Becoming ill from food or water contamination when traveling abroad can put a real damper on your vacation. This topic may not be at the top of your list when planning your trip, but knowing how to prevent food poisoning is essential to having a good time.

Here is what you need to know.

The reason you are more susceptible to becoming ill when traveling is because you are exposed to conditions that your body has not developed a tolerance against. The climate, social conditions, and sanitary standards and practices are different from yours at home, thus increasing your risk of developing “traveler’s diarrhea” or food poisoning. The good news is that you can reduce your chances of getting sick by being prepared. If you do happen to become ill, you will be able to combat it quickly and get on the road to recovery.

If you are traveling to a developing country, you will need to take extra precautions to guard against contamination. Foods in these countries can harbor germs and diseases such as cholera, typhoid, and hepatitis A.

Check with Your Physician Prior to Travel:

The Centers for Disease Control and Prevention recommends that travelers ask their physicians for suggestions on over-the-counter medications that should be packed. Some doctors may also recommend prescribing an antibiotic in advance “just in case” you get  food poisoning while abroad.

Precautions to take for Infants and Children:

Children two years old and younger are at a higher risk of developing dehydration with diarrhea. Pack some Pedialyte and check with your child’s physician for advice on what to do if your child gets food poisoning or diarrhea. They can suggest what over-the-counter medicines would be best to pack.

When mixing baby formula, brushing your child’s teeth or washing their face, be sure to use bottled water. It is best to bring bottled water from home.

Do not let children swim in ponds or rivers where they could swallow the water that could cause them to become ill.

Causes: 

Travelers are at a higher risk of food poisoning (traveler’s diarrhea) since they are eating unfamiliar foods, and potentially, at unclean restaurants. Food can become contaminated through improper cooking, handling, and storage. It can also happen when travelers ingest pathogens for which their bodies are unable to ward off, since they have not built up any immunities. For example, the locals are able to drink the water and ingest foods that may be contaminated with no ill effects, but travelers can have an adverse reaction.

Symptoms:

According to 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:

Food poisoning can be prevented by knowing what foods to avoid and how they are stored, cooked, and served. Choosing restaurants with a proper health certification is a good idea.

During a business trip (outside the U.S.) almost half of the people in our group ended up getting food poisoning the first night out. The hotel served a buffet dinner around the pool that included a fruit punch with ice cubes floating in it, garden salad, and fresh fruit. Those of us that skipped over those foods were fine, but the rest, unfortunately, did not fare so well and ended up spending the next few days in their room recovering.

Let’s keep that from happening to you.

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

• If local water is the only water available, boil it for ten minutes before consuming.

• Do not eat dairy products (including ice cream) that are not pasteurized. Before eating cheese and other dairy products, make sure it is cold and has not been sitting out.

• Wash your hands with soap and water and carry 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 ask 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 can be rinsed in bottled water and eaten safely. 
• Hot tea and coffee that has been boiled should be safe to drink.

• Pack bottled water from home. Not all bottled water purchased abroad is safe. Some of it is impure and even counterfeit (contains tap water).  If you do purchase it abroad, make sure the seal has not been broken and look for a certification such as by the NSF, a Public Health and Safety Organization.

• Order fried eggs cooked on both sides—do not order sunny-side up. Make sure your meat is 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 are lukewarm. Food should be steaming hot when served. Also make sure the food being served is protected from insects (lids covering it, etc.).

• 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 even breathing in the 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.

• Find out where the locals eat or where there are a lot of people eating. This usually means that food will not be sitting out and that there is a daily turnover so food will not be old.

• Avoid condiments made with fresh ingredients (such as salsa).

• Avoid flavored ice or popsicles. These are usually made with tap water.

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 that are sick (sharing utensils or cups, etc.)

What to do if You Get Food Poisoning:

Most food poisoning is mild and will resolve without treatment after a few days, although some types of food poisoning may last longer, according to Mayo Clinic. What is most important is to prevent dehydration.

Minerals that maintain the balance of fluids in your body are lost from frequent diarrhea and need to be replaced. Adults with diarrhea that isn’t bloody, and if they do not have a fever, may benefit from taking an over-the-counter medicine like Imodium A-D or Pepto-Bismol.

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

Recommended Treatments (per Mayo Clinic):

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.
• 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.

When to Seek Medical Care:

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 on how to prevent or treat food poisoning, visit the Centers for Disease Control and Prevention or Mayo Clinic. You can also check out NSF, the Public Health and Safety Organization on water and beverage safety.

For more travel insight, check out my book:

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

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and wherever books are sold.