Altitude illness is a condition which occurs in many travelers making rapid ascents to high altitudes. It is commonly referred to as acute mountain sickness (AMS). It most often occurs at altitudes of 3,000 meters (approximately 10,000 feet) or more. In some individuals, it has been reported as low as 2,500 meters (8,000 feet).
We suspect that altitude illness is caused by the body's reaction to lower levels of oxygen found at high altitudes. The disease may occur several hours to days after ascending to high altitudes. Symptoms range from mild to severe.
Classic, high risk areas of the world for altitude illness include any mountain range over 10,000 feet, such as the Alps, Andes, or Himalayas. In addition, travelers to areas of North American, East Africa, and the polar regions are at risk.
Altitude illness can range from mild to severe.
The last group of symptoms may represent fluid accumulation in the brain (high altitude cerebral edema) or lungs (high altitude pulmonary edema). In these severe cases, the disease can be fatal if not treated rapidly and requires descent to lower altitudes. Luckily, in most travelers, altitude illness is mild and does not become severe.
Asthma does not increase the risk of altitude illness. In fact, people with asthma often do well at altitude since there is less pollution in the air.
The best prevention is slow ascent. In general, start with a 2-4 stay at an altitude of 8,000-10,000 feet. This should be followed by a slow ascent of altitudes of no more than 1,000 feet (300 meters) per day about 10,000 feet. Upon arrival at altitude, you should avoid strenuous activity until you acclimate.
Maintain fluid intake to avoid dehydration and follow the maxim, "climb high and sleep low." Avoid alcohol, cigarettes and sedatives (including narcotics).
The active ingredient in coca leaves is a mild stimulant that may help you stay alert and hydrated. This may make you feel better at altitude. Unfortunately, it does not prevent altitude illness.
It is unknown whether these two medications are effective in preventing altitude sickness, and therefore, their use is not recommended.
Physical conditioning does not protect against altitude illness. Susceptibility is based on your body's response to altitude and is not reflective of aerobic capacity.
If slow ascent is not possible or if you have a history of recurrent altitude illness, preventive medications may be needed. An example is Mt. Kilimanjaro (19,340 feet), which is often climbed in less than seven days.
The drug of choice to prevent altitude illness is acetazolamide. Take this medication 24 hours before ascent above 10,000 feet through 24-48 hours after you reach peak altitude. Avoid this medication if you have a history of sulfa antibiotic allergy, liver or kidney disease, or severe lung disease. Acetazolamide may cause tingling of the lips, fingers and toes, frequent urination, and a metallic taste with carbonated beverages.
If you cannot take acetazolamide, dexamethasone can be used. If you've had adverse reactions to steroids or have diabetes, this drug may not be safe for you. Dexamethasone can cause headaches, nausea, dizziness, abdominal pain, and can suppress your immune function if used over a long period of time.
If symptoms of acute mountain sickness develop, you should stop your ascent, rest and get adequate fluids and calories. If altitude illness symptoms worsen, rapid descent to lower altitudes should begin as soon as possible. You should also see a medical professional.
Oxygen, use of hyperbaric chambers and medications may be needed.
Traveler's diarrhea is the most common infectious disease experienced by international travelers. It can be caused by bacteria (most common), viruses or parasites that have been ingested through contaminated food or drink. Traveler's diarrhea can be mild to extreme in severity.
Remember: boil it, cook it, peel it, or forget it! In other words, if you don't boil, cook, or peel your food, you could get sick.
Other prevention tips include:
Traveler's diarrhea can range from mild to severe. Treatment varies based on severity.
Mild traveler's diarrhea is characterized by 3-4 unformed stools in 24 hours with mild cramping.
Symptoms of moderate traveler's diarrhea include increased frequency of unformed bowel movements with one or more of the following: Fever up to 101° F, abdominal pain, nausea or vomiting.
Severe traveler's diarrhea is moderate diarrhea with increased bowel movements and all of the other symptoms. You can take antibiotics if you have severe diarrhea, but if symptoms worsen (increased abdominal pain, inability to drink fluids, or blood diarrhea), seek medical care. You may have giardia or amoebiasis.
Young children (under age 5) are particularly susceptible to becoming dehydrated from diarrhea. Do not use loperamine (Imodium AD™) in children.
If a breastfeeding infant has diarrhea, continue breastfeeding. An infant or toddler should have at least one wet diaper every 4-6 hours. If there is a longer period between wet diapers, the child needs more fluids and should be seen by a health care provider. Parents and guardians should have a low threshold for seeking medical help if a child in their care experiences vomiting and diarrhea.
Because several weeks may be required to complete a needed vaccine series, we recommend you come in for the initial appointment at least 4-6 weeks before your departure date. You should telephone for an appointment two weeks before that, if possible. When this is not possible, we will meet your travel health needs as completely as the time we have allows.
Before you travel or study abroad it’s important that you understand possible risks to your health and take appropriate precautions specific to your destination overseas. You can schedule a travel consultation at the UW Medicine Travel Clinic Hall Health Center prior to your study abroad program or any other world travel. Our travel health experts can inform you about:
Travel consultations at Hall Health Center are fully covered by most insurance plans including Premera Lifewise (SHIP and GAIP).
Please note that SHIP will no longer be offered starting Fall Quarter of 2015. Click here for more information.
Many insurance plans now also cover vaccines. For example, Premera Lifewise may cover the following immunizations:
Please contact your individual insurance plan to confirm travel consultation and immunization coverage prior to making an appointment.
Call (206) 685-1060 to schedule a travel consultation at Hall Health Center.
For more information about study abroad, see the International Programs & Exchanges website.
You may be at risk for chikungunya fever, a mosquito-borne ailment that causes high fever, joint pain and headaches. If you are planning a trip to the Caribbean, read more about chikunguyna fever.
Before you travel or study abroad it is important that you understand possible risks to your health. We recommend that you take appropriate precautions specific to your destination overseas. Read more here or check out the booklet co-authored by Travel Clinic Director Anne Terry, The Guide to Healthy Travel.
We recommend that you call us six weeks in advance of traveling for an appointment and immunizations. It may take several weeks to complete a needed vaccine series.
During your appointment, you and your provider will discuss various travel issues and suggested medicines.
During a typical pre-travel consultation, the following issues related to type of travel and destination are discussed.