Colonel John W. Gardner published a number of articles on the subject in Military Medicine. The articles discuss a number of cases of recruits who ëoverdosedí on water. In 1995, nine previously healthy Marine Corp recruits in South Carolina exhibited nausea, vomiting and confusion. Five of them developed seizures and delirium and then progressed into comas. After treatment, they were all able to return to normal duties.

In 1997, a previously healthy 18-year-old soldier at Fort Benning vomited and began complaining of dizziness, headache and nausea. He drank about 8 quarts of water before this. He rested and as it was a hot day, he was given more water, lots of it. He became lethargic, lost consciousness and died with diffuse cerebral and brainstem edema. (Edema is an abnormal accumulation of fluid.)

On a hot and humid day in South Carolina in 1999, a 20-year-old Marine Corps recruit came to a field station after a 9-hour hike and obstacle course exercise. While under evaluation, he had a seizure followed by another one on the way to the hospital. Over the next half a day, he diuresed over 6 liters. After a 5-day hospitalization, he was released and returned to recruit training.

Also during 1999, a 19-year-old Air Force recruit collapsed during a 6-mile hike. He had a body temperature of 108°F. He had also vomited. He later died of fatal cerebral edema. Over-hydration is suspected to have contributed to his death.

In 2000, a 20-year-old Army trainee reported for advanced training after returning from leave. She was not feeling well so she was excused from training for that day. The next morning she reported for drug testing but could not produce a urine specimen. She was instructed to remain on site, drink water and exercise until she provided a specimen. She drank about 12 quarts of water over the next four hours. Then she developed fecal incontinence, became confused, lost consciousness and died of cerebral and pulmonary edema.

There are other examples and all have a common denominator. Each victim had consumed a large volume of water in a short time, up to 20 quarts in a 2-hour period. In some cases, the victims were given more water after they developed symptoms that were diagnosed as dehydration. This caused the patients to suffer hyponatremia, a dilution of sodium in the blood stream. The sodium serum levels in the fatal cases were less than 130 mmol/L and sometimes near 120 mmol/L. Normal levels are above 140 mmol/L. The retention of 1 liter of water would cause a reduction of 4-5 mmol/L of sodium in the blood of a 60 kg female. To reduce the level from 140 to 120, she would have to retain 4-5 liters of water.

In 1998, the US Army approved new fluid replacement guidelines that limit water intake not more than 1.5 quarts per hour and 12 quarts per day. This was based on arguments that the gastrointestinal system cannot absorb more than 1.5 quarts per hour during exercise. Drinking more than this is likely to cause nausea and hyponatremia.

The body is a complex organism with many reactions and balances that must be maintained to stay healthy. While this information should not scare us from rehydrating as we lose fluids due to exercise, heat or other activities, it is important to recognize that over-hydration is just as serious a condition as dehydration.

Once again, living by the Islamic guidelines provides a proper basis for eating and drinking. Those guidelines teach avoiding excesses of food and drink and eating no more than one third of the stomachís capacity and drinking no more than one third the stomachís capacity.

(Information in this article was extracted from articles in the May 2002 issue of Military Magazine: International Journal of AMSUS, Volume 167/5, written by Colonel John W. Gardner, with the permission of the Association of Military Surgeons of US.)

One of the harmful types is E. coli O157:H7. E. coli O157:H7 is an enterohemorrhagic strain that causes hemorrhaging. This strain releases a toxin that damages the cells lining the wall of the intestine.

The bacteria are spread by various foods, including ham, turkey, undercooked ground beef, cheese, raw vegetables, unpasteurized milk and apple cider and contaminated water. It can also be spread from an infected person to others by hand to mouth contact. It is very important to observe good hygiene and to wash hands before eating or touching the mouth.

There are various precautions that can be taken to prevent infection by E. coli. These include:

• Cooking ground beef thoroughly so the meat is no longer pink and the juice is clear. This generally means getting the meat to a temperature of at least 70ƒC (160ƒF).
• Avoiding the consumption of unpasteurized milk or apple cider.
• Washing all fruits and vegetables thoroughly before consumption.
• Practicing good hygiene and being sure to wash hands before eating and after using the toilet or handling pets, livestock and diapers and before preparing or cooking foods.
• Cleaning utensils and counter tops thoroughly after contact with raw meat or poultry.
• Keeping cold foods below 4ƒC (39ƒF) and hot foods above 70ƒC.
• Avoiding drinking from open streams or lakes.
• Being extremely careful when preparing foods if you suffer from diarrhea. It is best to avoid food preparation in such cases.
• Avoiding the use of the same utensils for raw meat and for cooked meat without thoroughly washing them between the two items.

E. coli related illness was first recognized in 1982 when a severe outbreak of diarrhea occurred. The cause was contaminated hamburgers. Ground beef or hamburgers seem to be the major contributor to E. coli outbreaks. If the bacteria are present in the beef, it is normally on the surface. However, when the beef is ground, it becomes mixed in all the meat. In the United States, there are around 73,000 infections and 60 deaths every year related to E. coli O157:H7.

Over the years, there have been a number of food recalls due to E. coli contamination. Most recently, Con Agra recalled 19 million pounds of contaminated ground beef. Past E. coli incidents have involved ground beef, apple juice, raw milk, fresh cheese curds, alfalfa sprouts, contaminated lake water and salami.

The best way to eliminate E. coli is at the source. Until that is accomplished, be sure to wash your hands frequently and before eating and after using the toilet or handling diapers, and make sure you wash raw fruits and vegetables thoroughly, cook meat and poultry well and avoid raw milk and dairy products.