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Hazardous to Your Health

Adventure Travel

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If the high altitudes of some adventure travel don't get you, the infections might. Diseases with names such as leishmaniasis (caused by sand fly bites), and leptospirosis and schistosomiasis (both related to contaminated water) can be contracted by tourists in remote locales.

In one of the largest recorded recent outbreaks, about half of more than 150 participants in a multisport expedition called Eco-Challenge-Sabah 2000 in Malaysian Borneo contracted leptospirosis, developing symptoms such as fever, headaches, chills, and muscle aches. Investigators at the CDC concluded that these individuals, who participated in several grueling days of canoe paddling, open water swimming, and mountain biking, may have become infected while swimming or paddling in the Segama River, and inadvertently swallowing water contaminated by Leptospira organisms from the urine of infected animals. If untreated with antibiotics (such as doxycycline), leptospirosis can lead to kidney damage, liver failure, meningitis, and in rare cases, death.

According to Kozarsky, president-elect of the International Society of Travel Medicine (ISTM), there have been recent outbreaks of diseases such as schistosomiasis in people who have rafted down the rivers in Ethiopia, and histoplasmosis (a fungal infection) in groups who have gone into caves in Nicaragua. "None of these people was told ahead of time that there might be health risks," she says.

Participants in adventure sports need to keep in mind that if a health problem develops, they can't dial 911 and summon immediate medical help. "The last thing I want to do is limit the number of people going to these amazing, beautiful places," says Bellis, who wrote about her adventure travel experiences in the British Medical Journal in April 2002. "But it concerns me that many people do not appreciate what the risks are and how remote they are from help if a problem should arise."

Before embarking on an adventure holiday to unfamiliar regions, Kozarsky recommends visiting a travel medicine clinic and consulting with a physician who stays up to date on the health risks of particular areas and how to minimize them. ISTM maintains a list of these clinics on its web site (www.istm.org).

General guidelines for reducing your risk of altitude sickness include the following:

  • At high altitudes, ascend slowly and sleep at a lower elevation, says Kozarsky.
  • Drink liquids frequently to keep well hydrated.
  • Talk to your doctor about taking a prescription drug called acetazolamide (Diamox), which can help you acclimate to high altitudes; it is also used as a treatment for altitude sickness.

To minimize your risk of being infected by waterborne organisms, the American College of Emergency Medicine provides these suggestions:

  • Do not swim in polluted lakes or streams (indications of pollution include floating debris and dead fish).
  • Do not swallow water during swimming.
  • Wear nose plugs, ear plugs, and goggles while swimming.
  • Wash cuts and scrapes with clean water after swimming.
  • Shower before and after swimming.

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