With vacation season still in swing, it’s time to touch on a topic for safe travelling. Travelers diarrhea, or TD, can range from ruining a vacation day to spending some time in a foreign hospital. It’s more dangerous that it seems. Depending on the destination and season about 30% to 70% of travelers will be affected.

Let’s say 100 people were travelling for 2 weeks. 50 of those people will have at least one episode of TD, while 10 of those 50 will be confined to a bed for a day. 1 of those people will be hospitalized for their TD.

Those are the statistics. 1 in 2 people, over a two-week period will likely get travellers diarrhea.

What is Travelers Diarrhea?

Over a 24-hour period if you must rush to the bathroom three or more times, there’s a good chance you’ve been struck by TD.

This is usually caused by a bacterium (5-8% of the time it is caused by a virus). ETEC (a form of E. Coli) is the most common cause, followed by Campylobacter Jejuni, Shigella SPP., and Salmonella SPP.

TD usually begins abruptly. Most cases cause 3-5 loose stools per day and sometimes (20%) can cause more than 20 in 24 hours!

Other symptoms include:

  1. Blood/Mucous in Stools
  2. Fecal Urgency
  3. Nausea
  4. Abdominal Pain
  5. Tenesmus
  6. Fever lasing 1-2 days (40% of patients)

The main issue with TD is it can lead to dehydration in severe cases. This dehydration can cause Hypotonia, Muscle Cramps, Arrhythmias, Shock and even Coma.

Risks for TD

The most common source of TD is food. There’s many reasons food can cause TD so to make sure you only go to reputable restaurants while travelling and be careful about what you buy.

Some of the ways food can get infected are:

  1. Fertilization of crops with human fecal matter
  2. Inadequate transport/storage of food items
  3. Poor refridgeration
  4. Lack of pasteurization
  5. Unhygienic food handling practices

Contaminated water is not as common of a source of TD infection as you’d think. The pathogen comes in lower concentrations in liquids but it is still best to exercise caution against foreign water.

Risk factors also include the health of the traveller or the type of travel:

  1. Immunocompromised
  2. Low gastric acidity
  3. Extreme travellers or adventure travel such as backpacking or camping
  4. Higher socioeconomic status
  5. Over six years old
  6. Young adults have a higher risk than elderly individuals for developing TD likely because they eat larger amounts of food and are also less selective in the foods they eat
  7. Location of travel – higher rates in Asia, Middle East, Africa, Mexico, Central America, South America, and the Caribbean

Preventing TD

To start there’s a few simple tips for avoiding TD:

  1. “boil it, cook it, peel it, or forget it”
    • May not always be practical
  2. Hot, thoroughly grilled, or boiled food
  3. Processed and packaged food
  4. Cooked vegetables and peeled fruits
  5. Carbonated soft drinks
  6. Carbonated water
  7. Boiled water (most effective form of purification)
  8. Purified water (bottled water is likely safe where available)
  9. Eating at recommended restaurants
  10. Avoiding street vendors
  11. Avoid salads, sauces, and salsas
  12. Avoid tap water
  13. Avoid raw or poorly cooked seafood and meat

Prevention with medication is an option as well. Bismuth subsalicylate (such as Pepto-Bismol), probiotics (generally safe but inconclusive), preventative antibiotics (only for high risk short term travelers), or bovine colostrum (Travelan) have been used for prevention.

Vaccination is also an option (but not a very effective one) in preventing TD. The estimated overall protection in actual travelers for all destinations is thought to be around 25%.

Treatment Options

If you end up getting a case of TD, you will need to ensure you’re staying well hydrated, and depending on the severity, you may need a course of antibiotics.

It’s best to talk to your friendly Capsule Pharmacists to figure out the best preventative measures, and if you have any questions on safe travel!

Happy Trails!


by Capsule Pharmacy | | Categories : Categories: Uncategorized

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