by Diane Spicer
A common hiking illness list is a great tool to use as you prepare for a day hike or a backpacking trip.
It's important to know the likelihood of running into trouble on the trail!
So here is the list, arranged from most common to least likely.
1. Nausea, vomiting, diarrhea (N/V/D)
2. Allergies or reactions (pre-existing or contact with plant toxins)
3. Infections (urinary tract, flu, waterborne such as giardia, broken skin or wounds, respiratory such as common cold)
4. Respiratory illness (asthma attack)
5. Abdominal pain (appendicitis, food toxins, constipation, unknown)
6. Fatigue, exhaustion
7. Cardiac issues
8. Altitude related illness: HAPE, HACE
Did you notice that the first three hiking illness categories on the list (covering the majority of sickness a hiker will face on the trail) have something in common?
Symptoms like vomiting and diarrhea mean that your body is trying to rid itself of a poison or a troublesome microorganism.
The same goes for a skin rash, allergic reaction (sneezing, runny eyes, GI changes) or an infected wound (pus is a pile of dead white blood cells warriors).
So this list gives us an excellent clue about how to stay off the list:
Believe it or not, organizations collect detailed statistics on the most common complaints reported by hikers.
The National Outdoor Leadership School (NOLS) is a great example.
Download their free pdf report, written by the Wilderness Medicine Institute, entitled Evidence Informed Wilderness Medicine: What Really Happens Out There?
NOLS pulls together statistics from many sources, including hiker surveys, youth programs, government reports on national park incidents, SAR reports (Search And Rescue) and more.
Fascinating reading if the subject of hiking illness is important to you!
No medical advice about diagnosis or treatment is being given on this website.
Instead, let's focus on what you as a smart hiker can do to prevent hiking illness from setting up shop in your body.
You've got some great tools: mindfulness, planning, behavioral changes and smart decisions.
So let's put them to work to prevent you from coming down with hiking illness.
Plan to stay healthy on the trail (and stay off that list) with tips in these categories:
I am constantly
amazed grossed out by the lax hand hygiene practiced by both day hikers and backpackers.
Unwashed hands transmit pathogens (germs like bacteria and viruses) that are common in feces, respiratory secretions (coughs, sneezes, nose picking) and gastrointestinal secretions (saliva, vomit).
Here's the best thing you can do to keep yourself from getting sick on a hike:
Take scrupulous hiking hand hygiene seriously.
In fact, put together a hygiene kit and carry it in an outside pocket of your backpack, within easy reach, and use it after you defecate, pee, sneeze, or cough.
Before you put anything in your hands to your lips, or unscrew your water bottle/hydration pouch, or prepare and handle food, be sure your hands are clean.
That makes having a ready supply of these hand cleansing options:
Let's not be coy: female hikers pee and poop.
That's why we need to use a well stocked, easy to use bathroom hygiene kit each time we eliminate body wastes.
Peeing is straightforward, because urine from a healthy body is sterile, meaning you don't have to worry about it contaminating surface water or your hands.
Feces is a whole different universe, teeming with microbes that you don't want to introduce to your mucous membranes or gut.
Put together that bathroom hygiene kit, and even in the absence of a bathroom, use it.
My kit includes these items:
You can also carry your menstrual supplies in this kit, and dedicate a separate resealable bag to hold them.
Say what now?
Mucous membranes: the doorways into your bloodstream and within spitting distance (so to speak) of your internal organs.
Staying well hydrated (tips coming up) keeps those membranes in top shape to protect you.
Keeping your dirty fingers away from those membranes also helps you avoid hiking illness.
So if you're a nail biter or a cuticle chewer, or love to wipe sweat and bugs out of your eye area with your fingers, make a conscious choice to change your behavior on the trail.
Eating with dirty fingers allows microbes to bypass your natural defenses, depositing them into your digestive track where they can begin to multiple.
Intimate behaviors with your partner or yourself with dirty hands?
When you pass around a bag of trail mix or nuts, pour some into your (hopefully clean) hand rather than reaching in for a big, germy handful.
Don't be shy about requesting a "pour" rule on any hike or backpacking trip.
It's one of the first things I bring up in a group setting as a health precaution.
Sharing beverages out of a common flask or bottle?
If you're having vague symptoms involving your gut, like gas or pressure, ask yourself:
Have you introduced anything new or different into your hiking menu?
It could be that you're having a reaction to something in the food you've eaten.
The days of drinking out of a seemingly pristine surface water source are over, unless you are in a very special place such as the Arctic or seldom traveled routes with access to glacial melt.
To protect yourself from organisms that would love to use your gut as real estate, treat all water as suspect, and have a water treatment plan - plus the gear to carry it through.
Waterborne illness like giardiasis is something you do not want to face, as it will impede your ability to get back to the trailhead.
Be mindful when you take out your backpacking stove.
This sounds like common sense because it is:
Remove tripping hazards like rocks or hiking gear from the area where you're going to prepare and consume your food.
Make sure your backpacking stove is the right one for your needs, and that your control over the flame is exactly what you want.
Anyone preparing food (including you on a solo hike) should deploy the hand hygiene tips above.
And anyone consuming food should also have clean hands, to prevent self inoculation with microorganisms found in soil, water, human and animal sources.
Don't let flies buzz around your uncleaned pots and dishes. Force yourself to get those dishes done ASAP.
Use an efficient and effective system for washing dishes, like this one.
Dayhikers, don't think you're immune to food borne illness.
Field guides are indispensable for so many reasons.
For the topic of hiking illness, these fact filled books are going to prevent you from contacting plants with oils and toxins that will damage your skin.
You probably already know the triad of "poisons":
But can you identify them?
