The Kokoda Track has gained increasing popularity for Australian travellers over the last decade. However, as more individuals undergo the difficult trek there has been an increase in the number of people who develop medical complications associated with strenuous exercise. Six trekkers have died on the Kokoda trail since 2006 including four last year, with the cause of death being unknown.

In 2006 and 2008 there were two reports of healthy trekkers becoming ill because of extremely low salt levels in their blood.  Low salt levels occur because individuals drink too much water while exercising.  This can lead to serious illness and even death if left untreated.

Currently, we do not know whether low salt levels are rare or whether a large number of trekkers experience this medical complication. Therefore, the aim of the study was to determine the number of individuals on the Kokoda track who develop low salt levels.

The principle investigators were Dr Sean Rothwell and Dr David Rosengren, specialist emergency physicians from the Royal Brisbane and Women's Hospital and Greenslopes Private Hospital and Fellows of the Academy of Wilderness Medicine.  The remainder of the research team was made up of emergency physicians, Dr Julian Williams and Dr Bill Lukin, also from the Royal Brisbane and Women's Hospital, University of Queensland Professor Allan Frost and barrister and former battalion Commanding Officer Mr David Thomae. The research team was also joined by Dr Julius Plinduo, one of the very few emergency medicine trainees in papua new Guinea.

The study was funded by the Australian and Papua New Guinea Governments via the Kokoda Track Authority under the joint Kokoda Track Safety Package.

The investigators were divided into two teams.  One team trekked into Isurava from Kokoda and the other team trekked into Ioribaiwa Village from Owers Corner.  At the villages, the investigators collected data from the passing trekkers from April 16 - 20, 2010. These locations were chosen because this is the first difficult day of the trek and is the point where medical emergencies reach their peak. For instance, it is around this time period that four deaths and both documented cases of low salt levels have occurred.

The participation rate was very high, with nearly 200 trekkers enrolled in the study.  Those who participated provided a blood sample and answered a short questionnaire.  Most of the trekkers had normal blood tests results.  However a small number of them did have low salt levels.  These trekkers had consumed a large amount of fluids.  Fortunately their salt levels were not dangerously low and the doctors were able to intervene and educate the trekkers about overdrinking.  The results of the study will be submitted for publication and also used to educate trekking companies and future trekkers in the prevention of this condition.

In summary, the Kokoda Track for nearly all trekkers is a safe and fantastic experience.  This study has confirmed that a small number of plugins/editors/tinymce/jscripts/tiny_mce/themes/advanced/langs/en.js" type="text/javascript"> people can drink too much fluid and potentially become unwell from low salt in their blood.  The best way to avoid this is to drink when you are thirsty.  Obviously drink enough fluids to prevent dehydration, but don't overdo it.