Travel to Developing Countries - Traveler's Diarrhea

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Water Precautions

Drinking contaminated water is the most common cause of acquiring traveler's diarrhea. The following methods or products help reduce exposure to contaminated water.

Boiling water is the best method for eliminating infectious organisms. There is some debate about how long to boil, but bringing the water to a good boil for at least 1 minute generally renders it safe to drink. Travelers might consider buying an electric heating coil to boil and purify tap water. (A plug adapter or voltage converter may be needed).

Carbonated bottled water may be used for brushing teeth and drinking. Carbonation increases the acid in the water and kills bacteria. Plain bottled water may not be safe, since it can be taken from contaminated sources. Even ice cubes can carry infection.

Iodine tablets such as Polar Pure, Globaline, or Potable-Aqua purify water. Water may be purified by adding one iodine tablet to a quart of water 30 minutes before drinking it. Adding 50 mg of vitamin C will eliminate the iodine taste and color. NOTE: Purifying is not effective against parasites such as Cyclospora and Cryptosporidium.

Small portable water filters remove parasites and clear murky water without leaving a chemical taste. They are particularly beneficial for pregnant women and people who cannot take iodine. NOTE: Filtering does not prevent viruses from passing through. When purchasing a filter, the phrase "EPA Registration" should be printed on the label, indicating that the U.S. Environmental Protection Agency has guaranteed its effectiveness.

Newer portable water purification systems, such as SteriPEN, use ultraviolet light to disinfect water. These handheld devices can destroy bacteria, viruses, and protozoa, such as Giardia and cryptosporidium.

In all cases, do not swim in water that may be contaminated or may contain parasites.

Food Precautions

Some important tips:

Seek restaurants with a reputation for safety. Even then, avoiding raw foods, and fresh fruits or vegetables that do not need to be peeled, is advised.

Heated food should be hot to the touch and eaten promptly.

Beware of sliced fruit that may have been washed in contaminated water.

Don't buy food from street vendors.

Peel all fresh fruits and vegetables yourself.

Vegetables may also be rinsed with diluted soapy water, soaked in a halide solution, and rinsed in purified water. (Certain fruits, such as strawberries, raspberries, and grapes should never be considered safe, even when washed.)

Avoid dairy products.

Avoid raw or undercooked meat and fish.

Avoid cold toppings and sauces -- even bottled sauces on tables. In one study, two-thirds of tabletop sauces in Mexico were contaminated. (Forty percent of sauces on tables in Houston, Texas, were also contaminated.)

Avoid tap water and ice cubes.

Avoid fruit juices, fresh salads, and open buffets.