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Health and Safety
Machu Picchu and the Inca Trail are a breath-catching 300-700 meters (980-2,300 feet) lower than Cusco. But to be on the safe side about altitude effects, locally known as soroche, get an ample intake of fluids and eliminate or minimize alcohol and caffeine consumption. (Both can cause dehydration, already a problem at high altitudes.) Smoking aggravates the problem. Some hotels have an oxygen supply for their guests' use. The prescription drug acetazolamide can help offset the alkalosis caused by low oxygen at high elevations.
Tap water is generally not safe to drink. Stick with the bottled variety, con gas (carbonated) or sin gas (plain). The San Luis brand is for sale everywhere.
Aguas Calientes employs a cadre of tourist police, whom you'll find stationed throughout the streets. Mudslides are an occasional problem from October-April. Severe flooding in January 2010 destroyed areas along the river, stopping railway service and leaving some tourists stranded. Despite damage to the tracks, rail services resumed in early April 2010, and at the time of this writing it's business as usual in the valley.
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