We've all heard the horror stories. Someone goes on vacation and ends up with a terrible case of Montezuma's revenge (traveler’s diarrhea) because he or she ate the local street food. This has prompted well-meaning friends to offer the advice: "Don't drink the water." While it is certainly the fodder for jokes, getting traveler's diarrhea when traveling can be quite serious, especially if someone is traveling to a less developed country than the United States where food and water safety standards are not as high. But if travelers follow these rules, they will significantly reduce their chances of becoming ill.
What Causes Traveler’s Diarrhea?
Traveler’s diarrhea is typically caused by the growth of harmful bacteria in food and water. Contamination can occur at all stages of production including growing, harvesting, shipping, handling or storing. Food can also be cross-contaminated, meaning that it wasn't originally contaminated, but came in contact with a surface that was during preparation. This is the reason that all food service workers in the United States are required by law to be certified to handle food safely, usually by the city or county in which they work.
The quality of water is a major problem in many places. Water can be a source of a number of contaminants, along with the different standards and practices of maintaining water quality in different countries. However, there are a number of ways in which water can be consumed safely while traveling abroad.
- Bottled water: Bottled water is the most convenient option for travelers provided that the water has been processed in a way that removes all bacteria and the bottles are sealed. Distilled water or purified water are the best options.
- Boiling water: Boiling is a relatively low tech way to purify water. Water should be brought to a vigorous boil for one minute and then allow to cool to room temperature. Do not add ice. If the altitude is above 6,500 feet, water should be boiled for three minutes. Salt can be added to water to improve its flavor.
- Ultraviolet light: Ultraviolet light is effective at killing bacteria found in water and products are available at outdoor stores that are the size of a large ink pen that emit ultraviolet light. These products have been proven effective.
- Chemically treating: Water can be chemically treated to remove bacteria. Both iodine and chlorine bleach can be safely used to purify water. This is recommended for water that comes from any wild source, even in the United States such as when camping. Water should be strained through cloth to remove any solid particles before chemically treating. Iodine tablets are available at outdoor stores and dosages are printed on the bottles. Chlorine bleach can also be used, though it is not as effective as iodine. It is better than nothing when it is all that's available. Add 1/8 teaspoon to each gallon of clear water, add ¼ teaspoon to each gallon that is cloudy. Mix well and allow the water to sit for at least 30 minutes if clear, an hour if cloudy.
Treated water should be used for everything, including cooking, drinking, and washing to avoid any risk of illness.
Food is a common source of bacterial contamination when traveling abroad. But there are ways to avoid becoming sick.
- Avoid eating raw fruits and vegetables. There is the possibility that fresh produce could have been washed with contaminated water. Only consume foods that are steaming hot or that have been peeled by the consumer, such as bananas and citrus fruits. Foods should be cleaned in sanitized water before eating. For more information, read Washing Fruits And Vegetables To Avoid Foodborne Illness.
- Avoid raw or unpasteurized products such as dairy products or fruit juices. Pasteurizing kills the bacteria that can cause foodborne illness. Opt instead for ultra-pasteurized products.
- Avoid foods that are room temperature. Foods should be held and served either very hot or very cold.
- Avoid food sold by street vendors in developing countries.
Sanitation is an area that people often over look when it comes to traveler’s diarrhea because it doesn't involve eating. But the same water that can make people sick by drinking it can also make them sick if it finds another way to enter their bodies.
- Brush teeth with sanitized water. Bottled water is fine as is chemically treated or boiled water.
- If the condition of the water is of concern, sanitized water can be used for bathing as well, though if someone has no open wounds or broken skin, it is usually safe to bathe in the water as long as the water is not entering the body.
- Use purified water for cleaning any wounds and treat with antibacterial ointment.
- Use purified water for washing clothing, especially under garments.
If you are planning to visit an area where sanitation could be a problem, following these tips can help ensure a more enjoyable trip, minus the traveler’s diarrhea.