“Traveling to High Altitude Destinations in South America: A survey on pre-travel preparation and acute mountain sickness in Cusco-Peru (3,310 m)”
Miguel M. Cabada, M.D.
Graduate Student, Clinical Science Program
Thursday, April 14
1.104 Ewing Hall
Abstract: The epidemiology of acute mountain sickness among regular tourists visiting high altitude destinations in South America is largely unknown. Preliminary data suggest that travelers to Cusco-Peru (3,310 m) are poorly prepared to avoid acute mountain sickness. A survey was design to study the epidemiology, pre-travel preparation, and impact of acute mountain sickness in travelers visiting Cusco. Foreign travelers, ≥ 18 years of age that stayed in Cusco ≤15 days were invited to participate. A convenience sample of 991 departing travelers was obtained at Cusco’s International Airport during June 2010. The Lake Louise Consensus score were used to assess the prevalence of acute mountain sickness and its severity. The median age of the participants was 32 years (IQR 25 – 49), 55.5% were female, 86.5% had higher education, 86.7% were traveling for tourism, and the main countries of origin were United States (47.7%) and England (8.1%). Most travelers (76.8%) flew from sea level to Cusco and 30.7% visited high altitude in the previous 2 months. Twenty nine percent received professional pre-travel advice about acute mountain sickness, 19% recalled receiving advice on acetazolamide use, and 16.4% used it. Frequent preventive measures were using coca leaf products (62.3%) and limiting physical activity (39.1%). Acute mountain sickness was reported by 47% of the participants and 16% reported severe disease. Twenty percent of travelers with acute mountain sickness altered their travel plans. In the multivariate analysis those older than 60 years, visiting high altitude in the recent past, visiting lower altitude cities during the same trip and using acetazolamide prophylaxis were less likely to have acute mountain sickness. Those using coca leaf products for prophylaxis and limiting their physical activity were more likely to have acute mountain sickness. This condition was common among the participants and had a significant impact on travel plans. Pre-travel preparation and healthcare seeking behavior were alarmingly inadequate. While acetazolamide prophylaxis was largely underutilized, coca leaf products were widely accepted but users were more likely to have acute mountain sickness.