Morbidity Among Athletes Presenting for Medical Care During 3 Iterations of an Ultratrail Race in the Himalayas

Wilderness Environ Med. 2020 Dec;31(4):437-440. doi: 10.1016/j.wem.2020.08.001. Epub 2020 Nov 7.

Abstract

Introduction: Although ultratrail races are increasing in popularity, there is a dearth of data regarding illnesses and medical care at these events. Data about injuries and illnesses for races taking place in the Himalayas, where the nearest medical facility can be hundreds of miles away, are even harder to find. This study aimed to describe the injuries and illnesses befalling the participants of a 7-stage 212 km (132 mi) trail race at high altitude.

Methods: Ethical approval was obtained from Nepal Research Health Council. A retrospective study of the record of medical encounters among the 100 participants competing in the Manaslu trail race in Nepal from 2014 to 2016 was performed. Diagnoses were classified into various categories. Informed consent was taken from all participants.

Results: Acute diarrhea was the most common ailment reported among the participants (18%), followed closely by musculoskeletal problems (17%). Altitude illness made up 6% of care provided. Approximately 35% of the athletes were using acetazolamide as prophylaxis for high altitude illnesses. The 1 case needing evacuation in the 3 iterations was high altitude pulmonary edema.

Conclusions: Ultratrail races at high altitude pose a challenge in terms of provision of medical care in a remote setting with limited resources. However, most of the illnesses are minor in nature and easily managed by the race doctor. Knowledge of common illnesses among travelers to the area can help aid in preparation and provision of proper care, especially in remote settings with limited resources.

Keywords: Nepal; athletic injuries; high altitude; trail running.

MeSH terms

  • Acetazolamide / administration & dosage
  • Acetazolamide / pharmacology
  • Adult
  • Altitude
  • Altitude Sickness / diagnosis*
  • Altitude Sickness / prevention & control
  • Altitude Sickness / therapy
  • Athletic Injuries*
  • Carbonic Anhydrase Inhibitors / administration & dosage
  • Carbonic Anhydrase Inhibitors / pharmacology
  • Diarrhea
  • Female
  • Humans
  • Hypertension, Pulmonary
  • Male
  • Marathon Running / injuries*
  • Nepal

Substances

  • Carbonic Anhydrase Inhibitors
  • Acetazolamide

Supplementary concepts

  • Pulmonary edema of mountaineers