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Children needn't avoid altitude after mountain sickness

The best way to avoid mountain sickness is still to move from low altitudes to high altitudes slowly.

Children neednt avoid altitude after mountain sickness

Children who have gotten sick on high-altitude excursions don't need to stay away from those altitudes in the future or take drugs to prevent mountain sickness.

Acute mountain sickness (AMS), sometimes called altitude sickness, typically becomes a concern above about 8,000 feet, where there is less oxygen in the air than at lower altitudes - and less oxygen circulating in the blood of people not acclimated to the thinner air. That lack of oxygen can cause small amounts of fluid to leak out from the blood vessels in the brain, leading to symptoms such as headaches and nausea. But the symptoms rarely turn into anything more serious, and usually go away on their own within a day or two.

Although a history of previous AMS is commonly used for providing advice and recommending its prophylaxis during subsequent exposure, the intra-individual reproducibility of AMS during repeated high-altitude exposure has never been examined. Researchers from Switzerland took a group of 27 non-acclimatised children and teenagers and 29 adults - all of whom got regular exercise and weren't obese - on a train trip to the Jungfraujoch High Altitude Research Station at 11,300 feet in Bern, Switzerland. The train ride started at an altitude of less than 2,000 feet. The study participants spent 2 days and 2 nights at the research station, and took an easy hike on the second day. They followed the same itinerary again between 9 and 12 months later.

During both trips, researchers had participants fill in questionnaires about any symptoms they had related to high altitude. On the first trip, 18 of the adults and six of the children got sick due to the altitude change. The second time around, 14 of the 18 adults who got sick during the first trip got sick again, and no adults who hadn't been sick before had symptoms of mountain sickness. Only four children got sick on the second trip - none of them the same children who were ill on the first high-altitude excursion.

The findings show that parents can still take their children on high-altitude hiking or skiing trips if they've gotten sick before - maybe with some ibuprofen packed away just in case children get a headache again. They also suggest that children are less likely to get sick from altitude than adults - which is somewhat surprising. The researchers' best explanation for that finding was that children might have a different perception than adults of what it means to be sick. For example, adults might have been very bothered by a night of difficult sleeping due to the high altitude, while children forgot about sleeping problems that didn't slow them down - or were too excited during the adventure to sleep well anyway.

In adults, a history of AMS is highly predictable of the disease on subsequent exposure, whereas in children it has no predictive value. A history of AMS should not prompt physicians to advise against reexposure to high altitude or to prescribe drugs for its prophylaxis in children. Medications that encourage breathing can prevent symptoms of mountain sickness, and are still recommended for adults who have been sick before and are going back to high altitudes but some of those drugs, including certain types of steroids, have side effects and can be dangerous for children. Also, the best way to avoid mountain sickness is still to move from low altitudes to high altitudes slowly, and to sleep at a low altitude, if possible.
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