Altitude Sickness and Travel Insurance Back-up

March 27, 2024

One of the major benefits of travel insurance is the medical evacuation and emergency treatment it provides when you are caught out by an unanticipated medical event.  For some travellers, altitude sickness is one of those.

Altitude sickness is something that can start to affect travellers at heights of around 1500m-1700m but which has real impacts at locations 2500m above sea level.  At such altitudes, the air pressure is significantly lower than most of us are used to and there is less oxygen when we are breathing.  The body has to get used to this high altitude hypoxia (low oxygen) situation and normally takes 3-5 days to do so.  If it gets no opportunity to acclimatise, altitude sickness is a real risk and one that can quickly become life-threatening, unless action is taken.

Maccu Picchu by Adrian Pascal on Unsplash

Who might need to call on their travel insurance for altitude sickness assistance?

Whilst, typically, a standard travel insurance policy won’t cover you for hiking at heights above 1500m, (and Europesure will cover you up to a height of 4000m), you do not have to be tackling a mountain climb to suffer from altitude sickness.  Whilst it does affect a significant number of those heading to Everest Base Camp and can be very problematic for people climbing an ‘easier’ mountain such as Kilimanjaro, where a rapid ascent is possible, it can equally impact holidaymakers and winter sports enthusiasts.

Many of the former will have bought a ticket for travel to South America and to a country that boasts a part of the Andes range.  Anyone can be caught out by altitude sickness in this region.  The Altiplano of the Andes is Earth’s second highest  and most extensive plateau, coming only in second place to Tibet’s.  It covers Peru and Bolivia, in the main, but also extends northwards, to the countries of Ecuador and Colombia and southwards into Chile and Argentina.

Photo by Florian Delee on Unsplash

Bucket list locations and altitude sickness

Some of the places you may well have on your bucket list will be found in this geographical location, whether that is the Inca citadel of Machu Picchu (2400m), nestled in the Andes, or a city such as Quito (2850m), Cusco (3399m), Bogota (2625m) or La Paz (3869m).  The latter is the highest capital city in the world.

These landmarks and cities can be attractive places in their own right, as can those in which altitude sickness can also be a factor, such as Mexico City, despite this only being at 2240 metres above sea level.  Places in the vicinity of Mexico City, such as the Izta-Popo National Park, can be much higher, at 5426m.

Gap year travellers, journeying across South America, should be particularly alert to the dangers of altitude sickness, as they venture from city to city.

Breckenridge by Andrea Stark, on Unsplash

Winter sports resorts and altitude sickness

If you are a ski or snowsports enthusiast, you could also suffer ill health after arriving in a high-altitude ski resort.  This is the case, for instance, in Colorado’s ski resorts, including Aspen (2400m) and Breckenridge (3000-4000m).  The problem is not confined to North America, however.  Altitude sickness can also occur in the Swiss and French Alps, especially where rapid cable cars quickly take skiers up to the slopes.  Examples where this can be an issue include Aiguille du Midi (3842m) and Jungfraujoch (3454m).[1]

Other bucket list locations to note

Altitude sickness has also been experienced by those heading to much lower-lying resorts and you do not necessarily have to be skiing to have a problem. You could simply be trying to take in the spectacle of the Grand Canyon, for instance.  This is one of the highest national parks in the USA, with a North Rim elevation of 2400m but points at which the height above sea level is even higher.

Venture to discover Shangri-la City in China and you will find yourself at an altitude of 3160m and in the world’s 10thhighest city (of over 100,000 inhabitants).

Travelling to step in the footsteps of British Raj colonials in Shimla (2205m) might present an issue, or perhaps even exploring Santa Fe (2194m), or Flagstaff, Arizona (2106m), would see some symptoms presenting themselves.

Call for better travel advice about altitude sickness

In March 2023, the issue of altitude sickness was debated in the British Parliament, when one MP, Rob Roberts, cited the instance of his sister-in-law who had put Macchu Piccu on her bucket list and died in her sleep from altitude sickness (HAPE), whilst in Peru.  He also mentioned former Welsh rugby player and commentator, Eddie Butler, who died from altitude sickness when taking on a charity fundraising mission.[2]

The MP’s view was that more needed to be done on official FCO travel pages to make travellers aware of the symptoms and dangers of altitude sickness.

