Follow These Tips to Prevent Montezuma's Revenge, an Unwelcome Souvenir
June 23, 2000 -- When traveling to foreign countries, the last
souvenir a tourist wants to pick up is diarrhea. But intestinal illness caused
by contaminated food and drink is the most common malady afflicting
international travelers, particularly in developing countries. Results of a new
study show that although travelers' diarrhea is common, changes in the diet can
help prevent the illness, and the nausea and bloating that often accompany
The popular travelers' creed "Cook it, peel it, or leave
it" might not be the best advice, according to researchers from the Centers
for Disease Control and Prevention (CDC) in Atlanta.
The study's lead researcher, Barbara Herwaldt, MD, MPH, tells
WebMD that the most important message for travelers in general is to "avoid
potentially risky foods and beverages." Herwaldt is a medical
epidemiologist in the division of parasitic diseases at the CDC.
In this month's issue of the journal Annals of Internal
Medicine, Herwaldt's team highlights what happened when diarrhea struck a
group of healthy, young Peace Corps volunteers in Guatemala. Researchers found
that several factors influenced whether the volunteers developed diarrhea.
Diarrhea was more likely when volunteers:
- Drank water from an unknown source
- Ate foods prepared by a Guatemalan friend
- Ate at a small, working-class restaurant and ate fruit peeled by someone
- Drank an iced beverage
- Ate ice cream, ice milk, or flavored ices
The CDC suggests that all overseas travelers select food and
beverages with care. Any raw food could be contaminated, especially in areas of
poor sanitation. And food from street vendors could be suspect.
Foods of particular concern include:
- Uncooked vegetables and fruit
- Unpasteurized milk and milk products
- Raw meat
If you peel fruit yourself, it is generally safe, as well as
food that has been cooked and is still hot.
Although most episodes of travelers' diarrhea resolve in a few
days, it is best to consult a physician rather than attempt self-medication
because of the risk of dehydration. You should seek medical help if diarrhea is
severe or bloody or does not resolve within a few days. You should also seek
medical help if the diarrhea is accompanied by fever or chills, or if you are
unable to keep fluids in.
No effective vaccines are currently available to guard against
diarrhea, so precautions need to be taken once you arrive at your destination,
Robert Edelman, MD, tells WebMD. The best advice for the general tourist, he
says, is: "Drink bottled water and beverages with labels on them." He
says carbonated beverages are best because they inhibit the growth of bacteria.
Edelman is director of the Travelers Health Clinic at the University of
Maryland in Baltimore.
But how does the typical globetrotter compare with Peace Corps
volunteers? Not very closely, according to Edelman. "Peace Corps volunteers
integrate themselves into the environment as much as possible," he says.
"As a result, they eat and drink things that a tourist on a four-star jaunt
... surrounded by a cocoon of preventive, trained guides, would not be exposed
Still, "we can take a lesson from this study," Edelman
says. If Peace Corps volunteers can get sick, anyone can. "Being informed
before traveling about good food and water hygiene" is essential.
Good advice. After all, an ideal trip abroad should send you
searching for landmarks and castles, not restrooms.