Traveler's Diarrhea

What is traveler's diarrhea?

Traveler's diarrhea (TD) is a term used to describe the diarrhea caused by infection with bacteria, protozoa, or viruses ingested by consuming food or water that has been contaminated. About 80 to 90 percent of TD cases are caused by bacterial pathogens--escherichia coli, Campylobacter jejuni, Shigella sp., and Salmonella sp. Ten percent of TD cases in long-term travelers are caused by protozoal pathogens--Giardia intestinalis, or Entamoeba histolytica.

What are the causes of traveler's diarrhea?

Traveler's diarrhea describes a specific condition that happens when visitors from countries that have good public sanitation and hygiene travel to countries that have poor public sanitation and hygiene. Poor hygiene practice in local restaurants has been identified as the main contributor to the risk for TD. These are often the developing countries, and high-risk areas are located in Africa, Asia, Mexico, Central and South America, and the Middle East.

Traveler's diarrhea is caused by drinking water or eating foods contaminated with fecal material, unsafe storage of food, improper food handling and preparation, and inadequate sterilization of surfaces and utensils used in food preparation.

What are the symptoms of traveler's diarrhea?

A normal course of traveler's diarrhea lasts about 3 to 7 days, and may be accompanied by:

  • nausea
  • bloating
  • urgency
  • fatigue
  • loose, watery stools

Can traveler's diarrhea be prevented?

The best preventives for traveler's diarrhea are:

  • only use water that has been boiled or chemically disinfected for:
    • drinking, or preparing beverages such as tea or coffee
    • brushing teeth
    • washing face and hands (alcohol-based gel can also be used to wash hands)
    • washing fruits and vegetables
    • washing eating utensils and food preparation equipment
    • washing the surfaces of tins, cans, and bottles that contain food or beverages
  • do not eat food or drink beverages from unknown sources, and only drink beverages that have been bottled and sealed
  • do not put ice in drinks 
  • any raw food could be contaminated, including:
    • fruits, vegetables, salad greens
    • unpasteurized milk and milk products
    • raw meat
    • shellfish
    • any fish caught in tropical reefs rather than the open ocean

Although antibiotics, antimicrobial drugs, antidiarrheals, as well as other over-the-counter medications are sometimes used as preventives, the Centers for Disease Control and Prevention does not recommend their use without the specific advice and supervision of a physician. Taking any medication without medical supervision can be dangerous. In addition to side effects or allergic reactions, long-term use of medications can mask symptoms that may need medical attention.

Treatment for traveler's diarrhea:

Traveler's diarrhea, although uncomfortable and unpleasant, usually lasts only a few days. Dehydration (loss of fluids) can be a serious side effect, especially for children and babies. Drinking plenty of non-contaminated fluids is important.

For diarrhea that is worse than normal or lasts more than three days, it is best for the traveler to consult a physician rather than try self-medication - especially for pregnant women and children. Seek medical help when diarrhea is:

  • severe.
  • bloody.
  • does not get better within a few days.
  • accompanied by fever and chills.
  • causes dehydration.

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