Incidence of High Altitude Illness at Mt. Kailash Mansarovar (4500m), Tibet by Direct Helicopter Flight, A Cross-sectional Study

Abstract

Introduction Most of the pilgrims with their religious purpose would like to visit at Mt. Kailash Mansarovar 4500m or Gosainkund Lake (4300m). The high altitude illness is used to describe the cerebral and pulmonary syndromes that can develop in unacclimatized persons shortly after ascent to high altitude. High altitude illness usually occurs at altitude above 2500m. Sometime it may occur at the altitude of 1500m. This is mainly caused by hypoxia but is compounded by cold and with rapid ascent. Objectives To determine the incidence of HAI (High Altitude Illness) which include AMS (Acute Mountain Sickness), high altitude cerebral edema (HACE), high altitude pulmonary edema (HAPE) in pilgrims who fly directly then drive with a single overnight at Taklacoat and then Mt. Kailash Mansarovar lake in Tibet (4500m) during the 2 nd day and returning back to Kathmandu on the 3rd day. Methods Study of 37 pilgrims at Mt. Mansarovar with a close look at their clinical history, signs and symptoms and evaluated by the Lake Louise Consensus for AMS, HACE, HAPE. Results Out of 37 pilgrims, who flew directly from Kathmandu at 1300m to Simikot, Hilsa, Taklacoat and Mansarovar. 35.13 percent (13) of them developed high altitude illness. Among total 13 illnesses, 9(24.32%) were affected with AMS and 4(10.81%) with dangerous early HAPE. There was no gender difference for AMS and HAPE. Younger ages were more susceptible for AMS as well as those who took a holy dip in the lake. Such persons developed more chances of having HAPE. Using Lake Louise criteria showed that the incidence of AMS was higher and that of HAPE was lower among high altitude illness. Those who flew directly with a drive on the 2 nd day to Mansarovar Lake were found to have a higher incidence of AMS, but fewer cases of HAPE. These results were found in spite of taking prophylactic Acetazolamide and Dexamethasone. Younger and elderly age groups were found to be more susceptible. Conclusion There should be at least a 1-2 over night stay at an intermediate altitude, to help the body acclimatize and reduce unwanted medical problems. This way more and more elderly and younger pilgrim can visit such holy places.