Travel diarrhea

Travel diarrhea is the most common health problem associated with tourism. As many as 10-40% of Finnish tourists get diarrhea during the trip. There is a particularly high risk when traveling to countries with poor hygiene. For example, South and Southeast Asia, India, tropical Africa, and Central and South America are at high risk for travel diarrhea. In Western Europe, North America, Japan and Australia, the risk is no higher than in Finland. Young children and young people are more vulnerable.

Reasons for travel diarrhea

Travel diarrhea is caused by various bacteria, viruses and parasites. Often microbe remains unclear. In warm countries, the most common diarrheal bacteria are coliform bacteria, Campylobacter, Salmonella and Shigella, and of the diarrheal viruses, rotavirus and norovirus and parasite Giardia. For nordic tourists the most common countries of origin for salmonella are Thailand and Turkey, for shigella Thailand and India. Serious but rare diarrheal diseases  include typhoid, amoebiasis, and cholera. There are vaccines for typhoid and cholera.

Symptoms

Typically, travel diarrhea breaks out at the end of the first week of travel. Some become ill only after when they return home. Typical symptoms are diarrhea, nausea and abdominal cramps. Fever and headache may also occur. Excessive diarrhea and possible vomiting can lead to rapid dehydration. It should be remembered that diarrhea with fever in a patient who has returned from a trip may also be associated with malaria. In general, travel diarrhea is fortunately mild and does not need any treatment. However, if the high fever persists for more than a day or if the diarrhea does not begin to go away on the third day or is so severe that dehydration cannot be compensated by drinking, it is advisable to see a doctor.

Prevention

The most important and effective way to prevent travel diarrhea is good hand and food hygiene. The danger can be reduced by cooking and heating food well, as well as by boiling drinking water if bottled water is not available. Hands should be washed well with soap or hand sanitizer before cooking and eating, and always after using the toilet. Hands should also be cleaned after handling raw vegetables, roots and raw meat and seafood. Probiotic dietary supplements have been shown to have only a weak anti-diarrheal efficacy.

The following foods should be avoided:

• cold cuts and mayonnaise-based salads
• cold sauces
• fruits and vegetables that cannot be washed or peeled, berries
• raw or insufficiently cooked foods containing meat, fish or eggs
• cold-served oysters, mussels, crabs and other marine animals
• cold desserts
• unpackaged and unpasteurised milk, cream, ice cream, butter and cream cheeses
• juices and beverages with added ice cubes