Travellers’ Diarrhea

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What is it

Travelers' diarrhea is the most common illness contracted by those who journey abroad. It is caused by many different bacteria (such as E. coli, Salmonella, Shigella and Campylobacter), parasites (such as Giardia, Cryptosporidium, Cyclospora and others) and viruses (such as norovirus and rotavirus).1 Traveler's diarrhea affects the intestinal tract, commonly causing a series of symptoms from fever to abdominal pain.2

Who is at risk

International destinations with poor standards of hygiene and sanitation or restaurants with improper food handling place travelers at risk. High risk destinations include developing countries in Central and South America, Mexico, Africa, the Middle East and Asia. There is a moderate risk in Eastern Europe and some parts of the Caribbean.1

Young children, the elderly, and people with existing health problems are more at risk.1

What are the symptoms

Each bacteria, parasite or virus that causes the illness may have different symptoms. In addition to diarrhea, they may include:

  • fever
  • nausea
  • vomiting
  • bloating
  • abdominal cramping
  • urgency in using the bathroom

Within a few days, most symptoms clear up without treatment. In more severe and rare cases, travelers' diarrhea can lead to dehydration and death, mainly for those with a chronic disease or weakened immune system. Anyone with blood in the stool should seek medical attention, no matter the symptoms.1

How is it spread

Consuming contaminated food or water or coming into contact with someone with poor hygiene spreads this unpleasant condition.1

How is it prevented

There is a vaccine available to help prevent diarrhea caused by enterotoxigenic E. coli, the most common cause of diarrhea in travelers. However, it does not prevent diarrhea caused by other organisms. Therefore, safe food and water precautions are needed to protect against harmful bacteria, parasites and viruses.3 Travelers should only eat foods that are well cooked and served hot and avoid undercooked (rare) meats and fish, including shellfish. Salads or other fresh produce should be avoided unless they are washed in safe water or peeled. Only water that has been boiled, disinfected or served in a commercially sealed bottle should be consumed.3

Travelers should also wash hands frequently with soap under warm running water for at least 20 seconds and use an alcohol-based hand sanitizer throughout the stay.4

How is it treated

Most symptoms clear up on their own after a few days. The most important treatment is to drink lots of safe (boiled, disinfected or commercially available) fluids. In moderate to severe cases, oral rehydration solutions may be used.1

In some cases, medication may be used to reduce the frequent and urgent need to use the bathroom. However, it should not be taken if there is bloody diarrhea or a fever.1

For further information regarding prevention or treatment of traveler's diarrhea, please speak with your healthcare provider.

REFERENCES

  1. Government of Canada. Travel. Travel Abroad. Travel Health and Safety. Diseases. Travellers’ Diarrhea. https://travel.gc.ca/travelling/health-safety/diseases/diarrhea
  2. WHO. News. Fact Sheets. Detail. Diarrhoeal Disease. Key Facts. http://www.who.int/en/news-room/fact-sheets/detail/diarrhoeal-disease
  3. Government of Canada. Travel. Travel Abroad. Travel Health and Safety. Eat and Drink Safely Abroad. https://travel.gc.ca/travelling/health-safety/food-water
  4. Government of Canada. Health Canada. Services. Healthy Living. It’s Your Health. Diseases. The Benefits of Handwashing. https://www.canada.ca/en/health-canada/services/healthy-living/your-health/diseases/benefits-hand-washing.html