Conditions Basics
What is traveller's diarrhea?
Traveller's diarrhea is a common medical problem for people travelling from developed, industrialized countries to developing areas of the world.
High-risk areas for traveller's diarrhea include developing countries in Africa, Asia, the Middle East, and Latin America. Low-risk areas include the developed countries of North America, Central Europe, Australia, and Japan.
What causes it?
Traveller's diarrhea is usually caused by a bacterial infection. Bacteria such as Escherichia coli (E. coli), Campylobacter, Shigella, or Salmonella are the most common causes. These bacteria are in water contaminated by human or animal stools. Drinking water, water used to wash food, or irrigation water may be affected. When the traveller drinks this water or eats contaminated food, he or she is likely to get diarrhea.
Common sources of bacteria that cause diarrhea are undercooked or raw foods, contaminated food, or contaminated water (including ice cubes).
What are the symptoms?
Traveller's diarrhea can be mild to severe. Most people who develop traveller's diarrhea have symptoms within the first 2 weeks, and often within 3 to 4 days, of arriving in a developing area. Symptoms include:
- Diarrhea.
- Abdominal cramps.
- Mild to severe dehydration.
- Low energy, nausea, and vomiting.
- Fever, vomiting, and stools with blood or mucus. These symptoms mean you have serious diarrhea, which is more likely to lead to problems with dehydration. Dehydration may change how some medicines work, such as birth control pills or medicine for malaria.
How is traveller's diarrhea treated?
Treatment for traveller's diarrhea includes drinking fluids so you don't get dehydrated, taking non-prescription medicines, and sometimes antibiotics and intravenous (IV) fluids.
- Take small sips of bottled or boiled water or a rehydration drink often and small bites of salty crackers.
- If possible, drink a solution made with World Health Organization (WHO) oral rehydration salts. Packets of the salts are available at stores and pharmacies in most developing countries. Add one packet to boiled or treated water, making sure to read the instructions for how much of the salts and water to use. Drink the solution within 12 hours if kept at room temperature, or within 24 hours if you keep it in the fridge.
- Begin eating a simple diet of bland foods, such as crackers, rice, bread, potatoes, or bananas, which usually will help slow diarrhea. After your diarrhea is gone, you may eat a regular diet again.
Children 2 years old or younger are at high risk of dehydration from diarrhea. If your child has diarrhea:
- Give your child a solution of WHO rehydration salts and keep giving them their regular food as long as diarrhea continues. If your baby has trouble keeping the liquids down, try giving sips by spoon often. It's important that the rehydration salts be added to bottled water or water that has been boiled.
- Continue breastfeeding normally. Bottle-fed babies should continue their usual formula.
- Feed your child starches, cereals, yogurt, fruits, and vegetables.
- Seek medical help immediately if you or your child has bloody diarrhea, fever, or persistent vomiting, and give rehydration fluids in the meantime.
Medicines
- Your doctor may recommend an over-the-counter medicine. These may include bismuth subsalicylate (Pepto-Bismol) or loperamide (Imodium). Read and follow all instructions on the label. Do not use these medicines if your doctor does not recommend them.
- Be safe with medicines. If your doctor recommends prescription medicine, take it as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
- If your doctor prescribes antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
How can you help prevent it?
The best way to lower your risk of traveller's diarrhea is to avoid food or water that may be contaminated. A good rule of thumb for food safety is, "If it's not boiled, well-cooked, or peeled, don't eat it."
Avoid drinking local water where you're travelling. Drinks that are usually safe include:
- Tea and coffee if made with boiled water.
- Carbonated bottled water or soda pop.
- Bottled beer and wine.
- Bottled water (make sure bottle is sealed).
Water can be boiled, treated, or filtered to make it safe to drink. Talk to your travel health professional about the best options for your trip.
Also, be aware that contaminated water may be used to wash fruits and vegetables, clean utensils and plates, and make ice cubes. Brushing your teeth with untreated water also may increase your risk of infection.
Foods and drinks to avoid:
- Any raw or undercooked meat, fish, or seafood.
- Salads or other foods served at room temperature.
- Drinks served with or made with ice.
- Unpasteurized fruit juices and dairy products.
- Foods from street vendors.
Good handwashing is important in preventing the spread of infectious diseases. Washing with treated water or using alcohol wipes or antibacterial gels to disinfect your hands are good ways to lower your risk of getting an infectious disease.
Talk with your doctor or travel health professional about antibiotics you can carry with you on your trip and instructions on when to use them just in case you get diarrhea.
Dukoral vaccine is a cholera vaccine. There is little proof that it helps prevent traveller's diarrhea, so it is usually not recommended for travellers.
Other information sources
- Government of Canada: Find travel information at www.travel.gc.ca.
- Travel health clinics: You should see a travel health professional at least 6 weeks before going to a developing country. To find a travel clinic near you, go to the Public Health Agency of Canada’s website at Travel Health Information.
- International Association for Medical Assistance to Travellers: Sign up for the free medical directory so you can find healthcare while travelling at www.iamat.org/medical-directory.
Health Canada's Travel Health program offers information on international disease outbreaks and treatment and prevention guidelines. Local health units can also access this information to help you determine what prevention measures—such as vaccines, antimalarial medication, or supplies to treat water—are appropriate for the area of the world you are travelling to. Travel Health also offers a website (www.travelhealth.gc.ca) with updated information for travellers.
