Public Health Agency of Canada
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Travellers' Diarrhea
June 2009
Travellers' Diarrhea
What is Travellers' Diarrhea?
Travellers' diarrhea is the most common illness that affects travellers. It is easily spread from person to person or by eating food or drinking water contaminated with feces.
Cause
Many different bacteria (including E. coli, Salmonella, Shigella, Campylobacter), parasites (Giardia, Crytosporidium, Cyclospora and others) and viruses (such as norovirus and rotavirus).
Risk to Travellers
- Travellers are at higher risk when going to destinations with poor standards of hygiene and sanitation and poor food handling practices.
- Travellers' diarrhea most commonly affects people travelling from developed countries to developing regions of the world.
Severity
- Depends on which bacteria, parasite or virus has caused the illness.
- Most episodes of diarrhea are not severe and last only a few days.
- Travellers with chronic diseases face a higher risk of complications.
Prevention
- Practice safe food and water precautions.
- Wash your hands frequently with soap and warm clean water, or use hand sanitizer.
Treatment
- The most important treatment is rehydration. Carry oral rehydration salts while travelling.
- In some cases anti-motility medication (for abdominal pain) may provide some relief of symptoms and allow travellers to continue their activities.
- Your health care provider may discuss self treatment using antibiotics for one to three days.
Symptoms
- Usually include fever, nausea, vomiting, abdominal cramping and diarrhea.
- Generally, the symptoms go away in a few days without treatment.
- In more severe cases, travellers' diarrhea can lead to dehydration and death. This is a particular concern for children, the elderly and individuals with chronic diseases or weakened immune systems.
- If you have blood in your stool, you should seek medical attention even if your other symptoms are not very severe.
Transmission
- Travellers' diarrhea is spread by eating or drinking contaminated food and/or water.
- Travellers who visit areas with poor standards of hygiene and sanitation are at greater risk.
Where is Travellers' Diarrhea a concern?
The risk of travellers' diarrhea occurs worldwide.
High risk destinations include developing countries in Central and South America, Mexico, Africa, the Middle East and Asia.
There is a moderate risk in Eastern Europe, South Africa and some parts of the Caribbean.
The risk is lower in northern and western Europe, Australia, New Zealand, Japan, the United States and Canada.
Related Travel Health Notices
None
Recommendations for Travellers
- Practice safe food and water precautions
- Boil it, cook it, peel it or leave it!
- Always wash your hands before eating or drinking.
- Eat only food that has been well-cooked and is still hot when served. Avoid uncooked foods, especially shellfish and salads. Fruits and vegetables that can be peeled are usually a good choice.
- Cold foods should be eaten cold, hot foods should be eaten hot.
- Drink only purified water that has been boiled or disinfected with chlorine or iodine, or commercially bottled water and drinks in sealed containers.
- Avoid ice, unless it has been made with purified water.
- Avoid unpasteurized dairy products and ice cream.
- Avoid food from street vendors.
- Avoid swimming in polluted or contaminated water.
- Brush your teeth with treated or bottled water.
- Wash your hands frequently
- Use soap under running water, especially after diaper changes or using the toilet.
- Alcohol-based hand sanitizers can also be used if soap and water are not readily available - keep some with you in your pocket or purse.
Carry oral rehydration salts
- Oral rehydration salts can help to fight dehydration in cases of severe diarrhea.
- Oral rehydration salts are available in most countries although it is recommended to include them in your medical kit.
Don't Forget …
- Consult a doctor, nurse or health care provider, or visit a travel health clinic at least six weeks before you travel.
- What to do if you get sick when you are travelling.
- What to do if you get sick after you return to Canada.
- Know what vaccines you need and when to get them.
Other Related Information
- The Committee to Advise on Tropical Medicine and Travel (CATMAT)- Statement on Persistent Diarrhea in the Returned Traveller
- World Health Organization - Diarrhoeal Diseases
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