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Ykhealthguide.org

Traveller’s Diarrhea
This fact sheet provides basic information only. It must not take the place of medical advice, diagnosis or treatment.
Always talk to a healthcare professional about any health concerns you have, and before you make any changes to
your diet, lifestyle or treatment.

What is traveller's diarrhea?
Traveller's diarrhea is frequent, loose, or watery bowel movements resulting from eating food or
drinking liquids that are unclean or contaminated.
What are the symptoms of traveller’s diarrhea?
Symptoms may include abdominal cramps, nausea, vomiting, bloating and feeling unwell. It is
the most frequent health problem encountered by travellers to tropical countries. Food can be
contaminated due to unwashed hands of kitchen workers, direct contact with human excrement
used as fertilizer, or sewage-contaminated water used for "freshening" vegetables in markets.
Preventing traveller's diarrhea
Following good personal hygiene practices and being careful about what you eat and drink are
the best ways to prevent traveller's diarrhea. Always wash your hands with soap after using the
bathroom or changing an infant's diaper, and before preparing or eating meals, to reduce re-
infection and/or spread of this illness.
The following are some guidelines for healthy eating and drinking while travelling: Eat foods that are well cooked. Never eat leftovers or food that has been sitting for along time. Don't eat food sold by street vendors.
Drink bottled water, bottled drinks, or beverages made with boiled water. Always avoidice and tap water.
Wash hands with soap often, and before eating.
Make sure dairy products such as milk, cheese, or yogurt are pasteurized and properlyrefrigerated. If in doubt, avoid them.
Wash and peel your own fruits and vegetables. Discard if the skin is broken or bruised.
Use bottled or boiled water for brushing teeth.
Don't eat custards, mousses, mayonnaise, or hollandaise sauce.
Don't eat raw vegetables, salads, lettuce, or fruits that cannot be peeled (e.g. grapes,strawberries).
Don't eat undercooked or raw meat, fish or shellfish.
Do not eat watermelon - it may have been injected with local water to increase weight.
Make your motto: "Cook it, peel it, or leave it!"
There is also a vaccine to help protect you against traveller's diarrhea. DukoralTM is the onlyvaccine currently available in Canada to help prevent traveller's diarrhea caused byenterotoxigenic E. Coli (ETEC). It also protects people from cholera. Ask your doctor orCommunity Health Nurse for details.
What to do if you get traveller's diarrhea
The most important treatment for diarrhea is to replace the fluids your body is losing.
These fluids should be replaced by drinking clear fluids for 24 to 48 hours. These could include
purified water either boiled or bottled, broth, or caffeine-free drinks. Stop all solid food for the
first 24 to 48 hours.
When you feel better, gradually introduce small amounts of bland, easily digested food such asbananas, salted crackers, carrots, or rice.
If diarrhea is severe or does not begin to improve after 24 hours, start drinking beverages thatwill replace the electrolytes or body salts being lost. Use a pre-packaged oral rehydration salt(ORS) mix mixed in purified water (e.g. Gastrolyte®). If you do not have ORS mix, you canmake your own, using one or both of these recipes: Homemade Oral Rehydration Solutions:
Recipe 1
240 ml (1cup) Fruit juice (canned or bottled)
2.5 ml (1/2 teaspoon) Honey, sugar, or corn syrup--pasturized
0.5 ml (1/8 teaspoon) Salt
1 ml (1/4 teaspoon) Baking soda
Recipe 2
1 litre Purified water
5 ml (1 teaspoon) Salt
40 ml (8 teaspoons) Sugar
Contact a physician if any of the following symptoms develop: high fever, blood or pus in stools,
signs of dehydration such as dry mouth, rapid pulse, reduced urine output or dark coloured
urine. Contact a physician if the diarrhea does not stop within 48 to 72 hours.
In addition, children under two years of age who develop severe diarrhea should be assessed
by a health care professional.
Medications
A number of different medications may sometimes be recommended for treatment of traveller's
diarrhea. These should be discussed with your health professional.
Some medications recommended for temporary relief of diarrhea symptoms include:
Loperamide Hydrochloride (e.g. Imodium®) - for two-day therapy, available without
prescription for travellers over 12 years of age. This does not treat diarrhea, but simply
slows it down. It should be taken as directed only when absolutely necessary (e.g.
travelling on a plane, boat or bus with no toilets available). Do not use if you have a fever
or bloody diarrhea.
Bismuth Subsalicylate (e.g. Pepto Bismol®) - available in liquid or tablets for relief of
diarrhea symptoms. Anyone who has problems with salicylates should not use Pepto
Bismol® until they check with their doctor. Follow the instructions on the package for use
of this medicine.
Ciprofloxacin (Cipro) - this is an antibiotic and requires a prescription. It can be taken
by people over 18 years of age. It is taken as one tablet twice a day for three days. If
diarrhea continues, take Cipro for a maximum of three days.
Azithromycin - children under 18 years of age may take this antibiotic to treat diarrhea.
It is one dose a day for 3 days. The pharmacist will provide instructions.
Contact Information
For more information contact Yukon Communicable Disease Control at
667-8323. #4 Hospital Road, Whitehorse, Yukon
In the communities call toll-free 1-800-661-0408 extension 8323.
Adapted from BC HealthFiles

Source: http://www.ykhealthguide.org/downloads/travellers_diarrhea.pdf

Version 7, 07/2005

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