Wilderness Medical Society snowmass 2005 Page 378
Abstract Presentations at the 2005 Wilderness Medical Society Meeting, Snowmass,
Colorado, July 23 to 27, 2005
Poster Presentation
The Epidemiology of Morbidity on Expeditions
Sean T Hudson MBBS. MSc. Caroline J Knox MBBS MSc, Neil Dignon MBBS BSc
Denny Levett MBBS PhD, Edward Gamble MBBS BSc
Expedition Medicine Ltd
Across the Divide Expeditions
Introduction: In 2003 one of the largest expedition companies in the UK ran 42
expeditions to 15 countries, involving 1452 people (median length 10 days). Each person
filled in a pre-expedition medical questionnaire. A doctor accompanied all trips and all
medical incidents were recorded.
Objective: The aim was to determine the incidence and nature of morbidity on short
adventurous expeditions.
Methods: A single observer conducted a retrospective analysis of the medical records.
1452 individuals participated in 42 expeditions during 2003. 21 expeditions reported no
incidents requiring medical intervention. The remaining 21 expeditions reported a total of
84 incidents (5% overall incidence of a medical incident). Of these 7 required evacuation
to a local medical facility and 3 more were repatriated to the UK. There were no
fatalities.
Results: Gastrointestinal illness was the most common disorder on expedition, causing
26% of all medical incidents (22 individuals), and affecting 28% of all expeditions. 5
required antiemetics and only 1 required IV fluids. None were evacuated.
Musculoskeletal injuries represented 15% of all reported incidents. All but one was a
lower limb injury. Other conditions included acute mountain sickness (12% of incidents),
dermatological conditions (10.7%), respiratory conditions (8%), heat/cold conditions
(8%). There was only 1 surgical condition (appendicitis). There were no tropical diseases,
psychiatric conditions or road traffic collisions. The commonest cause of evacuation was
respiratory illness (30% of evacuations).
Conclusions: For this cohort accidents were not a cause of morbidity on expedition. This
may be a manifestation of an increasing ratio of staff to participants, coupled with an
early- expedition briefing. The high proportion of gastrointestinal diseases could perhaps
be partially prevented with stricter public health regimes and participant education.
Altitude sickness may be minimized if guidelines regarding ascent to altitude and
acclimatization are followed. It is surprising that respiratory diseases were the
commonest cause of evacuation.
