Hawaii - Jeff Campbell [492]
The best treatment for AMS is descent. If you are exhibiting symptoms, do not ascend. If symptoms are severe or persistent, descend immediately. When traveling to high altitudes, it’s also important to avoid overexertion, eat light meals and abstain from alcohol. If your symptoms are more than mild or don’t resolve promptly, see a doctor. Altitude sickness should be taken seriously; it can be life-threatening when severe.
Bites & Stings
Hawaii has no established wild snake population, but snakes are occasionally seen, especially in sugarcane fields.
Leeches are found in humid rainforest areas. They do not transmit any disease but their bites are often intensely itchy for weeks afterwards and can easily become infected. Apply an iodine-based antiseptic to any leech bite to help prevent infection.
Bee and wasp stings mainly cause problems for people who have allergies. Anyone with a serious bee or wasp allergy should carry an injection of adrenaline for emergency treatment. For others pain is the main problem – apply ice to the sting and take painkillers.
Fire ants and centipedes also have painful bites; the latter occasionally infiltrate buildings, so check sheets and shoes.
Commonsense behavior and dress are the most effective protections: wear long sleeves and pants, hats and shoes (not sandals).
Mammal Bites
Do not attempt to pet, handle or feed any animal, with the exception of domestic animals known to be free of infectious disease. Most animal injuries result when people try to touch or feed the animal.
Any mammal bite or scratch – including bats, feral pigs, goats etc – should be promptly and thoroughly cleansed with soap and water, followed by application of an antiseptic such as iodine or alcohol. You may want to start antibiotics, since animal wounds frequently become infected. Hawaii is currently rabies-free.
Marine Animals
Marine spikes, such as those found on sea urchins, scorpion fish and Hawaiian lionfish, can cause severe local pain. If this occurs, immediately immerse the affected area in hot water (as high a temperature as can be tolerated). Keep topping up with hot water until the pain subsides and medical care can be reached. The same advice applies if you are stung by a cone shell.
Marine stings from jellyfish and Portuguese man-of-war (aka ‘bluebottles’) also occur in Hawaii’s tropical waters. Even touching a bluebottle a few hours after it’s washed up onshore can result in burning stings. Jellyfish are often seen eight to 10 days after a full moon, when they float into shallow near-shore waters, such as at Waikiki. If you are stung, first aid consists of washing the skin with vinegar to prevent further discharge of remaining stinging cells, followed by rapid transfer to a hospital; antivenoms are widely available.
Despite extensive media coverage, the risk of shark attack in Hawaiian waters is rare and no greater than other Pacific regions. Avoid swimming in waters with runoff after heavy rainfall (eg around river mouths) and those areas frequented by commercial fishing operators. Do not swim if you are bleeding or have open cuts, as this attracts sharks. Check with lifeguards about local risks.
Mosquito Bites
Where mosquito-borne illnesses have been reported, keep yourself covered and apply a good insect repellent, preferably one containing DEET. In general, adults and children over 12 should use preparations containing 25% to 35% DEET, which usually lasts about six hours. Children between two and 12 years of age should use preparations