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Hazardous to Your Health

Adventure Travel

WebMD Feature
Reviewed by Gary D. Vogin, MD

Vacations used to mean crowding the kids into the family sedan and heading for the closest national park, or perhaps boarding a jet for a trip-of-a-lifetime flight to Europe to pose in front of the Eiffel Tower. But in increasing numbers, Americans are giving new meaning to the phrase "get away from it all." Many have forsaken the traditional sightseeing holidays and have turned instead to the booming adventure travel or ecotourism industry.

In Walter Mittyesque style, they're heading for Africa, Asia, and South America to shoot roaring rapids, crawl through daunting caves, or scale mountain summits. In some cases, however, they're also contracting potentially serious illnesses with names they often can't pronounce.

Too often, people embark on these adventures unaware of the risks they might face with altitude sickness, for example, or infections with exotic organisms. "Ten years ago, the only people going to high altitudes were experienced mountaineers," says Fiona Bellis, MDBS, an emergency physician at Torbay Hospital in Torquay, England. "Now, just about anyone can go. And people are just not as well informed about the risks as you might expect."

At Emory University, infectious diseases specialist Phyllis Kozarsky, MD, is director of the TravelWell Clinic, and she stresses the importance of having a realistic view of your own capabilities for adventure travel. "So many people want to trek in Nepal," she says. "Some of them are of retirement age and have a long history of smoking, but still think they can easily climb to 14,000- to 18,000-foot elevations. They seem to have no concept that it's not going to be like traveling to Kansas City."

Altitude sickness is not only common among adventure travelers, but it is potentially fatal if it is not treated properly. It occurs most often at elevations above 8,000 to 10,000 feet, usually when a climber ascends too rapidly. As a decreased amount of oxygen reaches the brain, symptoms such as headaches, nausea, and fatigue can develop. In more serious cases, people may stumble and fall, become confused and irritable, and develop severe shortness of breath or a cough.

To complicate matters, the guides on these adventure trips can have varying degrees of experience and judgment. In just the past year, Bellis participated in mountain climbing expeditions in Tibet and Russia, and on both occasions, she treated fellow climbers who had developed moderate to severe altitude sickness. In each case, she recalls, the guides had exceeded the appropriate rate of ascent. Once, when a climber had become ill, the guide hesitated to order the proper procedure - an immediate descent from the mountain - to keep from spoiling the trip for the rest of the group.

"Generally, these guides are kind people who very much want to make sure that their groups have a good holiday," says Bellis. "They find themselves in the dilemma of needing to take one person down the mountain, which may mean the entire group has to descend as well."

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