The Inca Trail ... Thoughts of Two
Travellers
Are you considering a trek in a developing country at
altitude?
This type of adventure is a must for some and the
experiences will be long remembered. Our goal as travel
medicine experts is to ensure you can go on such a trek,
stay healthy and remember the things you want to!
We arrived, after a short flight from Lima, at the
quite elevated city of Cusco, Peru, (3300m), for the
compulsory two day altitude acclimatisation. The
country, whilst in winter, was brown from horizon to
snow capped peak. Quite impressive I must say, and it
looked daunting from the air as we planned to cross 3-4
ridges up to 4200m high on foot over the coming days.
We were scheduled to sleep on consecutive nights at
3300m, 3600m and 2900m on the trail, so were concerned
re altitude sickness. We took Diamox but soon
discovered that of the other 14 tour members, no-one
else was. So much for freedom of information! I was
concerned I would get a headache, and was very relieved
that I did not ... hiking with a headache did not
appeal! Those who tried coca leaves noted a stimulant
effect, but it was short lived.
Quite a few of the group really struggled with the
fitness required (we were not exempt) and the
altitude. Headaches and nausea were common, and
by the end a lot of people were very very tired.
Sunburn and dehydration were also issues worth
remembering, and you have to be self sufficient. Water
can be bought most days for about $1.50 equiv for 600ml,
the boiled creek water is a cheaper but much less
palatable option.
The food provided to us by our tour company was
excellent. Of course we had village dogs helping us
to eat, and they roamed freely around the campsites!
It was difficult to know how many became unwell because
of the food. We carried food for three days without
refrigeration, so by day three the chances of "off" food
had to have increased. Some did fall ill with
diarrhoea and vomiting, in fact about half of the
group were affected at some time. There is a vaccine to
help prevent these types of illnesses which we had three
weeks before departure. And it is a drink! And, better
still, we did not get sick! The vaccine is not 100%,
but it did the trick for us. We were very thankful.
Fighting with your tent zip because of severe
precipitant nausea at 5am is one experience we heard
vividly ... need I say more.
The dogs were of concern. Any bite from one of these
animals could potentially be rabies inducing, and of
course rabies is fatal in every case. Having rabies
vaccination before venturing off the beaten track is
an excellent idea. Many trekkers seemed unaware of this
risk and were petting the animals with no regard for
there own safety! Getting to medical care after being
bitten was actually impossible ...
 By
the final day we were marching downhill into Machu
Picchu and the views were astounding. The thought of a
hot shower and a cold beer were taking cerebral space as
the altitude dropped off on day four. We were woken at
4.30am to start the process of brekky, packing and
walking to arrive at the "Sun Gate" by sunrise.
Magnificent, see picture!
Moral of the story ... Be Prepared! Seek medical
advice well before you travel! And in training,
carry a 25kg pack up some steep hills to get an idea
of what walking uphill at altitude is like!
Dr Brian Gilbert
Travel Bugs
TMA member Adelaide
Outbreak news
Rabies - South Africa,
KwaZulu-Natal, Limpop, Vietnam
South Africa, KwaZulu-Natal, Limpop. 40 deaths so
far this year.
There were 87 rabies deaths in 2007 in Vietnam. About
600,000 people are bitten by a (potentially) rabid
animal each year in Vietnam.
Rabies vaccination is available if spending prolonged
periods in Africa. Dogs, mongooses, jackals and foxes
seem to be the vectors.
Ebola Virus -
Democratic Republic of Congo
A new outbreak of Ebola Virus has occurred in
Democratic Republic of Congo, 100 cases of this highly
fatal disease. No vaccination or treatment is possible
so avoiding bodily fluids and close proximity to any
seriously ill person is advised.
 Yellow
fever outbreak in Howler Monkeys in Brazil!
These monkeys have been found dead in various places
recently in Brazil.
Yellow Fever Vaccination is usually a requirement for
travellers to Brazil. This latest outbreak in monkeys is
a timely reminder why this is a good idea!. Australian
Immigration will insist on seeing proof of vaccination
when you return to our shores so do not risk this fatal
disease! Carried by mosquitoes, if the disease makes it
over to Australia it would become entrenched here, worst
case wiping out most of the populations in tropical
parts!
West Nile Virus
West Nile Virus is normally present in USA. This
debilitating virus is now also present in Israel.
Mosquito avoidance measures are all that travellers can
do. Recovery is fortunately the usual outcome.
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The Travel Medicine Alliance