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Traveller’s diarrhoea

Traveller’s diarrhoea is one of the most common illnesses for tourists going to tropical climates. As many as 60% of all travellers suffer some form of diarrhoea, sometimes dubbed "Delhi Belly" or "Montezuma's revenge". Traveller’s diarrhoea (diarrhoea) is acquired through ingestion of faecal contaminated food or water, or both. Both cooked and uncooked foods might be implicated if they have been improperly handled. Especially risky foods include raw or undercooked meat and seafood and raw fruits and vegetables. Tap water, ice, and unpasteurized milk and dairy products can be associated with increased risk of TD; safe beverages include bottled carbonated beverages (especially flavoured beverages), beer, wine, hot coffee or tea, or water boiled and appropriately treated with iodine or chlorine.
The onset of traveller’s diarrhoea is usually within the first week of travel, but can occur at any time during the visit and even after returning home.

Manifestations: It typically results in four to five loose or watery stools per day. The duration of diarrhoea is 3 to 4 days. Approximately 10% of the cases persist longer than 1 week. Approximately 15% of ill people experience vomiting, and 2% to 10% have diarrhoea accompanied by fever or bloody stools, or both. Patients usually self-treat, but experts say cases can be cleared up much quicker if sufferers take antibiotics. About 10% of all cases are serious and people with long-term symptoms should seek specialist advice. All patients with traveller's diarrhoea are advised to ensure they replace lost fluids with fluids and rehydration tablets. Traveller’s can experience more than one episode of diarrhoea during a single trip. It rarely is life threatening.

Diagnosis and treatment: Most cases of diarrhoea are self-limited and require only simple replacement of fluids and salts lost in diarrhoeal stools. This is best achieved by use of an oral rehydration solution. There are also specialist tablets available, best to take some with you before travelling.

Prevent traveller’s diarrhoea by:
• Drink canned water
• Carbonated water is safer than un-carbonated water
• Ask for drinks without ice
• Avoid popsicles and flavoured ices that may have been made with contaminated water
• Eat foods that have been thoroughly cooked and that are still hot and steaming
• Avoid raw vegetables and fruits that cannot be peeled
• Vegetables like lettuce are easily contaminated and are very hard to wash well
• Eat raw fruit or vegetables that can be peeled, peel them you. (Wash your hands with soap first.) Do not eat the peelings
• Avoid foods and beverages from street vendors. It is difficult for food to be kept clean on the street, and many traveller’s get sick from food bought from street vendors.