Since few people have been to the height of Kilimanjaro, it is hard to know who may be affected. There are no specific factors such as age, sex, or physical condition that correlate with susceptibility to altitude sickness. Some people get it and some people don't - some people are more susceptible than others. Most people can go up to 2,438 meters with minimal effect – altitude sickness is more common above 3000 meters. If you haven't been to high altitude before, it's important to be cautious. If you have been at that altitude before with no problem, you can probably return to that altitude without problems as long as you are properly acclimatized.

There are different degrees in altitude sickness: mild, moderate and severe, each with typical symptoms.If you have symptoms of mild or moderate AMS (acute mountain sickness), it doesn't mean you have to give up the climb, but whoever suffers from severe altitude mountain sickness should immediately stop climbing and start to descent as soon as possible.

Symptoms of AMS (Acute Mountain Sickness)

• Headaches
• Nausea, vomiting
• Lost of appetite
• Insomnia / sleeplessness
• Dizziness, light headache ness, confusion
• Weakness, fatigue, heavy legs
• Slight swelling of hands and face
• Breathlessness and breathing irregularly
• Reduced urine output

Symptoms of HAPE (High Altitude Pulmonary Edema)

• Water in your lungs
• Increasing shortness of breath even at rest
• Severe cough – Dry / productive
• Very tired unusual fatigue while walking
• High pulse rate
• Blueness of face, lip, fingernails (that means the inability of transporting oxygen into the blood)

Symptoms of HACE (High Altitude Cerebral Edema)

• Water in the head
• Severe headache
• Vomiting
• Walking like an intoxicated
• Mental confusion / altered mental status
• Irritable – does not want to be bothered by other people
• Unconsciousness or coma

Diamox (it is now generally agreed) does reduce the symptoms of acute mountain sickness. However it does not prevent you getting altitude sickness - it only allow your body to acclimatise faster. Remember Diamox has a number of side effects. PLEASE try if before you climb. Golden rule; do not use anything on the mountain you hadn’t tried before. Please consult your doctor regarding the use of Diamox – only available on prescription.

How to try preventing Altitude Sickness on Kilimanjaro

• Hike slowly (the Kilimanjaro shuffle)

• No alcohol, sleeping pills and smoking
• Drink enough liquid (3-4 litres a day) to prevent dehydration
• Do not carry heavy daypacks (10-12 kgs)
• Climb higher, sleep lower
• Make use of Diamox (Please consult your doctor regarding the use of Diamox)

Please keep the following golden rules in mind:

• Before your trip, please refresh your knowledge about altitude sickness so that you can help yourself and others as well.
• If you feel any altitude symptoms – TELL SOMEBODY
• If you get mild altitude symptoms, stay at the same altitude until the symptoms are completely gone. Descend 100m or more if needed and retry if you do not feel any symptoms anymore
• If you have worsening symptoms, go down immediately.
• Do not climb Kilimanjaro without travel insurance (which includes evacuation)
• Even when loosing your appetite, it is of most importance that you eat to keep your strength

Fitness
Although a very fit person may be just as prone to AMS as an unfit one, the unfit is more likely to encounter worse symptoms of mild AMS. An overweight person needs more oxygen than a thin person. Fatigue, which is a common symptom of AMS, will be doubly felt if you are unfit or very overweight.

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