice I have heard.
May not be necessary unless you get one or more external ear infections, like I did in my youth.

I once had a chronic eyelid infection for many years, thought it was normal to have slightly crusty lids on awakening, but the Doc said no, it was probably resident staph or strep. Short course of antibiotic ointment knocked it out, and it did not return.

Thanks for your honesty
and for taking the effort to share the info Dr_Disco, much appreciated. That five minute window could be a challenge but worth it especially if due to wax build-up the water can’t escape.

When I’ve been to ENT specialists for ear problems it has always been recommended to soften wax build-up and gently irrigate the canal with warm water. They sell little ear kits for this and it was also recommended to preceed with a tub soak with the ears immersed; and never insert anything like a q-tip to clean, due to the risk of puncturing the drum or doing other permanent damage.

Isopropyl Alcohol in Ear
Although this has been done for ages, ad suggested for cleaning babies ears long ago, I am a little shy of putting it inside the ear. If you look on pubmed there is an old study that found that the commercial formulation of ipa/acetic acid/ glycerol (isopropanol/vinegar/ glycerine) causes mild damage to the inner ear. Did not see there is any study proving beneficial efffect proven for treating swimmers ear or preventing it. My concern is for subtle effects from repeated use (say if you are a surfer or kayaker and do this several times a week.) It’s possible to get drugs directly into the blood stream with good blood brain barrier penetration by administering them in the ear, especially if you have abnormalities in the ear drum like Pikabike mentioned. (Remember how Hamlet’s father was done in, sublte poisons adminstered in the ear canal.) If you do this repeatedly you will be eroding sensitive tissue in your inner ear. IPA itself is fairly toxic and IPA can transport chemicals etc accross the skin. I have a professional paranoia of chemicals getting into the blood stream and brain. Physicians use a mild peroxide solution to clean out ear wax, I would only do that sparingly too.

Hi Heather
Could have been the water, especially since the bacteria had been provided with an earfull of water, giving it a nice, warm, moist environment for it to grow in. Surprised that he didn’t do a strep screen as this is a simple, quick test to perform. And without the culture OR CBC (a type of blood count) how could he determine you had a bacterial infection of any kind? He couldn’t, therefore; shouldn’t have put you on antibiotics without KNOWING you had a Strep infection. That said, the white, “Cheesy” stuff is yeast. The antibiotics kill the normal “Flora” or bacteria that NORMALLY resides in your mouth. That gives the yeast a chance to propagate. That should correct a few days after finishing your antibiotics. You can also do things like eat yogurt with live cultures to help quell the yeast and/or get your physician to take a look and Rx some Nystatin to swish in your mouth. Hope that helps! WW

If you have any indication that eardrum
is perforated, then it’s off to the doctor. A little comparative gentle pressure testing by putting the thumb over the ear canal and pressing inward should show if one of the eardrums is perforated. Closing nostrils and pressurizing gently may also reveal whether the two ears feel different in a way which suggests a pressure leak on one side.