This Cold Bug Is Bugging Me: How to Handle Flu-Like Illness in the Backcountry

Posted by: Sarah Buer on 1/12/17 9:46 AM

Viral, flu-like illnesses like stomach bugs or viral upper respiratory infections (“the flu” or “a cold”) can be common on wilderness expeditions. While having a cold is never fun, being in the backcountry when the bug decides to bug you can make it that much worse.

What’s the best course of action to take when the common cold decides to come around on a camping trip?


Photo from Pexels.

By the book:

According to Tod Schimelpfenig’s NOLS Wilderness Medicine, treatment principles for these flu-like illnesses in the backcountry are as follows:

  • General management for flu-like illness is symptomatic treatment.
  • Hydrate.
  • Wash hands and maintain good hygiene.
  • Rest and be patient.
  • Massage for muscle tension headaches.
  • Consider pain medications for headache and muscle aches.
  • Consider decongestants (for congestions) and anti-cough medications.
  • Consider antihistamines for a runny nose.
  • Consider acetaminophen or ibuprofen to reduce a fever.
  • Bland diets are best for gastrointestinal distress.

A little advice:

We also asked a few NOLS grads, staff, and instructors for their personal advice on managing a common cold in the backcountry. Here’s what they had to say:

"Sleep when I can, hydrate, make sure I eat bits even if I don't feel like it. I apply the ‘no fun rule’ when I'm on a personal trip, and for NOLS courses, if the I-team can safely take care of me and the students, grin and bear it while getting as much rest as possible .” -Era Aranow, NOLS Faculty, Staffing Coordinator

“Plenty of fluids and copious amounts of hand washing.” -Greg Gaskin, NOLS Faculty

“Make sure if you're sick you're especially careful about food prep and hand washing. I usually bow out of kitchen duty entirely—your cook group won't resent you, they'll thank you.” -Katherine Boehrer, NOLS Expeditions Grad, Social Media Coordinator

“Emergen-C, the beverage. Then I sweat it out in my sleeping bag.” -Clemencia Caporale, NOLS Faculty

“Peppermint tea, an extra muffler or scarf or neck gaiter…” -Judd Strom, Equipment and Materials Manager

“Lots of hot drinks. I try for 4-5 liters a day of fluids. Stay as warm as possible, rest if you can but make sure to get at least some light exercise.” -Drew Seitz, NOLS Faculty

Prevention is key

Viruses and bacteria can be spread and can take the form of communicable diseases in a number of ways. The best treatment is prevention.

Here are a few ways the NOLS Wilderness Medicine Handbook suggests avoiding spreading your cold once you have it:

  • Wash your hands well. After going to the bathroom, before cooking, etc.
  • Do not share water bottles, spoons, lip balm, etc.
  • Don’t use personal utensils in the communal cooking pot or reach hands into food bag.
  • Don’t cook for the group if you’re sick.
  • Clean cooking and eating utensils well and rinse with hot, disinfected water.
  • Cough into elbows or clothing to avoid spreading an airborne virus.

Photo by Johanna Garcia.

To Evacuate, or Not To Evacuate?

Sometimes having a cold can affect your expedition and how you feel enough that it may be best to call it quits. That can be a hard line to draw, though. You should always trust your own judgement, but here are a few guidelines from NOLS Wilderness Medicine on when it’s necessary to evacuate yourself or someone else with a cold.

  • Persistent fever that lasts more than 48 hours or is over 102 degrees Fahrenheit (39 Celsius)
  • Stiff neck, severe headache, or difficult breathing or wheezing develops
  • Signs or symptoms of pneumonia develop, like shortness of breath, decreasing exercise tolerance, increasing fever, worsening malaise (general feeling of illness or discomfort) and weakness with predominant coughing
  • Sore throat in conjunction with inability to swallow water/maintain adequate hydration develops
  • Isolated sore throat with fever or a red throat with white patches develops
  • Patient has a headache that does not respond to treatment. Evacuate rapidly if it is sudden and severe or is associated with altered mental status.

Do you have any remedies you swear by when a cold strikes in the backcountry? Want to learn more about recognizing, treating, and making evacuation decisions regarding flu-like illness and other medical situations in the wilderness?

Check out NOLS Wilderness Medicine course offerings here.

Sarah is a Wyoming native, recent Wilderness First Responder graduate, and marketing coordinator for NOLS Wilderness Medicine. When she’s offline she enjoys running, singing and playing guitar, and playing in the mountains