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Acute altitude sickness

Acute altitude sickness is caused by insufficient adaptation to the low oxygen pressure at high altitude. Any traveller can encounter acute altitude sickness when staying for 4 to 8 hours above 2000 meters. There is a 25% chance of getting altitude sickness when staying in areas above 3500 – 4000 m, and 45 % chance in areas above 5000 m. People who fly directly to high areas, such as Cusco (Peru, 3225 m), La Paz (Bolivia, 3658-4018 m), Lhasa (Tibet, 3685 m), Leh (Ladakh, 3505 m) etc. should certainly be aware of the possibility of acute altitude sickness.

Sensitivity to acute altitude sickness varies from individual to individual, and is not dependent on the degree of physical fitness, nor on the previous number of visits to high altitude areas. The individual sensitivity is reasonably constant: if there were problems on a previous visit, these are likely to return on subsequent trips. Patients with heart and lung diseases run a greater risk at high altitude. 

The symptoms can begin within 3 days after arrival and may continue for 2-5 days when remaining at the same altitude rather than move higher. Acute altitude sickness: At first the symptoms of acute altitude sickness are mild: the patient complains of headache, fatigue, lack of appetite, nausea, insomnia, dizziness and general malaise. The severity of symptoms depends mainly on the altitude and the number of days having acclimatised at about 2000m, the effort expended in getting there and whether the visitor stays overnight. The complaints can get worse (vomiting, dry cough and shortness of breath in rest, “it becomes impossible to finish a sentence without gasping for breath”), and can in some cases develop into a life-threatening condition (this seldom occurs below 3000 m) due to high altitude lung oedema (fluid in the vesicles of the lung, with a worsening dry cough, fever and shortness of breath even when resting) and/or high altitude cerebral oedema (swelling of the brain, with headaches that no longer respond to analgesics, unsteady gait, increasing vomiting and gradual loss of consciousness). 

Prevention is important and consists of the following measures:

  • Stay a few days at an intermediate altitude (between 1500 and 2500 m); the heartbeat-rate (pulse rate) when resting must stay under 100 beats per minute. During the day you can climb higher to encourage acclimatisation.
  • Make a flexible travelling schedule with extra resting days once you are above 3000 meter.
  • Avoid sleeping pills and alcohol abuse.
  • An adequate fluid intake; the urine should remain clear!) is absolutely necessary, even if you do not feel thirsty, as fluid loss via respiration increases substantially (e.g. through hyperventilation in a dry environment with a low atmospheric pressure)

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