Traveller's Diarrhea

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About Traveler's Diarrhea

Acute diarrhea affects millions of travelers each year. Especially, people who travel from developed countries to developing countries. Acute diarrhea is the most common illness among travelers. Up to 55 percent of persons who travel from developed countries to developing countries are affected. Food and water contaminated with fecal matter are the main sources of infection. Bacteria are the most common causes of traveler’s diarrhea. Parasites and viruses are less common etiologies. When you visit a place where the climate or sanitary practices are different from yours at home, you have an increased risk of developing traveler's diarrhea. Fortunately, traveler's diarrhea usually isn't serious, it's just unpleasant.

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Definition

What is traveller's diarrhea?

The classic definition of traveler’s diarrhea is three or more unformed stools in 24 hours with at least one of the following symptoms: fever, nausea, vomiting, abdominal cramps, tenesmus, or bloody stools. Milder forms can present with fewer than three stools (e.g., an abrupt bout of watery diarrhea with abdominal cramps). Most cases occur within the first two weeks of travel and last about four days without treatment.

Causes

What organism causes traveller's diarrhea?

|Bacteria

coli types: E. coli infections spread through direct person-to-person contact or contaminated water or food. Some strains of the bacteria secrete a toxin that can be life-threatening for small children and older people.
Salmonella: These bacteria are a major cause of food poisoning and are frequently found in raw chicken or eggs.
Campylobacter: Another common type of bacteria that can also make you ill if you eat poultry the food isn’t fully cooked Like a salmonella infection.
Shigella: They attack the intestinal wall and may cause ulcers that bleed. Shigella infections account for more than 160 million cases of diarrhea around the world each year.
Vibrio: This bacteria can lead to serious and sometimes lethal skin infections or food poisoning. If it causes serious food poisoning, you may need to be hospitalized.

|Parasites

Giardia lamblia: Which spreads easily through contaminated water and human contact. Bathing in and drinking water from contaminated streams or lakes can also lead to an infection and chronic diarrhea.
Entamoeba histolytica: Very common in in developing countries that have poor sanitary conditions.
Cryptosporidium parvum: A common culprit behind diarrhea epidemics in childcare centers and other public places. Cryptosporidium often causes watery diarrhea that can last for 2 weeks or more.

|Viruses

Rotavirus: It’s very contagious and is the most common cause of diarrhea in infants and young children worldwide.
Noroviruses: The most common cause of acute gastroenteritis (diarrhea and vomiting illness) around the world. It spreads easily through food and drink and can have a big impact on people's health

How contagious is traveller's diarrhea?

Diarrheal infections are highly contagious. They can spread from person to person via dirty hands, contaminated food or water, and some pets. Most cases are contagious for as long as a person has diarrhea, but some infections can be contagious for even longer.

Symptoms

What are symptoms of traveller's diarrhea?

Loose, watery stools
Nausea
Vomiting
Fever
Abdominal bloating
Dizziness
Loss of appetite

When to see a doctor?

Does traveller's diarrhea resolve on its own?

Traveler's diarrhea usually goes away on its own within several days. Signs and symptoms may last longer and be more severe if the condition is caused by organisms other than common bacteria. In such cases, you may need prescription medications to help you get better.

For adults

If you're an adult, see your doctor if:

Your diarrhea persists beyond two days
You become dehydrated
You have severe abdominal or rectal pain
You have bloody or black stools
You have a fever above 102 F (39 C)

A local embassy or consulate may be able to help you find a well-regarded medical professional who speaks your language.

For children

Be especially cautious with children because traveler's diarrhea can cause severe dehydration in a short time. Call a doctor if your child is sick and exhibits any of the following signs or symptoms:

Persistent vomiting
A fever of 102 F (39 C) or more
Bloody stools or severe diarrhea
Dry mouth or crying without tears
Signs of being unusually sleepy, drowsy or unresponsive
Decreased volume of urine, including fewer wet diapers in infants

How is traveler's diarrhea diagnosed?

