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Poisoned while up a mountain - what do you do?

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eurocentric:
You've just had your most arduous day so far, ascended a mountain, and the younger males in your group have dug out a snow trench in a blizzard. The wind is presently low, allowing you to get away with hitching the tent on only 2 end poles while you rest inside to eat and drink, before the tent centre ridge is secured for the night.

You may have utilised the tripod-mounted camera used earlier to take 2 trench digging photo's to help temporarily shore up the sagging middle of the ridge tent inside. The subsequent hurricane will see this later found on the ground with a smashed lens filter, and the bamboo ski pole holding up the far end of the tent will have snapped twice, the splitered ends stabbing into the billowing and flapping canvas snagging on anything it comes into contact with.
   
Your group is going for a cold night, so have brought no firewood up the mountain, so no camp fire. You only have dry kindling, but you still brought your stove with you in case the weather badly deteriorates a lot sooner than you imagined and you have to drop down from high altitude and seek shelter. Otherwise you'd have left it in the labaz your group made earlier, jettisoning the extra weight and bulk.

The reason you've come up here to pitch the tent is that you sense you are in a period of calm before a storm, the previous day saw winds like a jet engine but now it is calm despite foreboding skies, and you figure you can use a head start along the high ground to your destination, Mount Otorten, setting off very early AM before the weather changes, and have made ready a bucket of cold porridge for breakfast, and the Evening Otorten newsletter to leave as a traditional gift and also to prove you were there.

Group spirits are tired but buoyant; this time tomorrow you'll be back on schedule, and it will have been far easier to walk across firmer, shallower snow at higher altitude than negotiate the deep soft stuff which near defeated you lower down. You'll all have achieved Level 3 and be on the homeward leg of your trip, back to Vizhay, and everything will get easier.

And by pitching up a mountain, and with photographic proof, two pics taken to be sure one came out, you'll have a bragging right back at the UPI which will place you above your Blinov competitors on much the same trek.

But, within 30 minutes of eating and drinking, some of you start to feel very ill, quite suddenly, and there's a sense of dread, a realisation this must be serious, and you might even die. You are profusely sweating, burning up with a sudden high fever which sees you begin to remove clothing and feel oblivious to the static cold, and around 6pm it's understood by all that your group is suffering from a poisoning, a toxin of some kind.

You do not know what it is, but realise that either the dried loin, the bread rusks, or the water you tanked up on ready for the next 24 hours away from a camp fire and streams, is how you came to consume it. Suspicion may initially fall upon the stranger in your midst. Others point to how they've been feeling off for days, with poor performance, memory and mood maybe caused by lower doses of the same thing. But if so, your increased appetite and thirst has seen you overdose.

It could be anything, and you do not know how this is going to play out. You are scared of this unknown. You are faced with a medical emergency but there is nothing in your first-aid kit or training to deal with this, you are miles from help, and in an age without communication, and the medicinal alcohol is off limits unless you wanted to do nothing and have one last drink.

You know you must act, and fast, because the symptomatic clock is ticking down.

What do you do?

GlennM:
1. Throw up
2. Eat charcoal
3. Dose with antibiotic pill
4. Journal
5.. Tincture of time

There was a point when I thought the hikers stole alcohol on the train and it was more methanol than ethanol.

RMK:
Interesting.  eurocentric, what sort of poisoning are you proposing here?  Do you mean a toxic chemical in their food or drink?  Or, food poisoning from spoiled/rotten provisions?  Or, a biological pathogen, like waterborne bacteria or parasites?

eurocentric:

--- Quote from: GlennM on February 03, 2023, 06:58:14 AM ---1. Throw up
2. Eat charcoal
3. Dose with antibiotic pill
4. Journal
5.. Tincture of time

There was a point when I thought the hikers stole alcohol on the train and it was more methanol than ethanol.

--- End quote ---


Good calls, but the Streptocide antibiotics would only reliably be useful for treating streptoccal infection, chestiness, or as a 3-day course for cystitis, and they won't deal with this crisis fast enough, plus you'd need to risk washing them down with some more of the potentially poisoned water. It may have been too late to usefully induce vomiting by the time they realised the problem.

Here's what I'd do, and I'll write it from the perspective of Igor Dyatlov, to outline a theory I have over what happened.