Make sure you glance at the plants at your pee spot before you squat.
Look at what you're putting your hands and legs on during a snack break.
Don't burn dried plant material entangled with deadwood without identifying it first.
Plan ahead in case your canine trail buddy or hiking group runs into plant poisons.
Don't work against yourself by becoming physically or mentally depleted. That's when pathogens can gain the upper hand to create a hiking illness in your body.
Hydrate regularly, using these tips.
Eat often, using these trail snacks rather than candy bars.
Take a break when you feel stressed, hungry, tired, upset or confused.
If you're feeling depleted and can take a zero day (rest day, lounging day, layover, whatever you want to call it), do it!
More self care tips for hikers can be found here!
Many females have already "enjoyed" the experience of a urinary tract infection (UTI).
So you may already be on the "let's skip that party" wavelength with me.
Here's something to note:
You are in control of your time on the trail.
If you have to pee, take time to do it before it becomes urgent.
Got too many miles to cover and can't be bothered to squat?
You also control your hydration level.
This in turn dictates how often you need a pee stop: water in wants to come out, sooner rather than later.
If you strictly regulate your water intake to make needing to pee less likely on the trail, consider this: concentrated urine also makes the possibility of a UTI increase.
And dehydration is no friend to a hiker's cellls, leading to headaches, constipation, sore muscles and lack of energy.
So please drink often on the trail!
Just as with UTIs, many female hikers have dealt with the invasion of the yeast prior to hitting the trail.
On a backpacking trip, you're going to experience a dip in the strength of your immune system as you challenge your body day after day, eating different food and immersing yourself in trail dirt.
This is especially true if you're diabetic, pregnant, or taking antibiotics.
But there are a few things you can do to keep yourself out of yeasty trouble.
If you already know that you're prone to yeast infections, don't forget to tuck an over-the-counter anti-fungal cream or ointment into your first aid kit.
From personal experience, I have high motivation to warn you off going to high altitudes when your ears are bothering you.
It's better to reschedule your hiking plans for when your ears are back to normal, than to contend with the discomfort of ruptured eardrums or massive infection.
Use these tips to differentiate between inner ear infections and middle ear infections.
Anything that breaks your skin creates a highway for pathogens.
Take the time to cleanse and cover broken skin, rather than hiking "just one more mile" with an open blister.
If you burn or scald your skin, whether from ultraviolet radiation or the cooking stove, focus your attention of what you have in your first aid kit to address the problem (tips below).
Insect bites can become infected if you scratch them with dirty fingernails, so keep your nails as short and as clean as possible.
Carry an oil based, unscented skin lotion to prevent cracked cuticles and dry skin patches. I like Aveeno for this purpose.
Yes, there's a major amount of suckage coming your way when you experience body aches, chills, vomiting and all the rest of the "flu like" package on a hike or backpacking trip.
So you deserve some sympathy.
You also deserve to make the decision: try to hike out under reduced power, or lay down and let nature take its course.
Only you know your usual reaction to this type of infection, and only you can gauge how long it might take to feel strong enough to get your hiking boots and backpack on again.
Your hiking buddies will need to support you, regardless of which direction you're headed, by encouraging you to:
If your first aid kit includes over-the-counter remedies to suppress your symptoms, now is the time to consider using them if you want to keep hiking.
Don't be shy about asking for what you need.
And remember, even a few of the astronauts were plagued with the flu while encapsulated in a tin can (viruses love to travel), and they managed to complete their missions.
This too shall pass :/
And what if it's not the run-of-the-mill flu?
You may be looking at a longer course of illness that will require some outside help to deal with, either rescue or intervention.
It's important to note that your medical history comes right along with you on every hike, so pre-existing conditions are a responsibility you need to take seriously.
Be a good trail buddy by alerting your companions to any medical issues you have that could make illness more likely, such as asthma, diabetes or food sensitivity.
This puts extra pressure on campsites and hikers: crowded, stressed conditions create breeding grounds for infectious hiking illness such as norovirus and hepatitis.
Think strategically about your surface water sources, camp kitchen location, and sleeping spot.
Many other hikers have spit, peed, pooped, thrown up and had sex right where you're making camp.
It's in your best interest to take all of the precautions we've just discussed, beginning with impeccable hand hygiene.
And please use the strongest water treatment approaches to eliminating viruses: boil your water for several minutes, or use a filter with a tiny pore size.
That hackneyed phrase applies to hiking illness as well as outdoor navigation and trail techniques, but I find it to be especially useful as a mechanism to prevent hiking illness and injuries.
So I implore you to carve out some time to get educated about what hiking illness looks and feels like, and learn how you can deal with getting sick on a hike.
It's better to have a plan and never use it, than to need one and not have a clue - on top of feeling sick. Don't do that to yourself!
The REI Co-op website is a good source of knowledge for hikers.
It's great to have a first aid kit in your backpack, but do you know how and when to use everything in it?
Learn how to deal with your own solo hiking illness as well as how to be there for your hiking buddies when they suffer abdominal pain, infections or allergies.
REI Co-op is a great source for low key, informative and inexpensive classes, including this one:
And this one: Preparing for the Unexpected - Outdoor Emergency Basics.
That's a smart strategy, dear hiker.
You want to hike, not huddle in a whimpering heap beside the trail.
Use the proactive tips on this page to keep yourself strong (and upright).
Hiking Illness Any Hiker May Face
About the author
Diane is the founder of Hiking For Her.
She's been on a hiking trail somewhere in the world for 5+ decades & loves to share her best hiking tips right here.
All rights reserved.
Photo credits: All photos on this website were taken by David Midkiff or Diane Spicer except where noted.
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