By Dr. Frank Scafuri III
STATEN ISLAND, N.Y. — Nothing can ruin a vacation or business trip more quickly than traveler’s diarrhea. It is the most common illness you are likely to experience while traveling. While it is usually not serious, this condition can be very unpleasant.
How does someone develop traveler’s diarrhea? It is possible it may stem from the stress of traveling or a change in diet. However, almost always an infectious agent is to blame. The most important determinant of risk is the traveler’s destination. High-risk destinations are the developing countries of Latin America, Africa, the Middle East and Asia. Persons at particularly high-risk include young adults, immunosuppressed persons, those with inflammatory-bowel disease or diabetes, and persons taking H-2 blockers or antacids.
Each year 20 percent to 50 percent of international travelers — an estimated 10 million individuals — develop diarrhea. The onset of traveler’s diarrhea usually occurs within the first week of travel, but may occur at any time while traveling and even after returning home.
Traveler’s diarrhea usually begins abruptly and most cases improve within one to two days without treatment. In addition, it is rarely life threatening. However, you can have multiple episodes of traveler’s diarrhea during one trip.
SYMPTOMS AND SIGNS
The following are the most common symptoms and signs of traveler’s diarrhea: increased frequency, volume and weight of stool, frequent loose stools (usually about four to five loose or watery bowel movements each day), abdominal cramps, nausea, vomiting, urgency, malaise, fever and bloating.
If you are experiencing these symptoms, and believe you may have traveler’s diarrhea, you may wonder when you should see your doctor. Well, as stated previously, most cases of traveler’s diarrhea go away on their own within one week. However, if you have severe dehydration, persistent vomiting, bloody stools or a high fever, or if your symptoms last for more than a few days, seek medical help.
A traveler should also 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, bloody stools or severe diarrhea, a fever of 101 or more, dry mouth or crying without tears, signs of being unusually sleepy, drowsy or unresponsive, decreased volume of urine (including fewer wet diapers in infants).
REDUCE YOUR RISK
Travelers to high-risk areas can reduce, but never completely eliminate, the risk for traveler’s diarrhea by following some of the following suggestions.
First, avoid eating foods or drinking beverages purchased from street vendors or other establishments where unhygienic conditions are present. Don’t eat raw or undercooked meat and seafood. Avoid eating raw fruits and vegetables unless you peel them first. Beware of sliced fruit that may have been washed in contaminated water.
Avoid unsterilezed water and ice cubs or fruit juices made with tap water. Keep your mouth closed while swimming and showering. Use bottled water to brush your teeth, and bottled or boiled water to mix baby formula.
Unpasteurized milk and dairy products are also associated with increased risk for traveler’s diarrhea.
If handled properly, well-cooked and packaged foods usually pose no risk. Safe beverages include bottled carbonated beverages, hot tea or coffee, beer, wine and water bottled or appropriately treated with iodine or chlorine. A general rule of thumb is this: Boil it, cook it, peel it or forget it.
In conclusion, there are precautions you can take to avoid contracting traveler’s diarrhea. However, there is no fool proof method. If you find you are suffering from the illness, take the steps listed above and seek medical attention if your situation worsens.
This column is provided by the Richmond County Medical Society. Dr. Scafuri specializes in infectious disease and maintains a practice in West Brighton and Eltingville.