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Traveler's Diarrhea: Don't Let It Ruin Your Vacation

Robin considered herself a seasoned traveler. She'd been south of the border before, so when she visited a friend in Mexico City, she knew better than to drink the water. But she let her guard down at a dance club in Acapulco and had a drink with ice. She spent the next 7 hours on a bus battling traveler's diarrhea (TD). "The discomfort was excruciating," Robin adds.

Traveler's diarrhea is one the most common illnesses affecting travelers. Travelers who ingest contaminated food or drink may experience a range of symptoms, including watery diarrhea, nausea, vomiting, fever, and abdominal pain, that can last for 3-7 days.

Deciding on a Location

Visitors to developing countries, like Latin America, Africa, and the Middle East, put themselves at increased risk of TD, according to the US Centers for Disease Control and Prevention (CDC). TD goes hand in hand with poor sanitation and poor refrigeration. When you travel, use your common sense when determining where and what to eat while abroad. For example, hotels and established restaurants that cater to world travelers are generally safer bets than open-air markets. To avoid problems, don't eat at a street corner vendor or a festival.

Having a Prevention Plan

For travelers who do not want to limit their destinations, a healthy dose of awareness can lower their risk of TD. Here are some tips when visiting high-risk locations:

In general, you should avoid these foods:

It is a good idea to see your doctor to talk about antibiotics and/or anti-diarrheal medications before you go. Don't take the antibiotics unless you need to. In most cases, they are not recommended as preventive medication. In the long run, they do more harm than good.

Getting Treatment Right Away

What if you do get sick? At the first sign of diarrhea, start with a 2- to 3-day course of antibiotics if you got them from the doctor. Start taking anti-diarrheal medications as needed for more immediate relief. Don't take more antibiotics that your doctor advised.

Staying hydrated is an essential part of treatment. You replenish fluid balance better with oral rehydration salts (ORS). They can be purchased before your trip and packed in your toiletry kit or are available in most travel locations. You will have to mix the ORS with a safe water source.

Avoid giving anti-diarrheal medication to young children,. Young children with diarrhea should see a doctor early on because they are at a higher risk for dehydration than adults. For mild to moderate diarrhea in children, make sure your child is staying hydrated. If diarrhea is severe (10 or more watery stools per day) or the child is urinating less frequently (a sign of dehydration), get medical care right away.

Knowing When to Get Help

Seek immediate medical care for TD in any of the following situations:

In some cases, TD can persist despite antibiotic treatment. Rarely, it can trigger other gastrointestinal problems. See your doctor if symptoms worsen or do not resolve.

RESOURCES:

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

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

CANADIAN RESOURCES:

Public Health Agency of Canada
https://www.canada.ca

Travel Canada
https://travel.gc.ca

REFERENCES:

Food and water safety. https://wwwnc.cdc.gov/travel/page/food-water-safety. Updated October 20, 2015. Accessed September 25, 2017.

Traveler's diarrhea. Centers for Disease Control and Prevention website. Available at: https://wwwnc.cdc.gov/travel/page/travelers-diarrhea. Updated April 26, 2013. Accessed September 25, 2017.

Traveler's diarrhea. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116545/Travelers-diarrhea. Updated May 3, 2016. Accessed September 25, 2017.

Water disinfection. Centers for Disease Control and Prevention website. Available at: https://wwwnc.cdc.gov/travel/page/water-disinfection. Updated April 26, 2013. Accessed September 25, 2017.

Last reviewed September 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP  Last Updated: 9/25/2017