Traveller's Diarrhoea

What is Traveller's Diarrhoea?

When people travel to different parts of the world, they are often exposed to a variety of different germs that they have never been exposed to before.  When ingested through contaminated water or food, acute gastro-intestinal illness, usually vomiting and diarrhoea, may occur.  This illness is often referred to as “Traveller’s Diarrhoea”. A large number of germs (bacteria, viruses and parasites) may cause this illness.

How do you get Traveller's Diarrhoea?

Traveller's diarrhoea is caused by germs that are usually acquired through consuming food and water that is contaminated with human and/or animal waste. 

The most common sources of the germs that cause traveller's diarrhoea include:  undercooked beef, chicken, pork and raw fish; contaminated ice; contaminated well water; unpasturised milk and milk products; salad bars; raw vegetables and fruits (like strawberries, grapes, and raspberries) that cannot be easily peeled or cleaned; improperly refrigerated custards, mousses, mayonnaise, hollandaise sauce, etc.; non-bottled fruit or vegetable juices.

These products are often available from street vendors where food preparation and water sources are not regulated.

Susceptibility and Resistance

Depending on the infecting germ, people who are repeatedly exposed in areas where they reside may develop variable levels of immunity to the local germs.  However, travellers to those areas have usually not been exposed previously and are generally susceptible.

Incubation Period

The incubation period for Traveller's Diarrhoea is 1-10 days.

What are the Symptoms?

The symptoms depend somewhat on the infecting germ, but in general, the patient develops sudden onset of diarrhoea, sometimes with fever, fatigue, abdominal pain, nausea and vomiting.  The illness is usually short lived, mild and frequently subsides in 2-5 days without medical treatment.  However, depending on the germ, this illness may become severe, with possible dehydration and with repeated episodes over a long period of time.

Preventative Measures

Avoid consuming unsafe food and water.  The most common things to avoid include undercooked beef, chicken, pork and raw fish; contaminated ice; contaminated well water; unpasturised milk and milk products; salad bars; raw vegetables and fruits, like strawberries, grapes, and raspberries that cannot be easily peeled or cleaned; improperly refrigerated custards, mousses, mayonnaise, hollandaise sauce, etc.; non-bottled fruit or vegetable juices.

Do not consume food or beverages from street vendors. Travellers should try to drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. Water can be purified by boiling or by the addition of water purification tablets or drops.

All food should be fully cooked. 

Treatment

Treatment depends to some degree on the causative germ.  In general, maintaining adequate intake of fluids and treatment of symptoms with over-the-counter medications are sufficient.  If the condition persists, identification of the causative germ may be required in order to prescribe a definitive treatment, such as an antibiotic.  Travellers should seek immediate medical attention if symptoms continue in spite of initial treatment or if severe or bloody diarrhoea develops.

Medications

Where Does It Commonly Occur?

Since traveller's diarrhoea can be caused by a wide variety of germs, it can occur anywhere in the world.

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