Traveler's diarrhea prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Primary measures to prevent gastrointestinal illness are keeping good hygiene, getting specific vaccines and prophylactic medications. It is not recommend to take antimicrobial drugs to prevent traveler's diarrhea.
Primary Prevention
- Traveler's diarrhea is fundamentally a sanitation failure, leading to bacterial contamination of drinking water and food. It is best prevented through proper water quality management systems as found in responsible hotels and resorts. In the absence of that, the next best option for the educated traveler is to take precautions to prevent the disease.
- Maintain good hygiene and make sure that you drink safe water, even for teeth brushing.
- Use only safe bottled water. Reports of locals filling bottles with tap water, then sealing them and then selling the bottled water as purified water have come out of several countries.
- Drink safe beverages include bottled carbonated beverages, hot tea or coffee, beer, wine, and water boiled or appropriately treated by yourself.
- Active intervention involves boiling water for three to five minutes (depending on elevation), filtering water with appropriate filters or using chlorine bleach (2 drops per litre) or tincture of iodine (5 drops per litre) in the water. The wide availability of safe bottled water makes these interventions usually unnecessary for all but the most remote destinations.
- Avoid eating raw fruits and vegetables unless the traveler peels them.
- If handled properly, well-cooked and packaged foods are usually safe. Avoid eating raw or undercooked meat and seafood. Unpasteurized milk, dairy products, mayonnaise and pastry icing are associated with increased risk for TD, as are foods or drinking beverages purchased from street vendors or other establishments where unhygienic conditions are present.
- It is not recommend to take antimicrobial drugs to prevent TD, because they kill off beneficial bacteria and create resistant breeds of pathogenic (disease-causing) bacteria. Studies show a decrease in the incidence of TD with use of bismuth subsalicylate and with use of antimicrobial chemoprophylaxis.
- Several probiotics (Saccharomyces boulardii and a mixture of Lactobacillus acidophilus and Bifidobacterium bifidum) have significant efficacy. In a meta-analysis by McFarland (2005), no serious adverse reactions were reported in the 12 trials. Probiotics may offer a safe and effective method to prevent TD.[1]
References
- ↑ McFarland, Lynn. "Meta-analysis of probiotics for the prevention of traveller's diarrhoea" (PDF). Travel Medicine and Infectious Disease. 5 (2): 97–105.