Hiking the Appalachian Trail (A.T.) can take its toll on your body, so it's important to do everything you can to stay healthy while you're on the Trail. 

lyme disease

Ticks, which carry Lyme disease and other serious illnesses, are a risk on any hike. The black-legged or deer tick carries Lyme disease. The highest concentration of reported cases of Lyme disease along the A.T. spans from Virginia to Massachusetts, especially at elevations less than 2,000 feet. ​Other tick species may be encountered at lower elevations in other Trail states.

Although Lyme disease is the most common, there are six tick-borne illnesses present on the A.T. Combinations of diseases are common from a single tick bite. For comprehensive information about tick-borne illnesses and symptoms, click here.

The characteristic "bulls-eye" rash sometimes occurs with Lyme disease, but not always. Symptoms that may indicate tick-borne illnesses and a need for medical attention include fever, chills, headache, and muscle aches. For many tick-borne illnesses, symptoms may continue for months or even years and treatment may be difficult. Treatment is most effective immediately after a tick bite. Most humans are infected by juveniles (nymphs), which are about the size of a poppy seed and difficult to see.

When walking in prime tick habitat (grassy, brushy, or woodland areas) your chances of being bitten by a tick can be significantly decreased by taking these precautions:

Deer Tick Lyme Disease Information

  • Wear clothing treated with permethrin (kills or repels ticks on contact). You can purchase pre-treated clothing, spray clothing with permethrin, or send your own clothing to to be factory-treated.
  • Treated trousers or bug-net pants over shorts are very effective and the bug-net pants allow for ventilation on warm, humid days.
  • Spray-on permethrin can also be used to treat your pack and outer tent floor.
  • Wear light-colored clothing; ticks can most easily be spotted against a lighter color.
  • Use insect repellent that contains 20 to 30 percent DEET on exposed skin.
  • Check for ticks daily (or more frequently while hiking). Removing an embedded tick within 24 hours reduces risk of illness. Use fine-tipped tweezers or a tick key to lift under the mouthparts in a slow, steady pull.
  • Avoid tick-infested areas if possible, especially in May, June and July.
  • Once inside, put clothes in the dryer on high heat for 60 minutes to kill any remaining ticks.
  • Leave your dog at home, as your dog will attract many more ticks.

For an in-depth article about Lyme disease on the A.T., click here.


Although you will get dirty backpacking, it shouldn't be an unsanitary experience. Flush toilets and showers don't exist on the A.T., but you can still prevent the spread of norovirus and treat blisters to prevent infection.

Privy Bathroom on the AT 


Don't expect flush toilets on the A.T. Most A.T. shelters have privies, but often you will need to do your business in the woods. Proper disposal of human (and pet) waste is not only a courtesy to other hikers, but is a vital Leave No Trace practice for maintaining healthy water supplies in the backcountry and an enjoyable hiking experience for others.

No one should venture onto the A.T. without a trowel or a wide tent stake, used for digging a 6- to 8-inch deep "cathole" to bury waste. Keep in mind the following guidelines when pooping in the woods:

  • Bury feces at least 200 feet or 80 paces away from water, trails, or shelters.
  • Use a stick to mix dirt with your waste, which hastens decomposition and discourages animals from digging it up.
  • Used toilet paper should either be buried in your cathole or carried out in a sealed plastic bag.
  • Hygiene products such as sanitary napkins should always be carried out.
  • Use soap and water; hand sanitizers kill some germs but are not as effective against norovirus.

Showering on the AT 


Showers are rarely available right on the ​A.T. Hikers usually shower while at hostels or hotels in towns; less common are campgrounds with shower facilities.

To bathe in the backcountry, carry water 200 feet from the water source in a container and rinse or wash yourself away from streams, springs and ponds.

Blisters after hiking the AT 


Blisters are one of the most common ailments suffered by hikers. Not only can they be painful and take the fun out of hiking, but they can be an entry point for infections, which can be serious.

To help prevent blisters, break in new shoes or boots gradually before you begin your hike. As soon as you feel any discomfort or "hot spot" developing, stop hiking and place moleskin or duct tape over areas developing soreness.

  • Keep your feet as dry as possible while hiking.
  • When you stop for breaks, take your shoes and socks off to air out your feet or change socks.
  • Don't wait for a blister to develop before treating.

If a blister does develop and breaks, or is painful enough that it needs to be popped to reduce pressure, use a sterilized needle to puncture the blister. Clean and disinfect the area, apply antibiotic ointment, and cover with an adhesive bandage or blister care product. A couple layers of moleskin with a circle cut out just larger than the blister, or donut-shaped adhesive-backed callous cushion can relieve pressure.

Remember this advice: keep blisters "CDC," or Clean, Dry, and Covered. Click here for a poster!



Norovirus, a highly contagious stomach virus, is transmitted by contact with an infected person, contaminated food or water, or contaminated surfaces, and it is easily spread on parts of the A.T. that experience crowded conditions. Norovirus causes your stomach and/or intestines to become inflamed, which leads to stomach pain, nausea, and diarrhea.

The virus has a 12- to 48-hour incubation period and lasts 24 to 60 hours. Infected hikers may be contagious for three days to two weeks after recovery. Outbreaks occur more often where people share facilities for sleeping, dining, showering, and toileting; the virus can spread rapidly in crowded shelters and hostels; and sanitation is key for avoiding and spreading norovirus.

Take the following steps to prevent contracting and spreading the illness:

  • Do not eat out of the same food bag, share utensils, or drink from other hikers' water bottles.
  • Wash your hands with biodegradable soap (200 feet from water sources) before eating or preparing food and after toileting.
  • Be aware that alcohol-based sanitizer may be ineffective against norovirus.
  • Treat all water. To learn best how to treat your water, click here for information from the CDC.
  • Follow Leave No Trace guidelines for disposing of human waste.
  • For important prevention tips and information about how to report norovirus on the Appalachian Trail, click here.
  • For more information, click here.

Please keep us informed of any stomach bug or norovirus cases by sending email to [email protected] with the date and location of the outbreak.

other disease

Some critters on the ​A.T. are capable of transmitting disease. Learn about these diseases and how to minimize your risk before setting off on your hike!

​Hantavirus Pulmonary Syndrome (HPS)

One case of the rare but dangerous rodent-borne disease hantavirus pulmonary syndrome has been reported on the Trail. In 1993, an A.T. thru-hiker contracted hantavirus as he hiked through Virginia. He recovered and completed his hike the next year. Investigators were unable to pinpoint the exact location of infection.

Precautionary measures to avoid exposure to HPS:


Cases of rabies have been reported in foxes, raccoons, and other small animals. Although instances of hikers being bitten are rare, any animal bite is a serious concern.

More information is available from the Centers for Disease Control and Prevention.