The Jomosom trek is substantially protected from mountain sickness and hypothermia by not going over 10,000' 3,000 m, and with comfortable lodging along the way. Treks into Annapurna Sanctuary and across high passes between the upper valley of the Kaligandaki and Manang are more exposed to these risks. Trekkers should take precautions for themselves and all support staff. Specific concerns include physical fitness and altitude aclimatization. Immunizations and vaccinations that should be considered include tuberculosis, diphtheria, typhoid, tetanus, meningococcal meningitis, polio, hepatitis A and Japanese encephalitis, and also for anti-malaria. While trekking, constant intake of potable water is essential to avoid Advanced Mountain Sickness AMS. At altitude where water does not boil easily, add iodine tincture 5 to 8 drops per litre in advance 20 minutes at least. Carry diarrhea medicine and beware of Giardia lamlia a parasite common in glacial water of Nepal that infects trekkers.
Flights to Jomosom are not completely risk free. The Kaligandaki valley is subject to gusty winds and there has been at least one serious crash at the Jomosom airstrip.
There have been reports of robberies and fraud by locals against tourists in Manang. Manangis have a reputation as sharp businessmen and may not be averse to a quick profit by unethical means.
The Kaligandaki is effectively a caravan route with a significant transient element in addition to local population. The sort of precautions one might take at a truck stop would not be out of order.
