Altitude sickness deaths are rare in Colorado, UCHealth doctor says

Doctor calls into question post from Penn. mother
Altitude sickness deaths are rare in Colorado, UCHealth doctor says
Posted at 5:00 PM, Sep 02, 2017
and last updated 2017-09-02 19:00:43-04

DENVER -- After a Pennsylvania woman claimed on social media her young daughter died from altitude sickness while hiking in Colorado, Denver7 wanted to know more about the illness and its rare, but potentially deadly outcomes for people who live in the state and for those who are planning on visiting for a few days. 

What follows is a Q&A between Denver7 and Dr. Benjamin Honigman, the director of Altitude Medicine at UCHealth University of Colorado Hospital and Professor of Emergency Medicine at the Colorado School of Medicine. 

Editor's note: Before the conversation began, Dr. Honigman said it would be hard to determine whether Susanna Deforest did, in fact, die from altitude sickness as knowing the girl's history in Colorado would be important to effectively diagnose altitude sickness as a cause of death.  

This interview has been edited for length and clarity.

Denver7: How does altitude sickness develop in an individual? What are the signs one should look for? 

Dr. Honigman: People who come from sea-level altitudes, and even people from Denver, will get into trouble with altitude sickness. About 25 percent of individuals from out-of-state (and about 7 to 8 percent of people from Denver) will have mild-to-moderate cases characterized by headaches, difficulty sleeping, fatigue, mild dizziness and occasionally nausea. This is what's known as "acute mountain sickness." 

As it progresses, there's a worsening in headaches and vomiting, but in most cases people will adjust to the altitude and symptoms will disappear within 24 to 48 hours. 

It's not unusual for people from Denver to experience these symptoms. 

It's rare that these symptoms will worsen, but if they do after spending more than four days at elevations over 10,000 feet, a person will develop what doctors call cerebral edema, a buildup of fluids in the brain. In less than 1 percent of cases, this can progress to a potentially deadly condition known as high altitude cerebral edema (HACE). 

D7: What are some signs that hikers, campers or tourists in general should look out for?

Honigman: If early symptoms of headaches, difficulty sleeping, fatigue, mild dizziness and occasional nausea haven't improved, look for imbalance in walking -- that's the first sign that this has progressed to cerebral edema. It's recommended these people be brought down from the mountains as quickly as possible. 

There is another form of altitude sickness that people can develop at lower elevations -- between 8,000 to 10,000 feet -- called high altitude pulmonary edema (HAPE). 

Symptoms of HAPE will develop by about 2 or 3 days after being in the mountains and you should look for the following: Shortness of breath when a person is resting (either sleeping or just laying on the ground without having done extraneous physical activity). If you begin coughing for no apparent reason, you should worry about having water in the lungs. 

HAPE can be treated with oxygen and medicine and people can stay in the mountain resorts to receive this kind of care. If it's severe, however, people will be flown to Denver for medical care. 

Summit County sees between 200 to 300 HAPE cases a year.

About 15-20 years ago, there were several cases of people dying from HAPE that have since decreased significantly because people living in mountain communities recognize it quickly and treat it very well.

D7: What should a person due to prevent or alleviate these symptoms so they don't get worse?

Honigman: If have a milder form of the altitude sickness, make sure to stay hydrated and take ibuprofen to relieve headaches.

It's also good to take it easy for a day and to not put too much stress on your body until it adapts to the higher elevation. If you're going to the mountains, make sure to plan for a stay in Denver for a day so your body can adjust to the elevation. On the first day at higher elevations, don't exert yourself too much -- exercise can exacerbate symptoms. 

D7: What's the percentage of death cases from both HACE and HAPE? 

Honigman: The less than 1 percent of all cases from HACE and HAPE turn deadly. This is credited to the fact that people recognize warning signs early and ER in mountain resorts know how to respond when such cases arise. 

D7: What can contribute to altitude sickness? 

Honigman: Some of it is genetic. But you also have to taken into account the rate of ascent, the height of ascent, the amount of exercise being done, when you first arrived to the area. All of these can be contributing factors to altitude sickness. 

The Colorado School of Medicine began studying altitude illness since the 1960s, but the Altitude Medicine Clinic began in 2003. 

The Altitude Research Center is part of the Colorado School of Medicine. The Altitude Medicine Clinic is part of UC Health University of Colorado Hospital.