Traveler’s diarrhea

The diarrhea of the traveler , also known as diarrhea tourists, is a relatively common disorder among those travelers whose destination are both countries with poor sanitary and hygienic conditions. It is estimated that around 40% of international travelers suffer from this type of diarrhea at some point during their trip. Although in the vast majority of cases it is not a serious condition, it usually requires bed rest for two or three days.

Causes of tourist diarrhea

The cause of this type of diarrhea is found in a bacterium, virus or parasite. The microorganisms that give rise to the disease vary between different countries; the most common are the following: Echerichia coli, Shigela, Salmonella, Campylobacter, Rotavirus and Giardia Lamblia .

It is worth noting that tourist diarrhea can occur anywhere in the world. In the case of Spain, it is common for outbreaks of salmonellosis to appear in summer , for example. However, as we have pointed out, it is in underdeveloped countries, with poor hygienic and sanitary conditions, where they occur most frequently among travelers.

Traveler’s diarrhea: risk factors

There are a number of factors that significantly increase the risk of this disorder.

• Place of origin and destination: it is travelers from developed countries who are more likely to suffer from traveler’s diarrhea. Regarding the place of destination, they are the poorest countries in which this disease occurs more frequently; generally in Africa, certain areas of Southeast Asia, and Central and South America.
• Type of trip: Of course, the type of trip also has a significant influence on the chances of suffering from this type of diarrhea. The risk is greater in adventure tourism trips than in those that take place in a tourist complex.
• Travelers: the age and health status of travelers are also influencing factors. Tourist diarrhea is more common in children and young people, as well as in pregnant women and those with HIV and diabetes .

How is it transmitted?

Almost 100% of patients affected by traveler’s diarrhea acquire the disease orally , through the consumption of food or beverages contaminated by microorganisms. The foods that have a greater risk are those that can be found in street stalls, while the safest are those cooked by the tourists themselves.

The safest foods are the following: bread and its derivatives, meats and fish that are well cooked, fruits whose skin is intact and are washed by oneself, boiled vegetables, and dishes that are served very hot.

As for the least safe foods, there are shellfish and mollusks, dishes that contain any type of dairy, sweet desserts, cheeses, and sausages.

Next we indicate which are the different transmission routes of the microorganism.

• Feces – mouth: occurs when, for example, a person goes to the bathroom and, after cleaning the genital or anal area, does not wash their hands. Thus, if this person shakes hands with a third party, they can transmit the microorganisms. Thus, when this third person puts their hand to their mouth at mealtime without having previously washed their hands, they can become infected. In this case, the best prevention method is to wash your hands frequently, especially before meals.
• Feces – food: this type of transmission occurs due to the lack of hygiene and health among those responsible for handling food. Thus, prevention consists of properly treating both food and beverages. It is worth remembering that ice cubes can also be contaminated by microorganisms that lead to traveler’s diarrhea.
• Toxins: and finally, certain toxins, such as botulinum for example, can be found in canned foods. In this case, prevention is somewhat more complex since in some cases the toxins are very resistant to heat, making them difficult to eliminate, even when cooking food.

Symptoms of traveler’s diarrhea

The first signs of the disease usually begin two to three days after transmission. The first symptom, which is repeated in practically 100% of patients, is loose stools , which last for several hours or days and are accompanied by any of the following signs: nausea, vomiting, abdominal pain and fever . The vast majority of patients present around six bowel movements a day, although in the most severe cases they can reach twenty.

In some cases the diarrhea is accompanied by blood in the stool ; a serious situation that requires urgent medical assistance. Fever, chills, and fatigue are also common.

It is estimated that 3% of tourists have chronic diarrhea, which lasts for more than a month; the symptoms themselves are loose stools, weight loss, flatulence, and fever.

It is important to see a doctor immediately when you have a high fever, persistent nausea and vomiting, blood and mucus in the stool, signs of dehydration such as dryness and dark urine.

How to prevent traveler’s diarrhea?

So far there is no vaccine against the microorganisms that cause this type of diarrhea, so prevention consists of taking into consideration a series of basic precautions during travel, especially if they are to exotic and / or underdeveloped countries.

• One of the most important points has to do with the drinks. It is essential to ensure that the bottles are closed and have not been previously opened. Of course, you have to avoid tap water , even for brushing your teeth, for washing food, or for making ice.
• To get drinking water when bottled water is not accessible, a good trick is to boil it for 10 minutes and filter it. There are portable computers that are a very good option for travelers.
• Hygiene is of the utmost importance to avoid this disorder that can ruin the holidays. Hands should be washed frequently , using plenty of soap and warm water. To dry them, it is essential to make sure that the towel is completely clean.
• Although vegetables are one of the healthiest foods that exist, it is advisable to avoid those that are served raw, such as salads. The best cooked foods.
• When consuming fruit, it is important that it is not peeled.
• As for dairy derivatives , it is best to avoid those that are not pasteurized: ice cream, custard, custard, cream …

What to do with tourist diarrhea?

When a traveler is affected by this disorder, it is important to pay attention to a series of basic measures so as not to worsen the diagnosis.

First of all, the most important thing is to avoid dehydration , so fluid intake is essential. If the diarrhea lasts beyond 24 hours and the stools are practically continuous, it is best to opt for the administration of oral rehydration sachets ; If this type of medication is not available, it can be prepared by mixing a liter of water with six teaspoons of sugar and a teaspoon of salt. Food also plays a key role; the most advisable in this case is to consume cooked rice, bread and cereals.

It is advisable to go to the doctor to administer an antidiarrheal such as loperamide; markedly improves the symptoms of traveler’s diarrhea. If the diarrhea is moderate or severe, in addition to an antidiarrheal, antibiotics are recommended.

Complications of traveler’s diarrhea

In the vast majority of cases, tourist diarrhea is not a serious disorder; With proper hydration and medical treatment, it begins to subside after a few days without causing any type of sequelae.

The most frequent complications have to do with dehydration due to the loss of vital fluids, salts and minerals ; a dangerous situation in the case of children, the elderly and people with weakened immune systems.

Dehydration related to diarrhea can lead to very serious health conditions, such as damage to certain organs, or even a coma. The most common symptoms of dehydration are: dryness, intense thirst, little urine, and extreme weakness.

Conclution

As we have noted, traveler’s diarrhea occurs more frequently in tropical and subtropical areas of Africa, Latin America, and Southeast Asia . Therefore, when traveling to these types of destinations, especially those with chronic diseases such as HIV or diabetes, they should pay special attention to a series of basic hygiene and health recommendations. The best way to protect yourself from this disorder is through a correct selection of the foods and drinks that are consumed.