Travellers’ diarrhea

Diarrhea is the most common medical problem affecting travellers to developing countries.

Travellers’ diarrhea is often caused by eating food or drinking water contaminated by bacteria or viruses. Escherichia coli (E. coli) bacteria are the most common cause of travellers’ diarrhea.

Food can become contaminated when it is being transported, when it is not refrigerated properly and when people do not wash their hands or do not handle it properly.

Episodes of travellers’ diarrhea usually start suddenly either during travel or soon after returning home and are usually short-term. The travel destination and the type of travel (5-star accommodations vs. backpacking) could influence the risk of getting travellers’ diarrhea.

Symptoms usually last for 2 to 3 days and include:

• Frequent loose bowel movements
• Abdominal cramps
• Nausea
• Bloating
• Fever
• Vomiting

You should see a health care provider if the illness seems to be causing more serious symptoms.

Travellers’ diarrhea is spread by eating food or drinking water or other beverages contaminated by germs. People with traveler’s diarrhea can spread the infection to others if they do not wash their hands properly after using the toilet.

Travellers’ diarrhea usually goes away without treatment.

Medications for the treatment of diarrhea are safe and work well if taken as directed. They reduce the length and severity of diarrhea. These medications should not be used by travellers with fever or bloody diarrhea because they can make the disease worse.

People with travellers’ diarrhea are at high risk of dehydration:

• In adults, clear fluids are recommended.
• In children and older individuals, dehydration can be treated with specific solutions that are designed to help rehydrate. They are called “oral rehydration solutions”.
• Carefully follow instructions for preparing oral rehydration salts that use boiled or treated water. These solutions should be thrown away after 24 hours if refrigerated and after 12 hours if not refrigerated.
• Oral rehydration solutions can be purchased in developing countries. They can also be purchased in powdered form before you leave.

Travellers who develop 3 or more loose stools in an 8-hour period – especially if they occur with nausea, vomiting, abdominal cramps, fever, or blood in stools might be prescribed antibiotics. Because bacteria cause the majority of travellers’ diarrhea cases, antibiotics are usually effective. It is important that you finish all of the medication you have been given, even if you start to feel better.

*Any traveller with a fever and diarrhea who has visited a country where malaria is common must have a blood test done immediately to rule out malaria.

Travellers can lower their risk for travellers’ diarrhea by taking the following steps:

• Drink water that has been bottled, purified or treated.
• Eat foods that have been fully cooked and served very hot.
• Peel raw fruit and vegetables before eating them.
• Eat and drink milk products only if they have been pasteurized.
• Avoid foods from street vendors or market stalls.
• There is a vaccine available for travellers.