Date: July 16, 2019

Mainly cloudy with 60 percent chance of showers. Risk of a thunderstorm this afternoon. Wind southwest 20 km/h gusting to 40. High 29. Humidex 37. UV index 7 or high.

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Feels like 36C

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Travel Immunization Links

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Traveller's Diarrhea

This page was reviewed or revised on Tuesday, July 26, 2016 3:50 PM

Environmental Health & Prevention Services


Each year, thousands of Canadian sun-seekers may be returning home with more than just memories of their trip. Nausea, stomach cramps, vomiting and diarrhea can be some of the more unpleasant side effects from a getaway.

Diarrhea is the most common medical problem affecting up to 60% of travellers visiting developing countries.

Bacteria are the most common cause of gastrointestinal illness. The most common causes include Escherichia coli (ETEC E. coli), Campylobacter jejuni, Salmonelle species, and Shigella species.

Episodes of traveller’s diarrhea usually begin abruptly, either during travel or soon after returning home. Although usually mild and self limiting, travellers’ diarrhea can adversely affect the quality of a vacation or the success of a business trip.

Traveller’s diarrhea is avoidable. The risk will depend on the quality and purity of the food and water consumed, and the use of good personal hygiene practices.

Travellers’ are also reminded that too much sun, alcohol and spicy food may disturb their usual digestive processes. Protection from sun exposure, and none or moderate consumption of alcohol and spicy food are recommended.

Food-borne gastrointestinal illness

  • Contaminated food is the most common cause of traveller’s diarrhea
  • Highest risk foods include custards, mousses, potato salads, mayonnaise and seafood as well as salad bars, raw vegetables and fruits that cannot be easily cleaned such as grapes, strawberries, and raspberries
  • Although eating food purchased from street vendors can enhance the traveller’s cross cultural experience, many lack adequate sanitary facilities and proper refrigeration, allowing for an increased risk of travellers’ diarrhea

Water-borne gastrointestinal illness

  • While most drinking water in Canada is treated to remove organisms which can cause illness, this may not always be the case in other countries
  • If untreated water is used to wash or prepare food, the food can become contaminated with disease-causing organisms
  • Water-borne diarrheal illness usually results from the ingestion of viruses and parasites in water contaminated by human or agricultural fecal waste

Food and water precautions

Key principles to remember are:

BOIL IT, COOK IT, PEEL IT
OR
FORGET IT

  • Eat only food that has been well-cooked and is still hot when served
  • Drink only purified water that has been boiled or disinfected with chlorine or iodine, or commercially bottled water in sealed containers
  • Use bottled water for brushing teeth and rinsing toothbrush
  • Drinking carbonated drinks without ice, including beer, is usually safe
  • Avoid ice, unless is had been made with pure water
  • Boil unpasteurized milk
  • Avoid unpasteurized dairy products and ice cream
  • Avoid uncooked foods – especially shellfish and salads
  • Fruits and vegetables that can be peeled are usually safe
  • Avoid food from street vendors
  • Wash hands before eating or drinking

Symptoms

  • If nausea, stomach cramps, diarrhea or vomiting develops during travel or after returning, seek medical attention if the symptoms persist longer than 48 hours, or if there is bloody diarrhea
  • Most cases are self-limiting and clear up in a few days
  • Diarrhea can cause dehydration if the lost fluid and electrolytes are not replaced
  • The most important aspect of treating diarrhea is rehydration

Prophylactic Medications

  • Dukoral™ is an inactivated, oral vaccine licensed for protection against diarrhea caused by cholera and Escherichia coli (ETEC), the most common single cause of traveller’s diarrhea. This vaccine provides short-term protection (approx. 3 months) against diarrhea caused by ETEC.
  • The most effective antibiotics for prophylaxis are the fluoroquinolones (ciprofloxin, norfloxacin, ofloxacin, and levofloxacin).
  • Imodium® (loperamide HCL) is an effective antimotility agent available to decrease the duration and severity of diarrhea in mild to moderate cases in adults and children over 2 years of age
  • Pepto-Bismol - Bismuth subsalicylate coats the lining of your stomach making it harder for bacteria to penetrate and has an antibacterial property to it.

Treatment

  • Is it essential to drink more fluids as soon as possible
  • Most cases are self-limiting and clear up in a few days
  • Diarrhea can cause dehydration if the lost fluid and electrolytes are not replaced
  • The most important aspect of treating diarrhea is rehydration

Homemade Oral Rehydration Solutions

Ingredients Amount
Recipe 1 Fruit juice
Honey (pasteurized)
Salt
Baking soda
240 ml (1 cup)
2.5 ml (½ tsp)
0.5 ml ( tsp)
1ml (¼ tsp)
Recipe 2 Purified water
Salt
Sugar
1 litre
5 ml (1 tsp)
40 ml (8 tsp)