Photo by Rodrigo Gonzalez on Unsplash

What are the symptoms of altitude sickness?

Acute Mountain Sickness (AMS) can feel similar to a hangover, with a bad headache, nausea and tiredness. It may be accompanied by dizziness and fainting, nausea, loss of appetite and flu-like symptoms.  Sleep may be interrupted and sufferers may have irregular breathing patterns whilst sleeping.  Ignoring any of these symptoms can be dangerous, leading to the development of either High Altitude Cerebral Oedema (HACE) or High Altitude Pulmonary Oedema (HAPE).  Both of these can quickly result in death.

HACE is where brain swelling occurs, leaving the sufferer being confused and irrational and unable to walk in a straight line.  When suffering HAPE, fluid gathers in the lungs, leaving the sufferer extremely breathless even when resting, weak, suffering a fast pulse and often displaying bluish skin.

If suffering from AMS symptoms, the traveller should:

  • Immediately try to consult a doctor and advise your travel insurance provider of the situation
  • rest and not take on any strenuous activity
  • keep up a good level of hydration, drinking 4-5 litres of safe, clean water, to help with the blood’s oxygen saturation level
  • avoid alcohol, which can dehydrate the body and make matter worse
  • eat a light but high calorie diet 
  • add sea salt to food and drinks
  • get a good amount of sleep (7-9 hours), as this can increase blood flow and assist with oxygen in the cells.  
  • take painkillers, such as paracetamol or ibuprofen, for the headache. 

Remember that your travel insurer’s medical assistance team can liaise with local doctors and may well advise that you be immediately moved to a lower location (500m-1000m lower), or arrange that for you, by evacuating you from your current position.  They will also be able to speak to the local doctors in their language, to assess your situation and liaise with both you and any family back at home.  An air or road ambulance may be deployed to get you to safety, or back home, or transferred to a suitably equipped hospital locally.  

Please note that, whilst locals in South America recommend drinking Coca tea or Mate de Coca, there is no real evidence to show this combats altitude sickness.  

Photo by Joshua Sukoff on Unsplash

Preparing for altitude sickness

Flying straight to altitude from a sea level location is not advised.  If visiting a high-altitude city or landmark, the best advice is to ascend gradually, moving to higher altitudes over the course of several days.  There is good advice to be had in the “don’t go too high, too fast” rule.

If you are travelling to a high-altitude location, it is advisable to consult with a medic or travel clinic beforehand, who may recommend special medication to combat altitude sickness.

Anyone can suffer from altitude sickness, so do not feel immune just because you are physically fit or young and healthy.  Men tend to suffer more than women, particularly younger men, so being younger and healthier is not enough to prevent the issue.

Those who already have a pre-existing health condition affecting the heart or lungs, or related to diabetes, epilepsy or sickle cell, need to seek medical advice before even contemplating travelling to a high-altitude location.  They should also check the terms of their travel insurance policy, to assess whether it will cover their trip.  Anyone who is pregnant should also talk to a doctor before travelling to a location high above sea-level.

Other risks at altitude

Remember also that, at high altitudes, there could be great risk of sunburn and skin damage from UV rays, so apply a high-factor sunscreen and cover as much of the skin as possible with clothing.  Wear sunglasses with UV light filters and also use a sunblock for the lips, nose and ears.

Frostbite could be another issue in some locations, so make sure you have gloves, hats, socks and boots, wear goggles and change any wet gloves or socks very quickly.

Follow all of the advice and be very mindful of the symptoms and you should be able to enjoy your travels.  Just remember to act fast, if you suspect you or a fellow traveller has altitude sickness, and don’t delay in contacting a medical professional, as well as your travel insurance provider, if medical assistance or evacuation is required.

For the travel insurance policy that can provide medical assistance and emergency repatriation, should you need to call upon your cover, visit www.europesuretravelinsurance.com   Remember to check the policy terms and conditions carefully, to ensure you meet the criteria and also bear in mind that you must have cover in place before a medical incident or other eventuality occurs.  


[1] https://en.wikivoyage.org/wiki/Altitude_sickness

[2] https://hansard.parliament.uk/commons/2023-03-21/debates/AA0D04A9-4B1D-4790-9072-4857EC5CFC48/AltitudeSicknessTravelAdvice

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