Avoiding diarrhea

This is subscriber only post.
Get one year of online-only access — only $15!
Below is a sample of the article.
Please login or subscribe to ITN to read the entire post.

The common medical ailment associated with travel to developing countries is, as travelers to Mexico refer to it, “Montezuma’s Revenge.”

Montezuma’s Revenge affects 20% to 50% of travelers worldwide. According to the Centers for Disease Control and Prevention (www.cdc.gov), 10 million tourists a year are afflicted with travelers’ diarrhea. High-risk destinations include most of the developing countries of Latin America, Africa, the Middle East and Asia. Travelers’ diarrhea is slightly more common in young adults than in older people and affects men and women equally.

Travelers’ diarrhea typically occurs within the first week of travel, but it can start anytime during the trip and continue when the traveler returns home.

Eat carefully

It is extremely important for a traveler to eat only thoroughly cooked food or fruits and vegetables he has peeled himself.

Remember: boil it, cook it, peel it or forget it.

Safe beverages include hot coffee, tea, beer, wine, bottled carbonated beverages and boiled water.

Tourists can acquire travelers’ diarrhea through contaminated food (cooked or raw) and dirty water.

Foods that have the highest risk are undercooked or raw meat, seafood, raw vegetables and fruits. Tap water, ice and unpasteurized milk and dairy products can be associated with increased risk as well.

The most common culprit of travelers’ diarrhea is a bacterium known as enterotoxigenic E. coli (ETEC).

Travelers’ diarrhea usually lasts three to seven days.

The emblematic symptoms of travelers’ diarrhea also include nausea, bloating, urgency and a feeling of general sickness.

Other bacteria that have been known to cause travelers’ diarrhea are salmonella, camplyobacter and vibrio.

How to treat

Treatment for travelers’ diarrhea takes several approaches.

Fluid replenishment is essential.

Fruit juices, noncaffeinated soft drinks and salted crackers are suggested.

For those who become very dehydrated, oral rehydration solution (ORS) is highly recommended. ORS can be purchased from travel medicine clinics and usually is part of an “antidiarrhea kit.’’

Antibiotics also can play an important role in treating travelers’ diarrhea along with antidiarrheal medication. Both are part of a standard antidiarrhea kit.

Consider symptoms

Other diseases common among travels can be prevented in advance.

The most common vaccine-preventable disease is hepatitis A. This potentially serious viral liver disease uses the same basic mode of transmission as travelers’ diarrhea: fecally contaminated food and water.

Worldwide, hepatitis A accounts for 1.4 million cases annually. It causes fever, malaise, anorexia, nausea, abdominal discomfort and diarrhea, followed within a few days by jaundice (a yellowish discoloration of the skin or white part of the eyes).

The CDC says the disease ranges in clinical severity from no symptoms to a mild illness lasting one to two weeks to a severely disabling disease lasting several months.

A vaccine can offer protection for more than 10 years.

Bad blood

A significantly more serious viral liver disease that international travelers can prevent is hepatitis B. This can be a problem in underdeveloped countries if a traveler is injured and requires a blood transfusion. If the blood supply is not adequately screened for hepatitis B, the recipient of the transfusion can develop lifelong infection, cirrhosis of the liver, liver cancer and/or liver failure — and can die.

The symptoms of hepatitis B are similar to those of hepatitis A, but about 30% of individuals infected with hepatitis B have no symptoms. The good news is a vaccine is available to help prevent both types of hepatitis.

Dr. Larry G. Baratta is chief medical officer of Passport Health (www.passporthealthusa.com), with clinics nationwide.

Next month in this column, Dr. Alan M. Spira discusses staying fit while flying overseas.

Please login or subscribe to ITN to read the entire post.

The common medical ailment associated with travel to developing countries is, as travelers to Mexico refer to it, “Montezuma’s Revenge.”

Montezuma’s Revenge affects 20% to 50% of travelers worldwide. According to the Centers for Disease Control and Prevention (www.cdc.gov), 10 million tourists a year are afflicted with travelers’ diarrhea. High-risk destinations include most of the developing countries of Latin America, Africa, the Middle East and Asia. Travelers’ diarrhea is slightly more common in young adults than in older people and affects men and women equally.

Travelers’ diarrhea typically occurs within the first week of travel, but it can start anytime during the trip and continue when the traveler returns home.

Eat carefully

It is extremely important for a traveler to eat only thoroughly cooked food or fruits and vegetables he has peeled himself.

Remember: boil it, cook it, peel it or forget it.

Safe beverages include hot coffee, tea, beer, wine, bottled carbonated beverages and boiled water.

Tourists can acquire travelers’ diarrhea through contaminated food (cooked or raw) and dirty water.

Foods that have the highest risk are undercooked or raw meat, seafood, raw vegetables and fruits. Tap water, ice and unpasteurized milk and dairy products can be associated with increased risk as well.

The most common culprit of travelers’ diarrhea is a bacterium known as enterotoxigenic E. coli (ETEC).

Travelers’ diarrhea usually lasts three to seven days.

The emblematic symptoms of travelers’ diarrhea also include nausea, bloating, urgency and a feeling of general sickness.

Other bacteria that have been known to cause travelers’ diarrhea are salmonella, camplyobacter and vibrio.

How to treat

Treatment for travelers’ diarrhea takes several approaches.

Fluid replenishment is essential.

Fruit juices, noncaffeinated soft drinks and salted crackers are suggested.

For those who become very dehydrated, oral rehydration solution (ORS) is highly recommended. ORS can be purchased from travel medicine clinics and usually is part of an “antidiarrhea kit.’’

Antibiotics also can play an important role in treating travelers’ diarrhea along with antidiarrheal medication. Both are part of a standard antidiarrhea kit.

Consider symptoms

Other diseases common among travels can be prevented in advance.

The most common vaccine-preventable disease is hepatitis A. This potentially serious viral liver disease uses the same basic mode of transmission as travelers’ diarrhea: fecally contaminated food and water.

Worldwide, hepatitis A accounts for 1.4 million cases annually. It causes fever, malaise, anorexia, nausea, abdominal discomfort and diarrhea, followed within a few days by jaundice (a yellowish discoloration of the skin or white part of the eyes).

The CDC says the disease ranges in clinical severity from no symptoms to a mild illness lasting one to two weeks to a severely disabling disease lasting several months.

A vaccine can offer protection for more than 10 years.

Bad blood

A significantly more serious viral liver disease that international travelers can prevent is hepatitis B. This can be a problem in underdeveloped countries if a traveler is injured and requires a blood transfusion. If the blood supply is not adequately screened for hepatitis B, the recipient of the transfusion can develop lifelong infection, cirrhosis of the liver, liver cancer and/or liver failure — and can die.

The symptoms of hepatitis B are similar to those of hepatitis A, but about 30% of individuals infected with hepatitis B have no symptoms. The good news is a vaccine is available to help prevent both types of hepatitis.

Dr. Larry G. Baratta is chief medical officer of Passport Health (www.passporthealthusa.com), with clinics nationwide.

Next month in this column, Dr. Alan M. Spira discusses staying fit while flying overseas.