Food or water contamination when traveling abroad can put a real damper on your vacation.  According to Mayo Clinic, when you visit a place where the climate, social conditions, and sanitary standards and practices are different from yours at home, you have an increased risk of developing “traveler’s diarrhea” or food poisoning, hepatitis A, or typhoid fever.

Be Prepared…Just in Case:

Check with Your Physician Prior to Travel:

According to the Centers for Disease Control and Prevention, you should ask your physician for suggestions on over-the-counter medications or if they’d recommend a prescription antibiotic in case you get food poisoning or diarrhea while abroad.

Infants and Children:

Children 2 years old and younger are at a higher risk of developing dehydration with diarrhea. Pack some Pedialyte and check with your child’s doctor prior to travel for advice on what to do should they get food poisoning or diarrhea.  They can suggest what over-the-counter medicines you should plan on bringing.  It is better to be prepared in advance.

Causes: 

Travelers have an increased risk of food poisoning (traveler’s diarrhea) because they are eating at unfamiliar and potentially unclean restaurants.  Food can become contaminated through improper cooking, handling, and storage.  It can also occur when travelers ingest pathogens for which their bodies have no defense.  As an example, locals can drink the water with no ill effects; whereas travelers can have an adverse reaction to it.

Symptoms:

 According to the Mayo Clinic, food poisoning will vary depending on the source of the contamination and the health of the person.  In general, it causes nausea, vomiting, diarrhea, stomach pain, and cramps, reduced appetite, exhaustion, and fever.  The symptoms can last from a few hours to a few days, and in severe cases, can linger for more than a week.

Prevention:

The Centers for Disease Control and Prevention recommends that travelers eat at restaurants with proper health certification.  Food poisoning can be prevented by knowing what to expect in the way of local eating habits.

• Do not drink the water or anything that may be mixed with the local water. This includes ice cubes (when ordering, always ask to have your drinks without ice), juices made with local water, or sodas from a fountain machine.  Instead, ask for canned juice or pop (carbonated is better).

• If local water is the only water available, boil it for ten minutes before consuming
• Do not drink any juices or dairy products (including ice cream) that are not pasteurized
• Keep your hands washed with soap and water and carry some disinfecting wipes to wipe down public surfaces like tray tables, seat armrest on the plane, etc. When staying in a hotel, wipe down the TV remote control and telephone.  These rarely get cleaned
• Check guidebooks in advance for restaurant recommendations, or check with the hotel concierge. They will usually recommend quality establishments

• Avoid any raw foods that are subject to contamination or are rinsed with local water such as, salads, fresh fruits and vegetables, seafood, undercooked meat, shellfish, tropical reef fish, and more
•  Acidic fruits such as oranges and grapefruits or fruits you can peel yourself can be rinsed in bottled water and eaten safely
• Hot tea and coffee that has been boiled should be safe
• Pack bottled water from home, because not all bottled water abroad is safe. They can be impure and even counterfeit (contain tap water).  If you do purchase it abroad, make sure the seal has not been broken and look for a certification such as the NSF
•  Order fried eggs cooked on both sides—do not order sunny-side up, and order your meat well done
• As a general rule, foods that are boiled should be safe to consume
• Don’t eat any perishable foods that have been sitting out for over an hour or lukewarm food. Food should be hot when served
• Use bottled water for brushing your teeth and try to keep your mouth closed when taking a shower or washing your face. Elderly people or those with a weakened immune system may want to avoid breathing in steam or water vapors from hot baths or showers
• Avoid street food vendors selling ice cream (it’s most likely not pasteurized) and unwashed fruit or unlicensed restaurants
• Avoid condiments made with fresh ingredients (such as salsa)
• Avoid flavored ice or popsicles
• Avoid “bushmeat” (wild game, monkeys, or bats)

 In developing countries, food can harbor germs and diseases such as cholera, typhoid, and hepatitis A.

Hygiene and Cleanliness:

• Wash your hands often. If soap and water are not available, clean your hands with hand sanitizer that has at least 60% alcohol.
• Avoid touching your eyes, nose, and mouth.
• Try to avoid close contact with people who are sick (kissing, hugging, sharing utensils or cups, etc.)

 What to do if You Get Food Poisoning:

Mayo Clinic states that most food poisoning is mild and will resolve without treatment after a few days, although some types of food poisoning may last longer.  It is important to keep from getting dehydrated.

Since minerals that maintain the balance of fluids in your body are lost from frequent diarrhea, they need to be replaced.  Adults with diarrhea that isn’t bloody and there is no fever may benefit from taking an over-the-counter medicine like Imodium A-D or Pepto-Bismol.

Signs and symptoms may start within an hours after eating contaminated foods, or they may not be apparent until days or weeks later.

According to Mayo Clinic, the recommended treatments for food poisoning include: 

Replacement of Fluids and Electrolytes:

• Stop eating and drinking for a few hours to let your stomach settle
• Try sucking on frozen ice chips (be sure they are made with bottled or boiled water) or drinking small sips of water. You can also try sipping on clear soda, broth, or decaffeinated sports drinks (like Gatorade).  You’ll know you are getting enough fluid if you are able to urinate and it is clear and not dark
• Slowly ease back into eating with bland and low-fat foods such as soda crackers, toast, gelatin, bananas, and rice. Stop eating if you start feeling nauseated again
• Avoid eating certain foods like dairy products, caffeine, alcohol, nicotine, and fatty or spicy foods until you are feeling better
• Rest – the dehydration and illness can make you feel weak and tired

According to WebMD.com, if there is a concern about dehydration, adults can drink a solution made with World Health Organization oral rehydration salts.  Packets of the salt are available in pharmacies and stores in most developing countries.  Add one packet to boiled or treated water, making sure to read the instructions regarding the proper amounts of salt to water.  Drink the solution within 12 hours if kept at room temperature.

Seek Medical Care if Symptoms Persist:

According to Mayo Clinic, you should seek medical treatment if the following occurs:

• Frequent episodes of vomiting and the inability to keep liquids down
• Bloody vomit or stools
• Diarrhea for more than three days
• Extreme pain or severe abdominal cramping
• An oral temperature higher than 101.5 F (38.6 C)
• Signs and symptoms of dehydration—excessive thirst, dry mouth, little or no urination, severe weakness, dizziness, or lightheadedness
• Blurry vision, muscle weakness, and tingling arms

 For more information, check out CDC.gov or MayoClinic.org

For more insightful travel ideas, check out my book:

Know Before You Go:  Traveling the U.S. and Abroad