Travellers' Diarrhoea

What is travellers' Diarrhoea?

It is a condition characterised by a twofold or greater increase in the frequency of unformed bowel movements. It is quite commonly seen in persons travelling from one country to another. Virtually all cases of travellers' diarrhoea are caused by infectious agents acquired through faecally contaminated food or water. The infectious agents include bacteria, viruses and parasites, e.g. E. coli, Campylobacter, Salmonella, Shigella, amoeba, Rotavirus. Episodes of travellers' diarrhoea usually begin abruptly during travel or soon after returning home, and are generally self-limiting. The symptoms are diarrhoea, colicky abdominal pain, malaise, nausea, bloating and weakness. Severe cases may have fever and the stools may contain mucus or blood. There is a danger of losing too much body fluid and this is particularly dangerous to infants, children and the elderly. The illness usually subsides spontaneously within 1-5 days; rarely, it lasts 2-3 weeks.

Travellers' Diarrhoea is slightly more common in young adults than in older people. A very important risk factor is the standard of hygiene in the destination of the traveller. High-risk destinations include most of the developing countries of Asia, Africa and Central America. Intermediate-risk destinations include most of the Southern European countries and a few Caribbean islands. Low risk destinations include Northern Europe, North America, Australia and New Zealand.

How does it spread?

Travellers' Diarrhoea is acquired through ingestion of faecally contaminated food and water. Especially risky foods include raw vegetables, raw meat and raw seafood. Tap water, ice, unpasteurised milk and dairy products may be associated with increased risk. Safe beverages include carbonated drinks, beer, wine, hot coffee and tea, and water appropriately treated with iodine or chlorine. Foods sold by unlicensed street vendors are common sources of infective agents.

How can you prevent it?

The best way to prevent travellers' Diarrhoea is to observe good personal and food hygiene. Hand-washing is essential after defecation, before preparing and serving food. Food should be well cooked and water should be boiled. Avoid dairy products and all beverages that contain water of questionable quality. There is no vaccine available for prevention against travellers' Diarrhoea. Because of the risks of unnecessary use of antimicrobial agents, their use for prevention is not recommended.

How is it treated?

Oral fluids like fruit juices should be taken to replace the fluid lost. For severe body fluid loss, oral rehydration solution could be used. Physician advice should be sought in severe cases, e.g. when there is a large amount of fluid loss, fever, blood in the stool or severe weakness. Use of antibiotics can be very effective. However these should be taken under the guidance of a physician. Medications for relief of diarrhea and abdominal cramps may be self-administered if the diarrhoea is mild.