Hazardous to Your Health
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."
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.