When embarking on a journey abroad, you likely have an extensive checklist of must-see attractions and must-do activities. However, experiencing diarrhea, vomiting, and stomach cramps is definitely not on that list. Unfortunately, these digestive issues are all too common among travelers. According to the Centers for Disease Control and Prevention (CDC), 30% to 70% of vacationers experience traveler’s diarrhea, depending on their destination and the time of travel. While it is not always preventable, you can minimize the risk by being mindful of what you consume and following the “boil it, cook it, peel it or forget it” rule.
Leah Silberman, a registered dietitian at the Medical Offices of Manhattan, explains that traveling exposes you to new food sources, local food handling methods, and varying cleanliness standards. This increases the likelihood of encountering infections or pollutants for which your body may not have developed immunity. Unsafe drinking water or improper handwashing practices can also contaminate food, as noted by Mitzi Baum, CEO of the nonprofit organization Stop Foodborne Illness. Before traveling, it is wise to consult the CDC’s list of destinations, which highlights food and water safety concerns.
It is important to keep in mind that you can fall ill from foodborne illnesses anywhere, including within the United States. The CDC reports that one in six Americans contracts a foodborne illness each year, resulting in thousands of deaths and hospitalizations. However, traveling can heighten the risk of experiencing digestive issues. Factors such as being unaccustomed to the local cuisine, encountering different food handling processes, jet lag, and changes in climate can weaken your immune system, according to Silberman.
To protect yourself from traveler’s diarrhea during your next trip, it is recommended to follow these tips provided by dietitians and food safety experts. They explain which foods are more likely to put you at risk for foodborne illnesses.
What Is Traveler’s Diarrhea?
Traveler’s diarrhea is the most common illness associated with travel and is caused by consuming contaminated food or drinks, according to the CDC. The main culprit is E. coli bacteria, but travelers can also fall ill from salmonella, shigella, campylobacter, as well as viruses like astrovirus, norovirus, rotavirus, and the parasite giardia. These illnesses often result from poor food handling, inadequate sanitation, or contaminated water.
Symptoms of traveler’s diarrhea typically include diarrhea, abdominal pain, cramping, nausea, vomiting, and fever. While viral or bacterial infections usually manifest within six to 24 hours, parasitic infections may take a few weeks to show symptoms. The highest-risk destinations for traveler’s diarrhea are Asia (excluding Japan and South Korea), the Middle East, Africa, Mexico, and Central and South America, as stated by the CDC.
Reducing the risk of contracting traveler’s diarrhea involves frequent handwashing with soap and water, especially after using the restroom and before eating, according to Baum. Additionally, it is essential to avoid consuming certain foods and drinks that are more likely to be contaminated.
Foods And Drinks To Avoid When Traveling Abroad
While any food or beverage can potentially cause foodborne illnesses, some carry a higher risk depending on your travel destination. Food safety measures, hygiene standards, and culinary practices vary across different regions, warns Silberman. To make informed choices, research the food safety and health risks specific to your destination. However, here are some general foods and drinks to consider avoiding:
1. Raw fish and meat: Raw meat and seafood pose a significant risk as it is difficult to determine their origin, storage time, and handling practices. Silberman advises against consuming rare steaks, tartare, sushi, ceviche, or any raw or inadequately prepared meat, fish, or seafood.
2. Fresh fruits and vegetables: Be cautious with fresh fruits and vegetables that appear to have been left out for a while, as they may harbor harmful germs. Opt for cooked produce whenever possible, ensuring that it reaches high enough temperatures to kill pathogens. If you choose to consume fresh produce, make sure it is washed with safe water and peeled by you personally.
3. Dairy: Pasteurized milk and dairy products from sealed containers are generally safe to consume. However, avoid unpasteurized items like cheese, yogurt, or ice cream, as they are more likely to contain harmful bacteria such as listeria, salmonella, or E. coli. Additionally, be wary of dairy products that have been left at room temperature or exposed for extended periods.
4. Tap water: Contaminated water is a key cause of traveler’s diarrhea. Since pathogens are not visible to the naked eye, it is challenging to determine whether tap water is safe to drink. The CDC’s travelers’ health website provides information about the safety of tap water in different countries. If unsure, stick to factory-sealed bottled water, avoid consuming ice made from tap water, and consider boiling water for at least a minute to kill any potential pathogens. When bathing or brushing your teeth in areas with unsafe tap water, use bottled water.
5. Certain types of street food: Street vendors can offer unique local delicacies, but the CDC advises caution as their safety practices may not align with those of restaurants. Avoid consuming foods or drinks that appear to have been left out for a while. Instead, opt for items that are freshly cooked and served hot off the grill.
What If You Get Sick While Traveling?
Despite taking precautions, it is still possible to fall ill with traveler’s diarrhea. While it is usually not a severe illness, it can last for a few days or even weeks if caused by a parasite, subsequently ruining your trip. If you find yourself in this situation, Silberman offers the following tips for self-care:
1. Stay hydrated: Diarrhea and vomiting can lead to dehydration, so it is crucial to drink plenty of bottled water or other safe fluids to replenish lost fluids.
2. Take over-the-counter medication: Antidiarrheals like loperamide (Imodium) or anti-nausea drugs like dimenhydrinate (Dramamine) can help alleviate symptoms. It is advisable to consult a healthcare professional, especially if you are on other medications.
3. Seek medical attention if needed: If your symptoms persist, worsen, or if you experience a fever, bloody stool, or signs of dehydration, it is crucial to seek medical attention. Upon returning home, contact your doctor if symptoms persist or if you have an underlying medical condition.
While avoiding illness during travel is a high priority, Rissetto emphasizes the importance of enjoying the experience without excessive worry. It is essential to find a balance that allows you to make informed choices about what you consume while still embracing new culinary experiences.
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