Diarrhoea

• What is travellers' diarrhoea?
• What causes travellers' diarrhoea?
• What are the common symptoms?
• How can I prevent travellers' diarrhoea?
• What should I do if I contract travellers' diarrhoea?

What is travellers' diarrhoea?

Travellers commonly suffer attacks of diarrhoea particularly during the first week or two of a stay in a foreign environment. Travellers' diarrhoea is the most common health problem encountered by travellers and may affect up to 80% of travellers to high-risk destinations.

Even a brief episode of severe diarrhoea may spoil a holiday or ruin a business trip.

The risk of traveller's diarrhea is higher in countries with low standards of hygiene and sanitation and in such countries travellers should take precautions with all food and drink, including that served in good-quality hotels and restaurants

Remember though that poor food and water hygiene may be present in any country!

What causes travellers' diarrhoea?

The commonest causes are bacteria and viruses in contaminated food and water; however some parasitic and fungal infections may also cause travellers' diarrhoea.

Illness is also caused by certain biological toxins found in seafood (some shellfish, scombroid fish and puffer fish). The toxins involved in these poisonings come from microorganisms consumed by or otherwise contaminating the fish. Sporadic misuse of chemicals also occurs, such as the use of textile dyes in foodstuffs, which may give an unusually bright colour to the contaminated food.

What are the common symptoms?

Symptoms are usually those of abdominal cramps, vomiting and fever followed by diarrhoea lasting for about 2-3 days. In warm climates dehydration can make the experience worse

How can I prevent travellers' diarrhoea?

• Avoid cooked food that has been kept at room temperaturre for several hours
• Eat only cooked food that has been cooked thoroughly and still is hot
• Drinks bottled or pacjaged cold drinks, but ensure the seals are intact, hot beverages are usually safe
• Avoid uncooked food, apart from fruit and vegetables that cab be peeled or shelled
• Avoid fruits with damaged skins
• Avoid dishes containing raw or undercooked eggs
• Avoid food bought from street vendors
• Avoid ice cream from unreliable sources, including street vendors
• In countries where fish and shellfish may contain poisonous biotoxins obtain advise locally.
• Boil unpasteurised or unsterilised (raw) milk before consumption
• Boil drinking-water if its safety is doubtful; if boiling is not possible, use a certified, well-maintained filter and/or purifying tablets
• Avoid ice unnless you can be sure it is made from clean water
• Brush teeth withh boiled or treated water

What should I do if I contract travellers' diarrhoea ?

• Continue to eat if you feel hungry, but stick to a bland diet and avoid alcohol and dairy products until 12 hours after the last loose stool.
• Fluid replacement can be bought commercially or mixed as follows: - To 1 litre of clean water (boiled, bottled or from a purifier) add 1 level teaspoon of salt and 8 level teaspoons of sugar. For adults drink 2 glasses of solution per loose stool. Total fluid intake should be about 3 litres per 24 hours.
• Loperamide (Imodium) is an effective anti-diarrhoeal agent. Take in accordance with manufacturer's instructions. Two tablets may be taken in advance of important meetings.
• Antibiotics have been shown to shorten the duration of traveller's diarrhoea. A containing single dose of 500mg of ciprofloxacin (in a MASTA Travellers Diarrhoea Kit) taken after passing the first loose stool should reduce the duration of uncomplicated watery diarrhoea to about one day. If diarrhoea lasts longer than 4 days or there is a fever of 38 ° C or greater or there is blood in the stool then medical attention should be sought.

Reference: International Travel and Health 2005, The World Health Organisation - WHO Press: Geneva

Masta Limited 2005

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