MALARIA & MOSQUITO BORNE DISEASES:
Malaria is a risk throughout PNG. Dengue fever and other mosquito-borne diseases also occur, including in Port Moresby. Cases of chikungunya virus have also been reported since 2012. We encourage you to take prophylaxis against malaria where necessary and to take measures to avoid mosquito bites, including using insect repellent at all times, wearing long, loose-fitting, light coloured clothing and using a mosquito net at night. The mosquito-borne disease Japanese encephalitis is a risk throughout PNG but the risk to short-term visitors to urban areas is relatively low. A Japanese encephalitis vaccine is registered for use and is currently available in Australia. For further details please consult your travel health doctor.
MEDICATIONS & MEDICAL CONDITIONS:
If you require any personal medications, please discuss storage requirements with your doctor well in advance. Some medications are sensitive to temperature or must be kept dry - conditions on the Track may require adjustments to your normal medication. We strongly recommend that you carry a back-up set of medication to be carried separately by the tour leader or your personal porter. Please advise the tour leader at the pre-departure meeting in Port Moresby if you are taking medication - this information will be treated in the strictest confidence, but may assist medical staff to make decisions in the unlikely event of a medical evacuation from the Track.
TRAVELLER'S DIARRHOEA:
Diarrhoea during travel is thought to affect 10 million travellers each year. The most common cause is a bacteria called E. coli. Traveller’s diarrhoea is characterized by frequent loose bowel motions, abdominal cramps, nausea and vomiting. On the Kokoda Track, it can complicate an already gruelling exercise with severe dehydration and fatigue. The bacteria that cause traveller’s diarrhoea are sensitive to some antibiotics, including ciprofloxacin, norfloxacin and azithromycin. Prophylactic antibiotic treatment is not recommended for healthy adults. This risk of contracting traveller’s diarrhoea can be substantially decreased by strict adherence to simple hygiene precautions. Wash hands before eating and after going to the toilet, purify all water, ensure food is freshly cooked and fruit (and nuts) are peeled. For those who get traveller’s diarrhoea while on the Trail, a single large dose of antibiotic is usually all that is required.
CHAFING & FOOT CARE:
Chafing is a potentially serious problem in the moist jungle environment of the Kokoda Track, leading to bleeding, skin infections and extreme discomfort. It can be prevented by the wearing of bike-pants-style elastic undergarments such as Skins. Careful, early attention should be given to any areas that appear to be chafing with liberal use of barrier ointments like Bepanthen. Infected chafing areas may require antibiotic therapy.
Foot care is vital on the Kokoda Trail. Worn-in, supportive waterproof boots are a necessity. We recommend inner and outer hiking socks to minimise shearing, with at least a new set every second day. Ensure toenails are trimmed throughout the trek. Where possible, allow your feet to dry (eg. lunchbreaks, during the evening). When crossing creeks without your boots on, be sure to wear reef sandals or Croc-style shoes to avoid cuts and scratches from submerged rocks. Take similar care while bathing in the creeks and streams. Fungal infections can be prevented by the application of antifungal powder or cream in the evenings. Prevention of blisters can be achieved by applying hydrocolloid pad dressings (eg Dr Scholl, Spenco) to pressure areas. These often come off in extreme moisture and require an elastoplast dressing over the top to remain in place. The common pressure areas are the side of the big toe and the ball of the foot, but obviously this varies and individuals should become familiar with their particular pressure areas during training. Treatment of blisters consists of keeping them clean and avoiding further abrasion. Commercial blister pads (Dr Scholl, Spenco, Band-Aid) are useful for this purpose. Antibiotics may be required if the blisters become infected with bacteria.
INJURIES:
The Kokoda Track traverses slippery, steep, uneven slopes and sometimes treacherous river crossings. Almost any injury is possible. Those suffering serious injuries will require evacuation, usually by a combination of jungle stretcher and helicopter.
Injury prevention measures include boots with good ankle support and grip and trekking poles - one or two, depending on personal preference. Trekking poles decrease the amount of force going through your knee and ankle joints and also provide stability on slippery downhills. It is also important to accept assistance from your personal porter - decreasing the load on your back will improve your balance and decrease back strain injuries. Your personal porter will also assist you across log bridges and in slippery areas of the track.
PATELLOFEMORAL SYNDROME:
One of the most common injuries on the Track is an overuse injury known as patellofemoral pain syndrome (runner's knee). his condition has a variety of causes, but on the Track is due to repetitive knee flexion with extra weight loading the joint. Pain is usually felt behind the kneecap, especially when going downhill. To minimise this injury it is important to warm up and stretch properly before each day, wear good, supportive footwear and carry trekking poles to decrease the load on the knee joint. You may also benefit from quadricep strengthening during training or from taping or bracing the knee joint - see your physiotherapist if you are experiencing these symptoms in your training. Anti-inflammatory tablets can aid in pain reduction and decrease the inflammation. Once the condition has started, the treatment begins with rest which may not be possible so prevention is vital.
FLUIDS:
Your body's fluid balance will be placed under considerable stress while hiking in the humid mountain jungle of Papua New Guinea. The risk of dehydration is increased during strenuous exercise, in hot climates and when suffering illnesses such as diarrhoea. Some blood pressure medications called diuretics can also increase your risk of dehydration. Symptoms include increased thirst, dry mouth, decreased urine output, weakness, fatigue and confusion. Severe dehydration can lead to seizures, coma and death. Too much fluid can be equally dangerous. The practice of "drinking as much as possible" has lead to a condition called exercise associated hyponatraemia (EAH). A near-fatal case occurred on the Kokoda Trail in 2006 with the trekker requiring helicopter evacuation to Intensive Care in Port Moresby Hospital. Symptoms of EAH include lightheadedness, confusion, weakness, seizures and even death. Just how much should you drink? The best guide is your body's thirst requirement. Only drink fluids when you are thirsty. A rough guide is a maximum volume of 750ml/hour, with 1000ml/hour the absolute limit.
AFTER YOU RETURN:
Many tropical insect- and water-borne diseases including malaria, dengue fever and typhoid fever have an incubation period of from 3 days up to a couple of months after infection. If you become unwell after the trip, especially if your illness is accompanied by a fever, it is important to see a doctor and inform them about your recent travel to Papua New Guinea.
