Protecting yourself from traveler’s diarrhea

Going on vacation, exploring new places is one of life’s most pleasurable experiences.  What is not a pleasurable experience is coming down with traveler’s diarrhea (TD).  There is no worse feeling then being sick when hundreds if not thousands of miles away from home and having to contend with a bout of TD.

Traveler’s diarrhea is one of the most common traveler’s diseases. The Centers for Disease Control and Prevention (CDC) reports that as high as 50% of international travelers suffer from some form of traveler’s diarrhea. Diarrheal diseases account for 1 in 9 deaths worldwide, making diarrhea the second leading cause of death for children under the age of five.

TD is a stomach and intestinal infection and is the most common illness affecting those traveling.  How do you know if you have it for sure?  If you have three or more unformed stools passed within a 24-hour period accompanied by abdominal cramps, nausea, and bloating, you most likely have TD.  Other symptoms that may occur simultaneously are vomiting, fever, and bloody stools.  TD lasts anywhere from two to seven days but in some instances without treatment, it can last for months.

Causes of TD

The main cause is usually from eating or drinking bacteria- or virus-contaminated water or food.  When we visit places where the climate, social or sanitary conditions are different from what we’re used to, this increases your chance of contracting TD.  The people living in those areas have become accustomed to the bacteria and have developed immunity to them. 

While most diarrheal germs are spread from the stool of an infected person to the mouth of another, these germs can also be passed via a wide-ranging number of items including glassware, utensils, doorknobs, faucet handles, and tools. Other causes of traveler’s diarrhea include changes in diet, dehydration from flying, changes in climate, traveler’s stress, and even lack of sleep.

Before you arrive at your destination, check on whether the water is safe to drink or bathe in.  One common cause of TD is drinking unpurified water or ice, or swallowing water while showering or brushing teeth. 

Another common cause of TD is eating fresh fruits and vegetables or undercooked meats in foreign countries as they can be tainted with bacterial pathogens such as E. coli. 

Preventing traveler’s diarrhea

The best bet to avoid TD is to read up on the sanitary conditions of where you are going, particularly if traveling outside the United States.  Certain travel destinations pose a greater risk than others – particularly Asia, the Middle East, Africa, Mexico, and Central and South America.

If the area you are in looks suspect – limited plumbing and electricity leading to unsafe food storage and sanitation – you will need to be very cautious and practice these TD prevention tips:

·      Choose only cooked fruits and vegetables - avoid raw produce and avoid salads.

·      Try to eat vegetables and fruit (like bananas and oranges) you can peel yourself.

·      Avoid tap water or ice made from tap water

·      Avoid tea, lemonade or other beverages made with water unless prepared with boiled, bottled or purified water.

·      Drink only beverages coming from a sealed can or bottle.

·      Avoid undercooked or raw meat and seafood.

·      Do not eat any street food as they are often unregulated and can be a key source of contamination.

·      Brush teeth with bottled water

·      Wash hands often with soap and water especially after using the bathroom and before eating.  Use alcohol-based hand sanitizer if soap and water is not available.  Also keep your hands away from your mouth and face.

How to treat traveler’s diarrhea

The primary goal of treatment is to maintain hydration. During the first 24 hours, drink two to three quarts of fluid such as bottle ginger ale, fruit juice, caffeine-free soft drinks, hot tea, and clear soups such as broth. Oral rehydration solutions contain water and salts to replenish both fluids and electrolytes such as sodium and potassium.

If you become an unfortunate victim of TD, slowly reintroduce food into your diet when tolerated. Symptoms can be minimized by eating a bland diet consisting of soft, low-fiber foods that are not spicy (bananas, applesauce, toast) and by taking anti-diarrheal and antibiotic medications.  Many travelers carry antibiotics with them so they can treat diarrhea if they get sick.  Ask your doctor if you need one and which one to choose.

Medications such as Lomotil or Imodium can be bought over-the-counter to treat symptoms of diarrhea.  They will reduce the frequency and urgency of needing to go to the bathroom making it easier if you have to be traveling on an airplane or bus. 

If the symptoms do not subside or are getting worse, seek help from a medical facility.