Of all travel-related illnesses, traveler’s diarrhea is one of the most common. Estimates range from 30 to 70 percent of travelers become infected, although disease rates vary according to the season of the year and the destination. The Centers for Disease Control and Prevention rates different areas of the world as “low,” “intermediate” or “high risk,” with the high-risk areas including most of Asia, the Middle East, Mexico, and Central and South America.
Traveler’s diarrhea is most likely spread by poor hygiene in restaurants but can be caused by a number of different organisms. Bacteria is the most likely cause and can account for about 80 to 90 percent of all cases. Intestinal viruses are another likely cause. Protozoa infections result in about 10 percent of cases. Food poisoning, which includes diarrhea, results from ingesting toxins in the food rather than an infection.
None of the possible prevention strategies can eliminate the chance of getting traveler’s diarrhea, but they can drastically reduce the risk. Many of the organisms are transmitted in or on food, especially uncooked food. Hand-washing before eating can help reduce the risk; a small bottle of hand sanitizer carried in a purse or pocket is often helpful. Travelers should avoid uncooked food, raw fruits, salads and vegetables, and beverages that have not been pasteurized. Pepto-Bismol in liquid or tablet form can also help reduce the risk of traveler’s diarrhea.
Antibiotics are useful in treating traveler’s diarrhea caused by bacteria (and are used as a prevention strategy in some cases). Protozoan infections are treated with medications specific to that class of organism. Medications to reduce loose stools can provide relief of symptoms. Water and other beverages from sealed containers or that have been boiled or treated with iodine can be used to replace fluids.