I'd want to consume as much fresh water as I could, and from a source I could trust, to attempt to neutralise and dilute the toxin, even more so if I suspected the water I'd drank, in the hope this increased motility flushed it past my stomach and small intestine, off to be excreted. That would be my only antidote.

With no campfire at 3000ft to melt snow, the stove without firewood (according to Sharavin and others) so it couldn't be set up on the floor to melt snow, and the contents of the flasks distrusted, I'd head down 1079 towards the inevitable meltwater stream there will be between 2 snowy peaks and drink as much as I could. So the ravine, not the forest, is the destination.

The whole group would go, rather than the most ill wait inside the tent for our return with supplies inside rinsed containers as there was no guarantee we'd make it back, and it would take 2 hours or more if we did, so everyone would march off following a leader down the mountain slope by torchlight.

My focus would be on dealing with this immediate life-threatening crisis rather than thinking ahead of how I'd face the cold afterwards, especially when I felt so feverish, and I would not intend to remain away from the tent so I wouldn't take wood cutting or snow digging tools with me, but by the time my group reached the foot of 1079 some may have become incapable of returning so I'd then be involved in a desperate, ill-equipped battle to survive where we were.

I'd climb a hardwood tree to snap branches and develop pressure marks around my ankles from gripping the trunk and branches, and one of my comrades would end up injuring herself in a fall which caused a large 'baton' bruise to her side when she connected with a lower branch.

Some may have entered into the next major stage of a lethal toxin, seizure, collapsing to the ground, unable to break their fall when they did so, so sustaining head and chest injuries as those areas absorbed impact while their mobile limbs rotated at the joints so offered less resistance. Nobody would have a single broken clavicle or wrist or palm injuries.

I'd light a fire, using the matches already in pockets to keep them dry, and this was achieveable as it was a still night, but I'd need to light many to dry out the kindling I'd find. The string in a pocket, which could be used to make a rope lighter to burn incandescently in any wind, and wouldn't blow out, would remain unused, because it wasn't windy.

I'd arrange two men, initially the worst affected and too weak to stand, to lay near the fire, to stop them developing hypothermia, but while I was climbing trees to snap branches or otherwise distracted, they convulsed, their uncontrolled limbs getting too near the flames or embers, and unable to retract themselves across 2 to 3 minutes, they sustained burns.

Once his seizure ended or he was pulled away from the fire one of them would bite into his hand due to the agony and pass out with the skin in his mouth, neither spitting it out or choking. They would both die with fluids around their mouths, entirely consistent with fitting, and then I and others would reappropriate their clothing to help save ourselves as our bodies continued to respond to our freezing environment and we were damp with sweat. I ended up wearing a shirt trek medic Yuri Yudin gave Yuri Doro, which had 4 Streptocide pills in the pocket.

With others weakening, some injured from falls, I'd realise, if I was feeling up to it, that I needed to return to the part-erected tent and drag sled it, the blankets and the stove back down the mountain to set it up in the forest. 4 others were deteriorating and some started to seize, with one biting into the tip of her tongue through clenched teeth, which would later accelerate its decomposition.

So I and two others would prepare a 4-person den to temporaily house them while me and 2 others returned to the tent, but by the time the den was made it was too late and the 4 had become unresponsive, perhaps while sheltering in the ravine, and because their clothing was saturated from collapse into water, sealing their hypothermic fate, I would not be able to reappropriate their clothing for my underdressed self.

I'd then occupy the den with the remaining 2 survivors, explaining my relative lack of frostbite despite all the exposure, with none visible to my face and hands in my slab photo's. I had burnt all the joules of energy I had in my lean Soviet frame, and needed to rest, but as late evening encroached the convective overnight winds were increasing and there was the threat of the storm to follow, something which I knew would shred the unsecured tent.

So I'd set off with the others, to get the tent down off the mountain, but my stamina would soon give out. I'd tell the others to continue and I'd return to the den but I soon became unable to drag myself there and died with dilated pupils, partly due to the toxin and also because it was night.

Another guy collapsed from his head injury, fitting on the snow, his right arm outstretched and he did not get up again, and the last survivor crawled up the mountain until she could not move another inch, her fingers frostbitten from all the dipping into cold wet snow while her uncovered face remained unaffected. She would not have survived alone even if she'd made it back, and may not have been able to write what happened as her fingers were frostbitten.

