You can prevent TD (Travellers Diarrhoea) if you can avoid eating food or drinking water that is contaminated with stool.
However, this is harder than it might seem in countries with a poor ability to dispose of stool safely. The basic idea is to treat all water as if it is potentially contaminated and to avoid foods that are likely to be contaminated.
You can lower your risk of getting TD by understanding and using the following guidelines:
- Boiling is the best way to make water safe to drink.
- All organisms that cause TD are highly susceptible to heat, and they die at temperatures higher than 70°C (158°F). The time it takes for water to reach its boiling point and then return to a temperature below 70°C provides enough contact time to kill all TD-causing organisms, even when altitude is taken into account.
- Thus, water boiled for any length of time, at any altitude, is safe to drink. However, the U.S. based Centre for Disease Control and Prevention (CDC) takes a more conservative approach, recommending that you bring water to a rolling boil for 1 minute at altitudes below 6,500 feet (2 km) and for 3 minutes at altitudes above that level. You can improve the taste of boiled water by adding a pinch of salt to each quart or by pouring water back and forth several times between containers to aerate it.
- When you cannot boil water, you can disinfect it using chemicals. Iodine can kill most (but not all) organisms that cause diarrhoea, and you can use it to disinfect water, leafy vegetables and fruits.
- You can also use chlorine, but its ability to kill germs varies greatly with temperature and other factors; thus, it is less reliable than iodine. Iodine and chlorine cannot kill some organisms, including Cryptosporidium and Cyclospora.
- To obtain products to disinfect water see you local pharmacist for further advice, always follow the pharmacist’s instructions and product information
- Do not assume that portable filters will make drinking water safe. The CDC makes no recommendation about their use because there have not been enough independent studies done to confirm their effectiveness. However, in areas where there is a risk of Cryptosporidium or Cyclospora and boiling all drinking water is not practical, a good quality filter should provide some protection – always seek professional advice about filters and their use
- All bottled or canned carbonated beverages are generally safe to drink because the carbonation process makes the drinks acidic, which kills bacteria and other organisms.
- Water on the outside of cans or bottles might be contaminated. You should dry such cans/bottles before opening them and clean the surfaces that will have contact with your mouth.
- Non-carbonated water that is bottled or canned in developing countries, even if factory sealed, may not be any safer than tap water. Where possible check on its source - remember, tap water should not even be used for brushing teeth.
- Hot tea and hot coffee made with boiling water are generally safe to drink.
- Ice is not safe unless it is made from previously treated water - freezing does not kill the organisms that cause diarrhoea.
- Avoid unpasteurised milk and dairy products (such as cheese), as well as any milk that has not been boiled.
- Cooked food must be heated thoroughly and served steaming hot.
- Avoid foods such as lasagne, quiche and casseroles that have been cooked earlier and then served without sufficient reheating.
- Only eat fruit that you can peel yourself.
- Avoid salads that have been washed with tap water and uncooked vegetables.
- In many areas, human and animal faeces (nightsoil) are used as fertiliser. The bacteria or parasitic cysts in the faeces can contaminate fruits and vegetables grown in the fertilised soil - especially items such as lettuce and spinach that grow at ground level.
- Avoid raw or undercooked meat and seafood. According to the CDC, some fish may carry toxins in their flesh and are not guaranteed safe even when cooked. Tropical reef fish, red snapper, amberjack, grouper and sea bass can occasionally be toxic if caught on tropical reefs rather than the open ocean. The barracuda and puffer fish are often toxic and should generally not be eaten. Highest risk areas include the islands of the West Indies, as well as the tropical Pacific and Indian Oceans.
- Food and beverages from street vendors pose a high risk due to potential exposure to insects and a less rigorous sanitary environment.
- Breast-feeding is the safest food source for infants who are still nursing. If your child is already weaned, carefully prepare formula with boiled water and sterilised containers.
- If a hygiene situation arises in which you may be offered or feel that you have to accept food that may not be safe to eat, consider this situation carefully. The simple question to ask is, if you were presented with the same situation in your own home or in the UK would you eat? Report all suspicions to the hotel, ship or airline management, make a report to the tour operator’s representative in resort – you do not have to accept second best, whatever price you pay.
It is very important that if when you return to the UK, you are suffering with any diarrhoeal illness, that you seek urgent medical attention. It is also very important that you do not compromise any potential claim that you may have and we would also suggest that you contact us for further assistance.
If you have been affected by food and water holiday complaints, then please contact us at HolidayTravelWatch.
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