Published online December 29, 2008
PEDIATRICS Vol. 123 No. 1 January 2009, pp. 1-5 (doi:10.1542/peds.2008-0200)

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ARTICLE

Prevalence and Time Course of Acute Mountain Sickness in Older Children and Adolescents After Rapid Ascent to 3450 Meters

Jonathan Bloch, MD^a, Hervé Duplain, MD^a, Stefano F. Rimoldi, MD^b, Thomas Stuber, MD^b, Susi Kriemler, MD^c, Yves Allemann, MD^b, Claudio Sartori, MD^a and Urs Scherrer, MD^a

^a Botnar Center for Extreme Medicine, Department of Internal Medicine, University Hospital, Lausanne, Switzerland
^b Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland
^c Institute of Exercise and Health Sciences, University of Basel, Basel, Switzerland

OBJECTIVE. Acute mountain sickness is a frequent and debilitating complication of high-altitude exposure, but there is little information on the prevalence and time course of acute mountain sickness in children and adolescents after rapid ascent by mechanical transportation to 3500 m, an altitude at which major tourist destinations are located throughout the world.

METHODS. We performed serial assessments of acute mountain sickness (Lake Louise scores) in 48 healthy nonacclimatized children and adolescents (mean ± SD age: 13.7 ± 0.3 years; 20 girls and 28 boys), with no previous high-altitude experience, 6, 18, and 42 hours after arrival at the Jungfraujoch high-altitude research station (3450 m), which was reached through a 2.5-hour train ascent.

RESULTS. We found that the overall prevalence of acute mountain sickness during the first 3 days at high altitude was 37.5%. Rates were similar for the 2 genders and decreased progressively during the stay (25% at 6 hours, 21% at 18 hours, and 8% at 42 hours). None of the subjects needed to be evacuated to lower altitude. Five subjects needed symptomatic treatment and responded well.

CONCLUSION. After rapid ascent to high altitude, the prevalence of acute mountain sickness in children and adolescents was relatively low; the clinical manifestations were benign and resolved rapidly. These findings suggest that, for the majority of healthy nonacclimatized children and adolescents, travel to 3500 m is safe and pharmacologic prophylaxis for acute mountain sickness is not needed.

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Key Words: acute mountain sickness • altitude • adolescents • prevalence

Abbreviations: AMS—acute mountain sickness

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Accepted Apr 4, 2008.

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Personal experience with AMS

Michael Cater, MD

Pediatrics Online, 21 Jan 2009 [Full text]