Article Highlights:

  • Understanding Acute Mountain Sickness (AMS): Causes, symptoms, prevention, and available treatments.
  • HAPE and HACE: Recognizing and managing life-threatening high-altitude conditions for mountaineers and trekkers.
  • Common ailments like traveler’s diarrhea, food poisoning, gastroenteritis, and dehydration at high altitudes.
  • OTC and prescription remedies for AMS, HAPE, HACE and their availability/restrictions in the Seven Summits countries.
  • Allergic reactions and health risks linked to high-altitude trekking and mountaineering: what climbers need to know.

 

Mountaineering and trekking are exhilarating pursuits that challenge the mind and body. However, high-altitude activities bring specific health risks that climbers must recognize and manage. From Acute Mountain Sickness (AMS) to life-threatening conditions like HAPE (High Altitude Pulmonary Edema) and HACE (High Altitude Cerebral Edema), preparation and awareness are essential. These risks include common issues like traveler’s diarrhea, food poisoning, dehydration, and even allergic reactions.

For those seeking to conquer iconic peaks in the Seven Summits—including Everest in Nepal, Aconcagua in Argentina, and Kilimanjaro in Tanzania—knowing the remedies available and where they may be restricted, illegal, or unavailable.

 

Acute Mountain Sickness (AMS): The Basics

AMS, or altitude mountain sickness, occurs when the body fails to acclimate to reduced oxygen levels at higher altitudes. It typically strikes above 8,000 feet (2,400 meters) when climbers ascend too quickly. Symptoms vary but generally include:

  • Headache
  • Nausea and vomiting
  • Fatigue and dizziness
  • Difficulty sleeping
  • Loss of appetite

Preventing and Managing AMS

  • Prevention: Gradual ascent is the best prevention. Climbers should follow the “climb high, sleep low” principle, allowing the body time to acclimate.
  • OTC Medications: Over-the-counter (OTC) options like ibuprofen and acetaminophen can alleviate headaches caused by AMS.
  • Prescription Medications: The most common treatment for AMS is Acetazolamide (Diamox), a prescription diuretic that helps the body adjust to high altitudes by increasing respiration and reducing fluid buildup. It can be taken preventively or after symptoms appear.

 

HAPE and HACE: Recognizing Severe Altitude Sickness

While AMS is common and often mild, it can progress into two severe conditions:

  1. High Altitude Pulmonary Edema (HAPE):
    • Cause: Fluid buildup in the lungs due to low oxygen levels.
    • Symptoms: Shortness of breath, chest tightness, persistent cough, bluish lips or skin, and extreme fatigue.
    • Treatment: Immediate descent is critical. Supplemental oxygen and medications like Nifedipine (a prescription drug that reduces pulmonary pressure) are often used.

 

2. High Altitude Cerebral Edema (HACE):

    • Cause: Fluid swelling in the brain due to high-altitude exposure.
    • Symptoms: Severe headache, confusion, loss of coordination, hallucinations, and unconsciousness.
    • Treatment: Immediate descent and administration of Dexamethasone (a steroid used to reduce brain swelling) can be lifesaving. Supplemental oxygen is also crucial.

Both HAPE and HACE are medical emergencies that require swift action. Climbers should always carry a portable oxygen supply and be prepared immediately to descend if symptoms occur.

 

Common Ailments at High Altitudes

High-altitude trekking and mountaineering increase the risk of several other health issues:

1. Traveler’s Diarrhea and Gastrointestinal Issues:

    • Food poisoning and gastroenteritis are common, especially in regions with poor food safety standards.
    • Contaminated water sources can also lead to traveler’s diarrhea and waterborne diseases like typhoid and hepatitis A and B.
    • Prevention: Drink bottled or purified water, avoid raw foods, and carry OTC treatments like Loperamide (Imodium) and oral rehydration salts (ORS).

 

2. Dehydration:

    • Dry mountain air and increased physical exertion can quickly lead to dehydration, exacerbating altitude sickness symptoms.
    • Solution: Maintain regular water intake and use electrolyte solutions to replenish lost minerals.

3. Allergic Reactions:

    • Individuals may experience heightened allergies triggered by dry air, plant pollen, or dust at high altitudes.
    • OTC antihistamines like Cetirizine (Zyrtec) or Diphenhydramine (Benadryl) can help manage symptoms.

 

Availability of Medications in Seven Summits Countries

Travelers should know that access to AMS treatments and other remedies varies depending on the destination:

  1. Nepal (Mount Everest): AMS medications like Acetazolamide (Diamox) are widely available in Kathmandu and base camps. However, climbers should bring their supply, as remote regions may lack reliable pharmacies.
  2. Argentina (Aconcagua): OTC medications and prescriptions are generally available in major cities, but travelers are advised to carry their own supplies for remote expeditions.
  3. Russia (Mount Elbrus): Prescription drugs like Diamox and Dexamethasone are available but may require proper documentation. Language barriers can complicate access.
  4. Tanzania (Kilimanjaro): High-altitude treatments are limited, so trekkers should bring all necessary medications. Hospitals are sparse outside of major cities.
  5. USA (Denali): AMS treatments are readily accessible in the U.S., but climbers must consult healthcare providers for prescriptions.
  6. Antarctica (Vinson Massif): Medical facilities are virtually nonexistent. Climbers must be fully self-sufficient with medications and emergency plans.
  7. Oceania (Carstensz Pyramid): Papua, Indonesia’s access to medical facilities and medications is extremely limited. Pre-travel preparation is essential.

 

Voluntary Preparedness: Health Kits and Prevention

Every mountaineer or trekker should prepare a high-altitude survival kit, including:

  • Acetazolamide (Diamox) for AMS
  • Nifedipine for HAPE
  • Dexamethasone for HACE
  • Ibuprofen and antihistamines
  • Oral rehydration salts and electrolyte solutions
  • Water purification tablets

Pre-travel vaccinations for typhoid and hepatitis are highly recommended, particularly for remote areas.

 

High-Altitude Awareness Is Key to Survival

Trekking and mountaineering at high altitudes are life-changing experiences but have significant health risks. Understanding AMS, HAPE, and HACE, as well as their symptoms and treatments, can save lives. Furthermore, addressing dehydration, allergies, and gastrointestinal illnesses ensures a safer journey.

With varying medication access across the Seven Summits countries, climbers must plan meticulously and carry essential supplies. By prioritizing prevention and preparedness, mountaineers can focus on conquering peaks and making memories while safeguarding their health.

 

The Global Rescue Connection: High-Altitude Rescues

Participation in mountaineering, trekking, and other high-altitude activities has increased rapidly in recent years. Global Rescue is expanding and enhancing its services for this community by increasing its capabilities to provide emergency services in more regions, committing to longer deployments of its medical operations personnel, and extending its in-field rescue operational durations.

Implementing the High-Altitude Evacuation Package and making it available to members 16 years of age and older who travel above 15,000 feet (4,600 meters) during any part of their trip (excluding airplane travel) and who require emergency transport due to injury or illness enables us to continue enhancing our current service capabilities for the climbing and trekking community worldwide.

Members can add a High-Altitude Evacuation Package to their membership by contacting our member services team. Please note that the package must be purchased before an illness or injury occurs during a high-altitude trip and is limited to Global Rescue members who are 16 years of age or older.