Besides carrying the necessary medication prescribed by your physician and travel clinic, in our years of experience organizing treks, the following three are the most common illnesses acquired by travelers in Nepal for which you should carry medication:
- Diarrhoea: The organisms that cause diarrhoea are acquired from eating or drinking contaminated food or water. More than 80% of diarrhoea cases in Nepal are caused bacteria. Giardia – 12%, E histolytica – 1%, Gastrointestinal virus – 5% and Cyclospora are other causes. A bacterial diarrhoea can easily be shortened by antibiotic treatment. Bacterial diarrhoea is characterized by the sudden onset of relatively uncomfortable diarrhoea. This means you can recall the time of the day your illness began. In contrast, protozoal diarrhoea usually begins with just a few loose stools, making people wonder if they are getting sick. Diarrhoea treatments include the following:
- Bacterial diarrhoea – Norfloxacin (400 mg) or Ciprofloxacin (500 mg), both taken twice a day for one to two days. If the diarrhoea goes away quickly, no need to take further treatment. If it doesn’t, there is some other cause of diarrhoea present.
- Giardia – Tinidazole (2g) as a single dose each day for two days or albenazole (400 mg) once a day for seven days. The latter has fewer side effects.
- Respiratory infection:Many trips are ruined by severe respiratory infections. Virtually all respiratory infections begin as a common cold, caused by a virus. The symptoms consist of runny nose, congestion, sore throat and cough. The virus is picked up when you encounter people with colds, most likely at your lodge. Under normal circumstances the cold should last three to seven days and go away by itself. However, colds can lead to bacterial infections of the sinus (sinusitis), lungs (bronchitis) and ears (ear infections).
- Sinusitis – Any cold that is not getting better or, in fact, getting worse after seven days should be considered a possible sinus infection. Take Azithromycin (250 mg), two pills on the first day followed by one each morning for the next four days.
- Bronchitis and Pneumonia – Bronchitis is an infection of the breathing tubes in the lungs. Symptoms are progressively worse cough, accompanied by the production of greenish or yellowish mucus when you cough. Take Azithromycin (250 mg), two pills on the first day followed by one each morning for the next four days. A deep cough accompanied by high fever is pneumonia. Professional medical attention is required for Pneumonia.
- High altitude sickness:Most people are able to safely ascend up to 2,800 m (9,000 ft.) without suffering the effects of altitude sickness. If a person travels up to altitude more rapidly than her body can adjust, Acute Mountain Sickness (AMS) symptoms develop. Fluid accumulates in between the cells in the body and eventually collects where it can do the most harm. If ignored, the symptoms can occasionally progress to the more severe forms of altitude mountain sickness: High-altitude pulmonary edema and High-altitude cerebral edema.
- HAPE: With the onset of AMS, as fluid collects in the lungs, you become breathless more easily while walking, and eventually more breathless at rest. A cough begins, initially dry and irritative, but progressing to the production of pink, frothy sputum in its most severe form. The patient eventually drowns in this fluid if he or she doesn’t descend.
- HACE:When fluid collects in the brain, you develop a headache, loss of appetite, nausea, and sometimes vomiting. You become tired and progressively develop a problem with balance and coordination.
The best treatment for the two severe forms of altitude sickness is RAPID DESCENT. Pharmacological treatments include Acetazolamide (Diamox) for both prevention (125mg every 12 hours) and treatment (250mg every 12 hours) of Acute Mountain Sickness, Dexamethasone (4mg every six hours) for High-altitude cerebral edema and Nifedipine (10mg every eight hours) for High-altitude pulmonary edema. But with both HAPE and HACE, immediate descent is required.
All the above medications will be available in our first-aid kit.