Deadly infections in the cave: why rescued Thai schoolchildren were quarantined

After rescuing from Tham Luang cave 12 Thai high school students placed in quarantine, and even parents do not have access to them. BBC Russian Service explains that it is a matter of dangerous infections that lie in wait underground. But how serious is all this? What kind of diseases threaten underground researchers?

The children were held in underground captivity for 17 days—and could have spent several months there, as experts feared.

All those rescued were immediately taken to the hospital next door to help them recover, but the parents of the boys would have to wait before they could hug their children, who were placed in an isolated sterile ward.

All contacts with the outside world are made through glass. The families of teenagers are told that until the saved ones pass all the tests, they cannot be embraced or touched.

And even if the doctors do not find anything dangerous, the first meeting will take place at a distance of two meters, and parents will have to wear protective suits.

Why such extraordinary precautions?

Although thousands of tourists visit the cave complex Tham Luang every year, in addition to stalactites and the giant golden Buddha statue, less pleasant surprises await them there.

Caves in the tropics are hotspots for potentially fatal infections.

These caves have a surprisingly diverse range of inhabitants, from birds and bats to rats, which carry all sorts of germs, including rabies, Marburg virus and all sorts of little-studied fungal pathogens.

As you go deeper, the cave becomes a preserve of poisonous spiders, scorpions and centipedes.

Ticks that parasitize them carry the so-called cave fever, a rather rare disease that can sometimes be infected in abandoned buildings.

Bees-killers

“Yes, we encounter a lot of creatures,” says Rick Mercar, president of the National Cave Divers Association, an American organization that promotes the safety of those who explore flooded caves.

“For example, I was in Mexico, where in one of the caves we explored there lived a swarm of African killer bees. There were bats, and scorpions, and much more - and that’s just at the entrance. We always have to remember about bacteria.”

And now - about water. Moisture constantly accumulates on the walls of limestone caves. Actually, this is how these caves are formed - water penetrates deep through cracks, erodes the limestone, forming caverns.

Moisture saturation occurs constantly, and due to limited access of air, the humidity in some caves is close to 100%.

In the caves where bats live, the air is saturated with pathogenic fungi, and below, under the researchers’ feet, there is liquid dirt and animal droppings, an ideal environment for bacteria and parasites.

And finally, the caves are dark - so dark that many underground creatures do not have eyes, they simply do not need them.

For this reason, astronauts often train in caves to prepare for life in outer space, where there are no landmarks.

In such conditions it is easy to get injured, even when you have a flashlight, because you have to wade through narrow passages, along uneven walls.

“I'm sure the Thai guys got histoplasmosis,” says Hazel Barton, a cave diver and underground microbiologist. “In this tropical region, bats live in caves, so it is very likely that the teenagers inhaled spores of the fungus.”

The fungus Histoplasma capsulatum is found in bird and bat droppings, mostly in damp environments. The disease is usually treated with a course of antifungal medications taken over several months - up to a year.

On average, one of 20 children dies and approximately 8% of adults die from histoplasmosis-infected individuals. Particularly dangerous are those whose body and immunity are already weakened.

At the beginning of this year, a team of doctors reported the death of an 53-year-old Costa Rican admitted to a Florida state hospital with fever, cough and shortness of breath.

After several days of research and analysis on all sorts of tropical diseases, doctors felt that they were deadlocked. In the end, they managed to find out that the man likes to explore the caves and swim there underwater. Then he was checked for histoplasmosis.

Unfortunately, by the time the analysis confirmed this diagnosis, the man had died. This happened on the fourth day of his stay in the hospital.

Litter Bats

Hitoplasmosis is very easy to contract—Barton herself discovered this when she and her husband explored one of the caves in the United States last year.

“We walked in and I smelled a strong smell of bat droppings. “Oh, we’re in a histo cave!” I exclaimed. “Histo... What?” the husband was surprised. I covered his mouth with my handkerchief so that he would not inhale anything dangerous. But about 10 years later, in another cave, he still became infected.”

Often hidden in caves is the spiral-shaped bacterium Leptospira, which is transmitted by contact - through damaged mucous membranes and skin, when swimming in ponds with stagnant water and drinking raw water from natural sources.

The disease caused by this bacterium is called leptospirosis and starts as a normal flu. In 5-15% of cases, it develops into something more serious, with symptoms such as organ failure and internal bleeding. The outcome can be fatal.

Cave explorers infect this bacterium quite often. In the 2005 year, for example, a man became infected with it in the state of Sarawak (Malaysia), even though it was treated with antibiotics at that time.

However, the main danger facing the rescued Thai teenagers is melioidosis, an infectious disease common in Southeast Asia. Every year, about 165 thousand people become ill with it, of whom about half die.

This disease is caused by a bacterium that lives in the soil, and it can become infected during, for example, a non-hazardous activity such as rice cultivation.

Diagnosis is extremely difficult, because the disease has a lot of various symptoms (from cough to temperature), inherent in other diseases.

Melioidosis is not treatable with many antibiotics.

In Thailand, rescued teens and their football coach are now taking blood tests to help determine if they have become infected.

While they may not have symptoms of this disease, as it sometimes manifests itself only after three weeks.

But if they are found to be infected, they have a good chance of being cured. Prompt treatment for melioidosis is essential to recovery, and the boys have reportedly been on antibiotics for several days (though we don't know which ones or for what).

If you still haven't given up on exploring the caves, here are a few simple precautions to help you protect yourself from dangerous underground infections.

Just putting on rubber boots will prevent bacteria from getting on your skin when you walk on water that may contain bat dung.

“After you've been swimming underwater in a cave, it's important to wash everything off before you take off your suit,” warns Mercar. “It’s important to wash your shoes and everything else.”

Barton emphasizes that not all caves are an ambush, where deadly germs await you. It all depends on where the cave is and what is inside it.

“Most of the caves that we [the University of Akron in Ohio speleology group] explore are some of the cleanest places on our planet,” she says. “Some have fewer living cells than ancient Antarctic glaciers.”

"Thai teenagers were in a flooded cave in a tropical region - there is indeed a high risk of contracting an infectious disease through the water."

Recall a group of teenagers 11-16 years and their 25-year-old football coach disappeared on June 23 in the Tham Luang cave complex, where they went on an excursion. Because of the torrential rains that started in the cave, water began to flow sharply, and they were forced to go four kilometers deep, thus being cut off from the entrance.

The search for the missing football team lasted nine days. 2 July teenagers discovered British divers John Volanten and Rick Stanton. They were found on a hill about 4 km from the cave entrance.

All 13 people were alive and almost intact, although very weak, since they spent nine days in darkness and without food.

The group began to deliver food, oxygen cylinders and other supplies. During surgery killed the diver - Former Thai Navy soldier. Senior Saman Gunan delivered the boys and their coach oxygen cylinders, while he lost consciousness on the way back. Gunan pulled his partner out, but failed to save him.

The situation was focused on the attention of the whole world, readiness to assist in the rescue of undergrowth expressed the American entrepreneur Ilon Musk.

As a result, on July 10, the most difficult rescue operation was completed - divers were able to teach children the basics of diving and lead them through a flooded narrow dark cave. In operation was attended by two Ukrainian divers.

Read also on ForumDaily:

What is still silent in the rescue of Thai boys from the cave

Heroes who ensured the survival of schoolchildren in a Thai cave: who are they

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