title: Life and death on the Amazon: illness and injury to travelers on a South American expedition.
abstract: BACKGROUND
  Commercial expeditions provide an opportunity for travelers to undertake various specialized travel to more adventurous destinations in the relative security of an expeditionary group. Little is known about the illnesses and injuries occurring on such expeditions.
  
  
  METHODS
  From the commencement of the Blake Expedition in 2001, the expedition physician recorded all illnesses and injuries reported among the crew and also among the indigenous people encountered, while undertaking the expedition. The duration of the expedition was two and a half months, and involved travel by yacht, riverboat and jungle canoe or "bongo". The crew numbered 26 personnel: 24 men, including the expedition physician, and two women.
  
  
  RESULTS
  Seventy-eight health problems were reported and recorded among 19 (73.1%) members of the expeditionary team. There was one death, but there were no other major incidents requiring emergency evacuation or hospitalization. Types of illness were largely those related to ear, nose and throat disease (15/78, 19%), injuries (12/87, 15%), bites and stings (12/87, 15%), and respiratory (10/78, 13%), dermatologic (9/78, 12%) and gastroenterologic conditions (7/78, 9%). A further 24 health problems were reported and recorded among 22 indigenous people who approached the expedition physician for treatment. Types of illness were largely related to dermatologic conditions (9/24, 38%), accidents and injuries (4/24, 17%), and malaria (4/24, 17%).
  
  
  CONCLUSIONS
  This expedition was both noteworthy and newsworthy because of the death of the team leader, Sir Peter Blake, although the health problems encountered were largely similar to those reported for other expeditions. Tropical disease was uncommon. Adequate pre-trip preparation of expedition teams is considered important, and the inclusion of an expedition physician decreased the reliance on local health services, which are often scarce or absent on more remote-location expeditions. Adequate psychological preparation of expedition teams should also be included, to prepare expedition teams for unexpected outcomes, such as death or severe injury.
authors.affiliation: Worldwise Travellers Health Centres of New Zealand, Auckland, New Zealand.
authors.forename: Marc T M
authors.initials: MT
authors.lastname: Shaw
authors.forename: Peter A
authors.initials: PA
authors.lastname: Leggat
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D005101:Expeditions; D005260:Female; D006801:Humans; D015994:Incidence; D008288:Malaria / Q000453:epidemiology / Q000209:etiology; D008297:Male; D012871:Skin Diseases / Q000453:epidemiology* / Q000209:etiology; D014195:Travel; D014687:Venezuela / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology