Traveller’s Diarrhea

What is travellers’ diarrhea?

Travellers’ diarrhea is the most common illness that affects travellers. It is easily spread from person-to-person or by eating food or drinking water contaminated with feces.

Cause

Many different bacteria (including E. coli, Salmonella, Shigella, Campylobacter), parasites (Giardia, Crytosporidium, Cyclospora and others) and viruses (such as norovirus and rotavirus).

Risk to travellers

  • Travellers are at higher risk when going to destinations with poor standards of hygiene and sanitation and poor food handling practises.
  • Travellers’ diarrhea most commonly affects people travelling from developed countries to developing regions of the world.
  • Severity depends on which bacteria, parasite or virus has caused the illness.
  • Most episodes of diarrhea are not severe and last only a few days.
  • Travellers with chronic diseases or weakened immune systems face a higher risk of complications.

Prevention

  •  Pack a thermometer and medicine to treat diarrhea. Talk to your pharmacist about what medicine is right for you.
  •  Before you travel, talk to your doctor about antibiotics. Many people bring antibiotics with them in case they get seriously ill. A few people need to take medication to prevent diarrhea from happening at all.
  •  Be careful when you eat and drink. Remember the saying, “Boil it, cook it, peel it or forget it.”
  • Only eat or drink things that are not likely to make you sick. These are:
    •             piping hot foods
    •             fruit you peel yourself
    •             cooked vegetables
    •             carbonated beverages (with no ice cubes)
    •             boiled or bottled water
    •             pasteurized milk (properly stored)
  •  Avoid foods that will likely make you sick. These include:
    •             buffet foods at room temperature
    •             fresh soft cheese
    •             food from street vendors
    •             cold salads
    •             raw vegetables
    •             uncooked/cold sauces
    •             unpeeled fruit
    •             raspberries, strawberries, watermelon
    •             ice cubes
    •             undercooked meat or fish
    •             shellfish
    •             large reef fish such as snapper, barracuda, grouper, jack and Moray eel
    •             custard, mousse, mayonnaise and hollandaise sauce
  • Wash your hands, especially before you eat.
  • Avoid swallowing water while swimming.
  • Do not drink local water.
  • Drink bottled beverages from their original containers. Make sure the cap is properly sealed.
  • Talk to your pharmacist about what to do if you have diarrhea while you are away.
Minor Ailments.  © Canadian Pharmacists Association, 2013.  All rights reserved.

Treatment

The most important treatment is rehydration:

  • For most adults with mild travellers’ diarrhea, hydration can be maintained with safe liquids including diluted juices or sports drinks, purified water, or clear salty soups.
  • In moderate to severe cases, oral rehydration solutions should be considered, in particular in children and the elderly.

In some cases anti-motility medication (for abdominal pain) may provide some relief of symptoms and allow travellers to continue their activities.

Your health care provider may discuss self treatment using antibiotics for one to three days.

Symptoms

  • Usually include fever, nausea, vomiting, abdominal cramping and diarrhea.
  • Generally, the symptoms go away in a few days without treatment.
  • In more severe cases, traveller’s diarrhea can lead to dehydration and death. This is a particular concern for children, the elderly and individuals with chronic diseases or weakened immune systems.
  • If you have blood in your stool, you should seek medical attention even if your other symptoms are not very severe.

Transmission

  • Travellers’ diarrhea is spread by eating or drinking contaminated food and/or water.
  • Travellers who visit areas with poor standards of hygiene and sanitation are at greater risk.

Where is travellers’ diarrhea a concern?

  • The risk of travellers’ diarrhea occurs worldwide.
  • High risk destinations include developing countries in Central and South America, Mexico, Africa, the Middle East and Asia.
  • There is a moderate risk in Eastern Europe, South Africa and some parts of the Caribbean.
  • The risk is lower in northern and western Europe, Australia, New Zealand, Japan, the United States and Canada.
http://travel.gc.ca/travelling/health-safety/diseases/diarrhea

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