
Minimizing gastrointestinal problems
Since most of Nepal still gets along without modern sanitation, these are endemic. They range from self-limiting attacks of diarrhea where dehydration is the main risk, through intestinal parasites, amoebic dysentery and giardiasis which are chronic without proper medical treatment, to immediately life-threatening infections like cholera and typhoid. Habituation even to common intestinal flora generally takes about a year and many unpleasant bouts of stomach problems, so tourists contemplating shorter stays should take extensive precautions.
Get vaccinated and consider prophylactic treatment.
Malaria appears only in rural areas at altitudes below 1200 m (3937 ft) in the Tarai and Hill districts bordering India and for the areas of the inner Tarai valley areas of Udaypur Sindhupalchowk, Makwanpur, Chitwan, and Dang. It's recommendet to carry Lariam, Malarone, or doxycycline with you to treat this disease when you are infected.
Altitude sickness
Permanent snow lines are around 18 or 19,000' (5,500m), so base camps and passes in the Himalaya are usually higher than Mount Blanc or Mount Whitney. This puts even experienced mountain climbers at risk of altitude-related medical conditions that can be life-threatening. Risks can be minimized by choosing routes that don't go high, such as Pokhara-Jomosom or by sleeping not more than 1,000'/300m higher per day and to take an experienced guide like me if you plan to go in higher areas. According to the "climb high, sleep low" mantra, it is good to take daytime conditioning hikes that push acclimation, then to return to a more reasonable elevation at night.
Read more about this topic here
Hypothermia
is a risk, especially if you are trekking in spring, autumn or winter to avoid heat at low elevations. When it is a comfortable 85F/30C in the Terai, it is likely to be in the teens Fahrenheit or -10C at that base camp or high pass. Either be prepared to hike and sleep in these temperatures, or choose a trek that doesn't go high. For example at 10,000'/3,000m expect daytime temperatures in the 40s Fahrenheit or 5 to 10 degrees Celsius.
Rabies
Dogs are not vaccinated and catch this fatal disease from other dogs or wild animals with some regularity. All mammals are potentially vulnerable. Dogs are considered ritually polluting and are widely abused, so it can be impossible to know whether a dog bit you because it is paranoid about people or because it is rabid. You should be vaccinated against rabies before going to Nepal, but this is not absolute protection. Be on the lookout for mammals acting disoriented or hostile and stay as far away as possible. Do not pet dogs, cats or pigs no matter how cute. If bitten or exposed to saliva, seek medical attention. You may need an extended series of injections that provides a higher level of protection than routine vaccination.
Snakebite
The risk is greatest in warm weather and at elevations below 5,000' (1,500m). Poisonous snakes are fairly common and cause many deaths annually. Local people may be able to differentiate poisonous and non-poisonous species. Cobras raise their bodies in the air and spread their hoods when annoyed; itinerant snake charmers are likely to have specimens for your edification. Vipers have triangular heads and may have thick bodies like venomous snakes in North America. Kraits are strangely passive in daylight but become active at night, especially around dwellings where they hunt mice. Krait bites may be initially painless, causing only numbness. However without proper antivenin numbness can progress to deadly paralysis, even with bites from small, seemingly innocuous specimens. Wearing proper shoes and pants rather than sandals and shorts provides some protection. Watch where you put your feet and hands, and use a flashlight when walking outside at night. Sleeping on elevated beds and on second stories helps protect against nocturnal kraits.
