A pilot study on the prevalence of Acute Mountain Sickness at the Sikh pilgrimage of Hemkund Sahib in the Indian Himalayas

BACKGROUND: Hemkund Sahib is a popular pilgrimage located at 4,330 m in the Garhwal range of the Indian Himalayas. Many travelers to the region have observed pilgrims exhibiting Acute Mountain Sickness (AMS)-like symptoms. However, no systematic study on its prevalence at Hemkund has been conducted. MATERIALS AND METHODS: We surveyed 25 adults. AMS rates were determined using a standard Lake Louise Score (LLS). Responses to questions related to awareness of AMS, the perceived difficulty of the trek, and physiological data including arterial oxygen saturation (SpO(2)) and pulse rate, amongst others, were collected. RESULTS: Overall prevalence of AMS was 28% (mild AMS 20%, severe AMS 8%). Borg Rating of Perceived Exertion (RPE) was 3.9/10. Water consumption for the 4-5 hour trek to Hemkund was only 0.9 L and 20% of pilgrims consumed no water at all. Nine pilgrims claimed to be aware of AMS although only one had taken prophylactic medication. SpO(2) was 82.2 ± 1.2% and pulse rate was 106.5 ± 2.9 bpm (mean ± SEM). There were no differences in non-LLS-related parameters when pilgrims were subdivided by presence or absence of AMS. CONCLUSION: This pilot study has, for the first time, documented the prevalence of AMS amongst pilgrims to Hemkund Sahib in the Indian Himalayas.