Fifteen Sikh pilgrims from Pakistan, part of a larger group of over 100 devotees, were airlifted from Hemkund Sahib in Uttarakhand after falling ill due to high altitude conditions. Hemkund Sahib, located at an elevation of around 16,000 feet in the Chamoli district, is a sacred site for Sikhs, attracting thousands of pilgrims annually. The high altitude, combined with the physical exertion required to reach the shrine, can pose significant health risks, particularly for individuals unaccustomed to such environments. 

The group had undertaken a 17-kilometre trek to the revered shrine when 15 members experienced altitude sickness and fatigue. Authorities quickly arranged a helicopter to airlift the sick pilgrims to Govindghat, where they received medical treatment. Fortunately, timely intervention helped prevent the situation from escalating.

This incident highlights the dangers of altitude sickness, a condition that can affect anyone ascending to high altitudes without proper acclimatization. Below, we explore altitude sickness in more detail, including its types, symptoms, risk factors, and treatments.

Understanding Altitude Sickness

Altitude sickness occurs when individuals ascend to high altitudes too quickly, giving their bodies insufficient time to adjust to the reduced oxygen levels in the air. As altitude increases, the atmospheric pressure decreases, meaning each breath contains less oxygen. This can lead to various symptoms, collectively known as altitude sickness or acute mountain sickness (AMS). While altitude sickness is generally mild, in more severe cases, it can result in life-threatening complications such as high-altitude pulmonary oedema (HAPE) or high-altitude cerebral oedema (HACE).

Types of Altitude Sickness

• Acute Mountain Sickness (AMS): This is the most common and mildest form of altitude sickness. It is typically characterized by symptoms like headaches, nausea, and fatigue.
• High-Altitude Pulmonary Edema (HAPE): This occurs when fluid builds up in the lungs, leading to difficulty breathing. HAPE is a medical emergency that requires immediate attention.
• High-Altitude Cerebral Edema (HACE): This is the most severe form of altitude sickness, where the brain swells due to the low oxygen levels. HACE can be fatal if not treated promptly.

Symptoms of Altitude Sickness

The symptoms of altitude sickness vary depending on the severity and how quickly an individual ascends. For AMS, the mildest form, symptoms usually appear within 24 hours of reaching a high altitude. Common signs include:

• Headache
• Nausea and vomiting
• Fatigue
• Loss of appetite
• Dizziness
• Difficulty sleeping

In more severe forms like HAPE or HACE, symptoms may take two to five days to manifest and can include:

• Shortness of breath, even at rest (a sign of HAPE)
• Confusion, lack of coordination, and difficulty walking (a sign of HACE)
• Coughing up blood or pink frothy sputum (HAPE)
• Blurred vision or hallucinations (HACE)

Risk Factors for Altitude Sickness

Certain factors can increase the risk of developing altitude sickness. These include:

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• Higher altitudes: The higher you go, the greater your risk of developing symptoms. Most cases of altitude sickness occur at elevations above 8,000 feet.
• Rapid ascent: Ascending too quickly, without allowing your body time to acclimatize, significantly increases the likelihood of altitude sickness. It’s recommended to ascend no more than 1,640 feet (500 meters) per day above 8,000 feet.
• Alcohol and medications: Consuming alcohol or using certain medications, especially sedatives, can make it harder for the body to adjust to lower oxygen levels.
• Previous history: If someone has experienced altitude sickness in the past, they are more likely to develop it again during future ascents.

Contrary to popular belief, being physically fit does not reduce the risk of altitude sickness. However, pre-existing conditions like chronic obstructive pulmonary disease (COPD) or anaemia can worsen symptoms if altitude sickness occurs.

Prevention and Treatment

The best way to prevent altitude sickness is through proper acclimatization. Allowing the body to adjust to higher altitudes gradually can help reduce the risk of severe symptoms. Here are key approaches to prevention and treatment:

• Acclimatization: This involves spending time at intermediate altitudes before ascending further. Gradual ascent gives the body time to produce more red blood cells, which helps transport oxygen more efficiently.
• Hydration and diet: Staying hydrated and avoiding alcohol and caffeine can help the body adapt better to high altitudes.
• Descend if necessary: If symptoms worsen, it’s critical to descend to a lower altitude to allow the body to recover. Even a small drop in elevation can significantly improve symptoms.
• Supplemental oxygen: In some cases, breathing supplemental oxygen can help alleviate symptoms. Portable oxygen tanks are often used during high-altitude treks.
• Medications: Certain medications, such as acetazolamide or dexamethasone, can help prevent or treat altitude sickness. These drugs help the body adjust more quickly and alleviate symptoms.

Bottomline

The airlifting of 15 Sikh pilgrims from Hemkund Sahib due to altitude sickness underscores the importance of understanding and preparing for the risks associated with high-altitude environments. Altitude sickness can affect anyone, regardless of physical fitness, and requires proper acclimatization and caution. By taking preventative measures and recognizing symptoms early, travellers can enjoy their journeys to high-altitude destinations safely.