What to do if you get sick while hiking


Do you dream of hitting the trail for a long, really long, hike? In Ask a hiker, Liz “Snorkel” Thomas, a record long distance hiker, answers your burning questions on how to do it.

Dear Snorkel,

I’m quitting my job and going for my first hike next spring, and I’m afraid of getting sick on the trails. I will be away from my family, who I normally rely on to bring me soup and help me out when I am not feeling well. What advice do you have for what to do if I should contract an illness while hiking?

Soon called in case of illness

Dear call,

“What should I do if I get sick” is a common concern among hikers, especially in recent years, for obvious reasons. It’s no fun being sick, and it’s even worse when you’re away from central heating, cans of chicken soup, comfy beds, and loved ones who can take care of you.

By far the most common illnesses that occur on the trails are linked to 1) food poisoning, usually caused by something you eat in town 2) Giardia, often due to poor hygiene and, to a lesser extent, to contaminated water 3) other illnesses, such as colds, which are passed from hiker to hiker.

It’s cliché, but the first line of defense is prevention. Before leaving, part of your pre-hike preparation should be figuring out what types of benefits your health plan might offer for remote service, such as telemedicine. Checking with your insurance is also helpful in case you need to see an off-grid doctor or go to the hospital during your hike. Talk to your medical team before you go and develop a plan tailored to your known health concerns. As with all hikes, the more you know and have the skills to manage, the better equipped you will be for the unexpected.

Once on the trail prevention is simple: maintain good personal hygiene, always treat your water, and avoid sharing food or shaking hands with other hikers. Next-level prevention involves avoiding shelters, trail logs, or places like hostels where hikers congregate and where noroviruses and other germs can linger. Masking, especially in confined spaces, in vehicles, and indoors, will also go a long way in your safety, and making sure you are up to date with your vaccinations will help, too.

Hot liquids can help you recover from illness on the track, just like at home. (Photo: Alex Ratson / Moment via Getty)

Once you’ve caught an illness, you need a strategy to help you feel better. Here is my system, but again, speak with your doctor to find out what works best for you.

First, text people back home and let other hikers know you’re not feeling well. Consult your maps. If you’re near a side road or trail, consider hiking outside of the backcountry and seeing a doctor in town. If you are leaving the main trail, let your loved ones and other hikers know about your plan. Ask another hiker to accompany you. Side trails are one of the most common places hikers get lost. Most of the side trails are not as well maintained as the hiking trails. The disease can only increase the challenges of making navigation decisions.

If you have diarrhea, you may find that even the prospect of walking to the safety of a city of trails is too daunting a task. The good news is that some trail diseases, like food poisoning, can go away after a day. If you’ve found something with your doctor, text or call a medical professional to see if resting in a camp near the trail might be a better option.

If your telemedicine team thinks it is safe enough for you to sleep, I have found that in these situations it helps to stay hydrated, ideally with electrolytes. Especially for hikers with intestinal issues like giardia, dehydration is a very common symptom. I have heard of hikers who have been hospitalized not because of the giardia that struck them, but because of the dehydration resulting from the disease.

Whatever you do, if you are feeling sick it is essential that the people at home know that you are sick and where you are. If you’re missing on a side trail or are too ill to answer text messages, for example, this knowledge will help rescuers find you.

It is good to let other hikers know that you are sick as well. Not only is this common courtesy so they can protect themselves, other hikers can volunteer to camp with you or share food and water when you can’t get up. They may also choose to hike you to the safety of a nearby trail town where you can get medical help.

Don’t be afraid to ask other hikers for help. While we often start long trails for the joys of self-sufficiency, most hikers find that the joy of the trail is actually community. Also, other than a good bear encounter story, there is no greater backpacking story than “the time I walked 10 miles from the JMT to help a sick hiker into town. safely”.

In my fastest time known on the Appalachian Trail, I brought a disoriented hiker back to a mountain I had just climbed so he could safely reach his rescuer, who was carrying his heavy backpack in the climb. While this put my speed record behind schedule, I think the good track karma more than made up for it. I ended up reaching the hostel / restaurant where I had planned to stay that night an hour after the final check-in time. But the sick hiker had called ahead – uninvited – and even tried to pay for my meal. This remains one of my favorite stories of all my hikes.

If you encounter another sick hiker, consider taking a few hours out of your trip to make another strong human. While the kindness of strangers won’t solve all ills, it can certainly help.


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