Examining the Thru-Hiker Dropout Rate (Part II)

Invalid Lists and Sick Call: Forced home by illness

Hiking while sick is horrible. I’ve done it, and I don’t look forward to doing it again. I can think of nothing I’d wish more immediately upon my worst enemy than having a bad case of food poisoning about 17 miles from anywhere, and with no option but to force-march their way out. There’s an unforgettable feeling of having “innards by mixmaster” as you trudge quite uncertainly forward, seriously considering slitting your pants so you can keep moving and just get out a little faster. Oh, and the nausea isn’t helpful in making time either.

If that feeling isn’t purgatory, I’m not sure it could be terribly much worse and still be properly comprehended by the human mind.

Diarrhea affects 50% of hikers at some point according to one paper (page 16 in link). I personally think this might be overstated, or at least over a very, very long time interval. As they say, the infinitely improbable becomes infinitely probable over an infinite period of time. Everything else just happens more often.

Other ailments which afflict hikers are viruses, waterborne pathogens (not to be confused with pirates, which are Humanoid Waterborne Pathogens), bacterial infections, and food poisoning all come to mind. These can, of course, have diarrhea as symptoms, therefore this might not be an exaggeration after all.
We have come a long way from “Camp Fever” (Typhus) and the “Bloody Flux” (Dysentery) which used to plague travelers historically. This is good, because the symptoms of those diseases were horrific, and frequently lethal. Now, most of what we deal with on trail are such more minor issues like food poisoning. If you have taken care to cook your foods, and care for your cooking equipment, this should be pretty rare. Other problems from the history books in the USA are things like malaria, which was endemic in the country until the 1950s.

Other illnesses which knock people down on trail include Norovirus. This is a virus which will cause vomiting, diarrhea and a horrible feeling, and is normally transmitted through poor sanitation. Like Norovirus, other of this classification appear from time to time, and are more prevalent in crowded areas.

Lyme disease is also a risk, rising each year as ticks both expand their range and numbers. With ticks becoming more and more of a threat to hikers, and with the predators of the insect’s natural carriers basically eradicated, there is little to be done for Lyme aside from daily body inspections, and application of repellents rated for ticks.

Many of these diseases all can be prevented by good sanitation. Following Leave No Trace Guidelines on human waste, using privies when available, cleaning dishes, properly cooking food, and washing your hands are all proven methods of not only preserving your health, but the health of anyone else near you.
These illnesses may not kill you, but they will certainly ruin your day at best. As for how much illness contributes to casualties overall, 5% of participants listed illness on a 2013-2014 PCT Sample for the reason they got off the trail. That’s a pretty low number, which tells us that while illness might not stop you, it can certainly slow you down. With some basic precautions, you can avoid getting sick in the first place, however, which is likely your best bet.

Just not getting sick is my advice. There’s no more effective way to prove who your friends are than being violently ill 17 miles from extraction, in the rain, weakened to the point you can’t carry your own pack, and need someone to lean on as you feel yourself expelling the last of your organs all over their shoes. This is also my number one recommended thing not to do, ever, if at all avoidable.

Now go properly wash your hands for the hell of it. Then do so again before you eat anything, or look at anything, or think about anything, or do anything. Then wash them again after you’re done washing your dishes and ensuring your clothes are appropriate for the climate, in good working order, and clean. And use soap like your mothers always told you to, y’peasants!

Requiem for the Dead: Death, Dying, and Hiking

There are a lot of long-distance hikes available in the US. Tens of thousands of hikers embark on expeditions on them every year, and sometimes, a few don’t come back.

Death is rare in the hiking world, even long-distance hiking. Most of the time, deaths are an unfortunate side effect of human error: getting lost, and having the wrong equipment for conditions are common examples of those errors, compounded with bad luck. Sometimes, it’s just bad luck, with unforeseen health crises on trail, or an accident which causes a fatality.

Getting lost is a real threat. Knowing what to do in this case is critical to survival, as well as having a way to signal for help. As was tragically proven in the case of one hiker in Maine, a knowledge of navigation, compass skills, and a map are all critical tools to staying alive. If lost, follow the proper procedures, attempt to alert others to bring aid, and signal for help however possible. Always bring a map and compass, signaling devices such as signal mirrors and whistles, and know how to use them.

Related to getting lost, but not requiring any specific location, are threats like hypothermia. Hypothermia is frequently a result of having the wrong equipment for the environment you find yourself in. Hypothermia can sneak up on you, and if luck conspires against you, a sudden and unexpected change in conditions can kill. This is not unheard of in New England and New York, and at high altitude. In these areas, having more insulation than you think you will need is critical to staying alive.

In most cases, this doesn’t just mean a 50-cent space blanket, but proper clothing for freezing conditions. Space blankets should NEVER be considered a viable form of insulation on their own in the Northern Tier or at altitude.

Other threats from weather and conditions include lightning, flash floods, landslides, and others. These are, of course, less common, and difficult to predict. While they can kill, they are not something that any maxim can be given for: Essentially, use your best judgement, and remain aware of your surroundings at all time. Take whatever action is necessary and viable to reduce the potential lethality of whatever threat you face.

Accidents can happen any time, and are of varying import. Life threatening accidents, such as tree-falls and dropping widow-makers can kill, but again are uncommon. Situational awareness is key in avoiding these threats, and when they do arise the key to survival is quickly applied first aid and evacuation. Unforeseen Medical Emergencies are essentially impossible to avoid. After all, if you foresaw them, you would be able to plan around it. Heart attacks, and an assortment of other illnesses can kill when fast response is impossible.

In the case of injury or sudden sickness, the importance of high quality first aid and rapid evacuation cannot be overstated. If you suffer from any known conditions, keep the medications necessary to treat them in your kit, hike with someone who knows about them, and don’t push your limits past what would be reasonable to evacuate from with those same conditions.

If injury or illness does occur, alert authorities as fast as possible by any means available. Further, if in a group, have one person treat the injury, and another ascertain your location with your navigational equipment. When you pass word to first responders, the more information you can include the better, from your current location, your ability to evacuate and planned route, the nature of the emergency and what first aid measures you are able to employ.

Further information on First Aid and Evacuation will be covered in another article in this series.
Murder and violence is a statistical outlier, even within the outlier of death while hiking. While there are cases of murder on the Appalachian Trail at least, the proportion of casualties from these causes are so small as to be a non-issue. These are the stuff of legends, and not really a threat. Again, some situational awareness should prevent most hikers from ever getting into the slightest probability of a similar situation.
Death is, of course, unavoidable. You won’t get away from it in the grand scheme of things, and it is distinctly non-scalar. However, in the short term most people generally agree that avoiding this tall, glowing-eyed skeleton in a cloak with a scythe and deep booming voice inside your head, is task number one.

This doesn’t really change if you’re on or off trail, and for the most part, the skills and knowledge to continue to evade his visiting you in particular are similar on and off trail. You’ve gotten this far, so keep sharp, and you’ll likely be fine for a while yet.

AS ALWAYS: You are encouraged to take a First Aid Course, and download the Red Cross First Aid App on your Smartphone to practice the knowledge should a fellow hiker become ill or injured.

If you have attempted or completed a long distance trail, check out the survey HERE to contribute to the available data pool. 


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