Later, my body and the others would be found by Mansi noticing the tent stuck on the ridge, using their old trail 400 yards from the tent site, this long before any rescue party arrived, and carrion visiting the ravine to drink would peck out the eyes of 2 of my dead comrades.

I would hope a pathologist would determine what had happened to us, what drove us from our tent, but he simply saw Leichmann Spots and convinced himself most of us died from hypothermia, and he would template evidence towards his conclusions across our autopsies, assigning frostbite to people who didn't have it in the text of their report, or in their slab photo's. He would not suspect a poisoning so would not commission special blood tests or urine analysis, describing only the volume and colour, and not even in all cases. His ill-equipped and sloppy approach would cause my death and that of 8 others to turn into a 64-year mystery.

eurocentric:

--- Quote from: RMK on February 03, 2023, 11:19:02 AM ---Interesting.  eurocentric, what sort of poisoning are you proposing here?  Do you mean a toxic chemical in their food or drink?  Or, food poisoning from spoiled/rotten provisions?  Or, a biological pathogen, like waterborne bacteria or parasites?

--- End quote ---

I doubt it was a pathogen like botulism or ergot because that needs time to replicate in the human gut before it overwhelmed the immune system, and it's unlikely to suddenly deliver the same level of health crisis across a number of the hikers at once, and they wouldn't have had the energy to do all they did before being stricken.

So it's a chemical compound, either in the river water they likely filled their flasks with (near their labaz), or it's something commonly available which may have either an accidental or deliberate inclusion, such as strychnine, used as a rodenticide.

It's hard to find data on deaths from river poisonings from naturally occurring dangers, such as algal bloom (which does kill dogs rapidly), but plenty of illness, less common today as people are aware of the risks and take their own bottled water. Obviously some rivers are extremely toxic, full of industrial waste or fertilisers, and this was a region with some mining and prospecting.

The Mansi deer had been dying of bacteriosis, caused by streptoccal bacteria, which deer, like humans, permanently carry but is held in check by healthy immunology, but an animal rendered ill from drinking toxic water will see the bacterium flourish and develop hoof rot, unable to move. The Mansi were told not to use the streams after the DPI, this warning maintained for 3 or 4 years. And the Mansi hunters were said to have been ill when the hikers died, this may have been a lie, providing an alibi to confine all bar one at home so they didn't get the blame, but if true then this also suggests that a hunting party may have consumed bad water and back home, in the warm, and cared for by others, they survived.

I should imagine that during periods of lower water flow in the frozen months, and below a blanket of ice and snow preventing evaporation and light, the chemistry of such a river may become more dangerous. They didn't have water purification tablets, and if I thought they might detect a taste, a smell, it seems they liked to boil water and prepare flasks of coffee etc, which would mask things.

Strychnine is a white odourless and tasteless powder which can be ingested, inhaled or rubbed into the eyes. It is notoriously difficult to detect at autopsy unless there is direct suspicion, whereas the other common rodenticide, warfarin, would be obvious from internal haemorrhage.

It causes fever followed by a series of agonising seizures where the brain fires off neurons making every muscle group contract, with nobody surviving their fifth seizure. External stimulus, such as a gust of wind, can trigger another seizure.  Ultimately, away from the cold, death is from suffocation as the lung muscles stop working, and Nurse Solter, her husband and all colleagues were apparently convinced the hikers suffocated. But in that frozen environment death would be determined by hypothermia when they became so exhausted they could not move and/or their clothing was saturated during collapse in the ravine.

Dried loin, which requires no cooking and won't freeze as the water contents removed, is usually air cured for months, and if rodenticide was used, as I'm sure it must at a butchers, there may have been a cross contamination, though I'd imagine that others would also be affected by this public health issue, so maybe some meat set aside as bait accidentally entered the food chain when the hikers placed a large order and so the contamination became specific to them. Loin skins were seen on the tent floor, not just cut pieces (Sharavin interview) so they definitely consumed it inside the tent.

If the bread rusks, found scattered everywhere on the tent floor, then possibly someone at Vizhay tampered with their bread supply, either at the point of baking, or later while the hikers slept, this fate eluding the Blinovs as they did not stay the night.

I think the hikers themselves would suspect their water the most, as that would appear to them to be the main variable, they had eaten loin and rusks before but their water supply, the source, would change.

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