by Sonnenberg E

IMAGE Robin considered herself a seasoned traveler. She had been to Mexico before. When she visited a friend in Mexico City, she knew not to drink the water. However, at a dance club in Acapulco she had a drink with ice. She spent the next 7 hours on a bus with traveler's diarrhea (TD).

TD is one the most common travel illnesses. It happens to travelers who ingest contaminated food or drink. They may develop symptoms such as:

  • Watery diarrhea
  • Nausea and vomiting
  • Fever
  • Belly pain

Symptoms can last for 3 to 7 days.

Decide on a Location

TD is most likely to affect visitors to Latin America, Africa, South Asia, and the Middle East. TD is a risk in places with poor sanitation and poor refrigeration. When you travel, be careful where you eat. Choose hotels and restaurants that cater to world travelers. They are generally safer than open-air markets. Do not eat at a street corner vendor or a festival.

Have a Prevention Plan

If you do decide to visit a high risk location:

  • Do not drink tap water or add ice cubes. Drink only bottled water. Bottled carbonated beverages, steaming hot tea or coffee, wine, and beer are usually okay to drink.
  • If necessary, boil tap water for 10 minutes. Or you can add iodine or chlorine tablets to disinfect tap water.
  • Brush your teeth using bottled, boiled, or iodine-treated water only.
  • Do not eat raw foods. This includes salads and fruits—unless you can peel them yourself.
  • Do not eat cooked food that has been sitting out in the open—even if it is re-heated. Food still hot from an oven is generally safer.
  • Feed children 6 months and younger breast milk. If you give formula, prepare it with sterilized water.
  • Do not eat seafood from tropical reefs. Some fish can be toxic even after cooking.

In general, do not eat:

  • Foods that are not steaming hot
  • Unpasteurized dairy products
  • Cold sauces and toppings
  • Open buffets
  • Undercooked or incompletely reheated foods
  • Fruit juices

See your doctor before you travel overseas. Your doctor may give you medicines to take with you. They may include antibiotics and medicine to stop diarrhea. You can use them if you develop TD. These medicines are usually not advised to prevent problems.. Ask your doctor if you have questions.

Getting Treatment Right Away

What if you do get sick? At the first sign of diarrhea, take the antibiotics as advised by your doctor. Do not take more antibiotics than the doctor advised. Start taking anti-diarrheal medicines as needed. They should help ease symptoms faster.

Drinking lots of fluids is very important. Oral rehydration salts (ORS) will provide important minerals. You can buy them before your trip and pack them in your toiletry kit. They are also available in most travel locations. You will have to mix the ORS with a safe water source.

Do not give anti-diarrheal medicine to young children,. Young children with diarrhea should see a doctor early on. They are at a higher risk for dehydration than adults. Make sure your child is drinking plenty of fluids. . Be alert for severe diarrhea (10 or more watery poops per day). Also watch if the child is peeing less frequently (a sign of dehydration). Get medical care right away.

Knowing When to Get Help

Get medical care right away if you have:

  • Vomiting or diarrhea that lasts longer than a couple of days
  • Symptoms that do not go away after 3 to 7 days and/or after antibiotic treatment
  • Lightheadedness
  • Worsening pain
  • High fever and/or confusion
  • Stools (poop) is bloody and/or contains mucus
  • Signs of dehydration, such as decreased saliva or urination
  • Fast, uneven heartbeats, or chest pain
  • You are pregnant or caring for a young child who develops diarrhea

In some cases, TD lasts despite antibiotic treatment. Rarely, it can trigger other digestive problems. See your doctor if symptoms worsen or do not go away.

RESOURCES

Centers for Disease Control and Prevention  https://www.cdc.gov 

International Society of Travel Medicine  http://www.istm.org 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

Travel Canada  https://travel.gc.ca 

References

Food and water safety. Centers for Disease Control and Prevention website. Available at: https://wwwnc.cdc.gov/travel/page/food-water-safety. Accessed October 26, 2021.

Traveler's diarrhea. Centers for Disease Control and Prevention website. Available at: https://wwwnc.cdc.gov/travel/page/travelers-diarrhea. Accessed October 26, 2021.

Traveler's diarrhea. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/travelers-diarrhea. Accessed October 26, 2021.

Water disinfection. Centers for Disease Control and Prevention website. Available at: https://wwwnc.cdc.gov/travel/page/water-disinfection. Accessed October 26, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board
  • Review Date: 10/2021
  • Update Date: 10/26/2021