Traveler’s Diarrhea

Traveler’s diarrhea affects half of all travelers to developing countries.

What is it?

Traveler’s diarrhea is a stomach and intestinal infection that occurs as a result of unsanitary handling of food. It is characterized by the passage of several watery stools with abdominal cramps. Fever, vomiting, and bloody stools are NOT typical symptoms. The disease is usually caused by bacteria and less commonly by viruses and parasites. Travelers develop the condition after inadvertently swallowing germs during mealtime or from contaminated hand to mouth contact.

How do I avoid it?

Traveler’s diarrhea occurs more often from contaminated food than from water.

Food

• Avoid buffets, cold foods, and salads (which are often washed with contaminated water).
• Eat only fruit that has a thick skin that you have peeled personally.
• Do not eat raw or undercooked meat, seafood, or vegetables.
• Insist that food and hot beverages be served piping hot.
• Do not eat food from street vendors.
• Carry hand sanitizer at all times and use it liberally. Wash hands with soap before eating.

Water

• Boiling water for three minutes is the safest disinfectant method.
• Drink bottled water and juices, and steaming hot coffee and tea. Make sure bottles are unopened and have an intact seal.
• Use bottled water to brush your teeth.
• Avoid milk and dairy products, which may be unpasteurized.
• Do not use ice that is made from local tap water.
• Consider using iodine tablets to disinfect water, unless you are pregnant or have a thyroid condition. Iodine can also be used after water is passed through a portable water filter. Iodine disinfection and filtering are not foolproof, but they can reduce your risk.

How do I treat it?

If you contract traveler’s diarrhea, treatments are available to shorten your illness. Rehydration is the cornerstone of treatment. This is especially true for children, who become dehydrated more quickly.

• Drink fluids. Bottled juices and water, as well as broths made from boiled water, are excellent choices.

• Oral rehydration salts (ORS) are readily available around the world. Pedialyte is one brand well-known in the U.S. Dilute ORS with bottled water to rehydrate.
• You can make your own rehydrating solution by mixing together 1 tsp salt and 8 tsp sugar in 1 qt of clean water.
• Use loperamide (Imodium AD) if symptomatic relief is needed. Follow label directions. Do not take it if you have a fever or bloody stools.
• Consider taking with you an antibiotic prescribed by your travel physician if you have no relief from loperamide.
• Wash your hands frequently to prevent infecting others.

When do I need a doctor?

If the diarrhea is severe, or is accompanied by fever or rectal bleeding, consult a physician. In most cases of traveler’s diarrhea, this is not necessary. Nevertheless, if you have questions about your symptoms, or are uncertain about self-medicating, then seek medical advice.