Maybe it was those fish tacos you ate on the beach. Perhaps it was the salad you had for dinner in the hotel. It could even have been the ice in your drink. Whatever it was, you wish you hadn’t eaten it, because it has made you suddenly and violently ill, ruining an otherwise perfect vacation.
Food-borne illness strikes thousands of tourists every year, and the effects can range from minor discomfort to life-threatening emergencies.
“Food safety is a real concern for travelers going abroad,” says Dr. Scott Prince, an associate professor at the University of Kentucky College of Public Health and an expert on travel medicine. “But a little knowledge and a few precautions can help reduce the risks of getting sick.”
Common-sense food safety
In general, Prince says, cooked foods are safer than raw foods, and foods prepared in restaurants are safer than food purchased on the street. Hotels and restaurants that cater to foreign tourists are often safer than local cafés, and those that do a brisk business are typically the best bet.
“Those local delicacies served up by street vendors might look tempting,” Prince says. “But if you want to play it safe, it’s probably best to pass them up and stick to places that come with a recommendation from a trusted source.”
Municipal tap water is often the source of food-borne illness in travelers. Foreign water supplies, especially in poor or developing countries, are often teeming with bacteria and protozoans invisible to the naked eye. They don’t usually trouble the native population but can cause serious illness in visitors whose bodies are not adapted to dealing with them.
In countries where tap water is not considered safe for tourists, Prince recommends sticking to bottled water or other beverages in bottles and cans. Bottled water should be used for brushing teeth as well. (Tap water that has been boiled for at least 15 minutes should also be safe.)
Order drinks without ice, and avoid raw foods that may have been washed in tap water, such as salads. Fresh whole fruits are generally safe to eat, but be wary of prepared fruits sold at outdoor markets. These are often sprayed with water to keep them looking fresh, and that water may be contaminated.
Contamination isn’t the only cause of sickness in travelers, Prince says. The digestive system is sensitive to changes in routine, and traveling can be a shock to the system, causing traveler’s diarrhea.
The human digestive tract is a complex ecosystem populated with billions of microorganisms and more than 400 species of bacteria that all live in peaceful coexistance. Visiting a foreign country and eating unfamiliar foods can throw the whole system out of balance, resulting in sickness and discomfort.
Usually lasting only a few days (and therefore not typically a serious threat to health), traveler’s diarrhea can still be a miserable experience that can take the joy out of a journey abroad. In some countries, as many as 25 to 50 percent of visitors may be affected.
Travelers can come prepared by packing a supply of over-the-counter anti-diarrhea medications, such as loperamide (Imodium) or bismuth salicylate (Pepto-Bismol). People with sensitive stomachs might want to stick to more familiar-looking foods and carry along a supply of packaged snacks.
Those who do become sick should drink plenty of bottled water to prevent dehydration. Any diarrhea lasting longer than 10 days (or more than three days if severe or if present in a small child) should be evaluated by a physician. Immediate medical attention is required for diarrhea accompanied by fever, severe abdominal pain, blood in the stool, or vomiting.
“In most cases, travel-related diarrhea will resolve spontaneously after a few days, as the body adjusts to the change in routine,” Prince says. “But anyone experiencing severe or persistent symptoms should seek out prompt medical treatment.”