Your healthcare provider will ask about your health history and your symptoms. He or she will ask about your recent travel. You may also have a stool culture or other tests. A stool culture is done by taking a small sample of stool. It is then sent to a lab to check for bacteria, viruses, and parasites. If your symptoms last longer than 10 to 14 days, you may have other tests.

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Complications

What can be complications of traveller's diarrhea?

Answers Because you lose vital fluids, salts and minerals during a bout with traveler's diarrhea, you may become dehydrated. Dehydration is especially dangerous for children, older adults and people with weakened immune systems.

Dehydration caused by diarrhea can cause serious complications, including organ damage, shock or coma. Signs and symptoms of dehydration include a very dry mouth, intense thirst, little or no urination, and extreme weakness.

TREATMENT

Does traveller's diarrhea resolve on its own?

Traveler's diarrhea usually goes away on its own within several days. Signs and symptoms may last longer and be more severe if the condition is caused by organisms other than common bacteria. In such cases, you may need prescription medications to help you get better.

Is CocaCola or carbonated drink good for traveller's diarrhea?

Coke has long been suggested as a remedy for diarrhea, but the International Foundation for Gastrointestinal Disorders (IFFGD) suggests that caffeinated beverages, fructose, fruit-sweetened drinks and some sugar substitutes can actually make diarrhea worse. Harvard Health suggests that caffeine can actually increase the loss of water and salt.

How do you get rid of traveller's diarrhea fast?

Traveler’s diarrhea typically resolves within two to three days, but even mild cases can last up to seven days. It may resolve faster with treatment. Because symptoms may not start until several days after exposure, it may be difficult to pinpoint exactly what made you sick. While recovering, be particularly careful to avoid any contaminated food or water sources. This will speed up healing and prevent continued or repeat exposure.

Prevention of traveller's diarrhea

Watch what you eat

The general rule of thumb when traveling to another country is this: Boil it, cook it, peel it or forget it. But, it's still possible to get sick even if you follow these rules.

Other tips that may help decrease your risk of getting sick include:

Don't consume food from street vendors.
Avoid unpasteurized milk and dairy products, including ice cream.
Avoid raw or undercooked meat, fish and shellfish.
Steer clear of moist food at room temperature, such as sauces and buffet offerings.
Eat foods that are well cooked and served hot.
Stick to fruits and vegetables that you can peel yourself, such as bananas, oranges and avocados. Stay away from salads and fruits you can't peel, such as grapes and berries.
Be aware that alcohol in a drink won't keep you safe from contaminated water or ice.

Don't drink the water

When visiting high-risk countries, keep the following tips in mind:

Avoid unsterilized water — from tap, well or stream. If you need to consume local water, boil it for three minutes.
Avoid locally made ice cubes or mixed fruit juices made with tap water.
Beware of sliced fruit that may have been washed in contaminated water.
Don't swim in water that may be contaminated.
Keep your mouth closed while showering.
Feel free to drink canned or bottled drinks in their original containers — including water, carbonated beverages, beer or wine — as long as you break the seals on the containers yourself. Wipe off any can or bottle before drinking or pouring.
Use bottled water to brush your teeth.
Use bottled or boiled water to mix baby formula.
Order hot beverages, such as coffee or tea, and make sure they're steaming hot.

If it's not possible to buy bottled water or boil your water, bring some means to purify water. Consider a water-filter pump with a microstrainer filter that can filter out small microorganisms.

You can also chemically disinfect water with iodine or chlorine. Iodine tends to be more effective, but is best reserved for short trips, as too much iodine can be harmful to your system. You can purchase iodine tablets or crystals at camping stores and pharmacies. Be sure to follow the directions on the package.

Additional tips

Here are other ways to reduce your risk of traveler's diarrhea:

Make sure dishes and utensils are clean and dry before using them.
Wash your hands often and always before eating. If washing isn't possible, use an alcohol-based hand sanitizer with at least 60 percent alcohol to clean your hands before eating.
Seek out food items that require little handling in preparation.
Keep children from putting things — including their dirty hands — in their mouths. If possible, keep infants from crawling on dirty floors.
Tie a colored ribbon around the bathroom faucet to remind you not to drink — or brush your teeth with — tap water.

updated on 20 May 2021.

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