In general, gastrointestinal illnesses among tourists — travellers’ diarrhea and food poisoning — is especially likely to occur in countries where the water supply is unsafe. But there are also many cases of food poisoning and hundreds of deaths, in the United States every year, and these infections can occur anywhere there are lapses in how food is handled. Raw or undercooked meat, fish and shellfish can be contaminated and the Centers for Disease Control and Prevention’s list of high-risk foods includes raw eggs and unpasteurised milk.
Travel presents additional concerns. “People may be in places where the tap water is not necessarily safe and they don’t have control over how food is prepared or handled,” said Dr Adam Ratner, director of the division of pediatric infectious diseases at Hassenfeld Children’s Hospital at NYU Langone in New York. “When you’re home, you have some control. It can be harder to assess safety somewhere else.” Parents should be especially vigilant. Babies and young children are vulnerable to dehydration, which is generally the most dangerous aspect of gastrointestinal illnesses; other groups at high risk include pregnant women, older people and anyone who is immunocompromised. But even younger adults and adolescents may not realise how serious the symptoms of food poisoning can be and when it is important to get medical help.
Here’s what you need to know to be prepared when travelling and what to do if you suspect that you or your travel companions have food poisoning.
What is food poisoning?
Food poisoning means you’ve eaten something that is contaminated, most often with bacteria and the toxins they produce, but sometimes with a virus or a protozoan parasite. It can happen because the food wasn’t thoroughly cooked, or because it became contaminated after being cooked. In other words, the problem can arise at any point while food is being prepared, handled and served.
When members of a group who ate together get sick at the same time, that’s usually evidence of food poisoning. The typical symptoms are diarrhea and vomiting, sometimes accompanied by fever, chills and abdominal pain. With some contaminants, especially certain bacterial toxins, people get sick within a couple of hours, while with others it can take 24 hours or so.
The biggest danger is fluid loss and dehydration. However, some bacterial toxins can do other kinds of damage to the body and there are some bacteria that can actually produce a general infection, or sepsis, especially salmonella.
What foods should you avoid on vacation?
Stay with food that has been thoroughly cooked and served hot. Avoid raw shellfish, which may have come from contaminated water and raw or undercooked meat. Especially in countries where the water supply isn’t safe, avoid precut fruits and salads, which may have been washed in that water.
Basically, food is safest when it’s thoroughly cooked and served hot. That means buffets can be problematic, with food often standing for long periods. If you do eat at a buffet, the hot food should be truly hot and if there is cold food, it should be truly refrigerated; nothing should be approaching room temperature.
If food has been cooked and then allowed to sit around — as is often the case with street food — stay away.
Be suspicious of ice — boiling kills potential pathogens, but freezing does not. If the ice is made from contaminated water, it isn’t safe. If you have concerns, stick to bottled drinks from the refrigerator.
Any shots you should get before you travel?
Everyone should be immunised against hepatitis A, a virus that is a common cause of gastrointestinal illness in many parts of the world. Children are routinely immunised against hepatitis A in infancy now, but check that adolescents have had the vaccine — and adults should get it if they haven’t had it.
What should you take with you?
You can travel with packets of oral rehydration solution — basically a combination of sugar, salt and potassium that can be mixed with clean water and drunk to replenish fluids and electrolytes.
Some doctors will prescribe antibiotics to carry with you. The idea is to take the antibiotics if you develop diarrhea, hoping to shorten the course of the disease. However, having the antibiotics — or even taking them — should not make you cavalier about symptoms; you still need to get medical attention if you’re seriously ill.
For parents, it’s worth talking with your child’s pediatrician about how to be in touch from abroad if you have concerns and you should look into insurance coverage while travelling. You might also want to research in advance how to find medical help in your destination — whether that means knowing the location of the nearest hospital or the emergency phone number. It may be helpful to refer to the International Society of Travel Medicine’s global clinic directory.
What should you do if you develop symptoms?
Above all, stay hydrated. Drink sports drinks; sip clean water, broth or tea; and use your oral rehydration solution.
Take the illness seriously. If there are repeated episodes of vomiting and diarrhea, if you truly can’t keep anything down and particularly if things are getting worse, don’t wait to seek medical attention. You should be especially concerned if fever, chills, bloody diarrhea or severe abdominal pain develop.
With a younger child, dehydration can happen quickly — over a matter of hours — and it can be difficult to get a sick young child to drink. The American Academy of Pediatrics advises contacting a doctor promptly if a child is not drinking.
Most likely, especially at a resort, you will find yourself going through your hotel to find medical help. The most important advice is that if you are concerned you need to be willing to insist on medical attention and if necessary, go to a local clinic or hospital. “Don’t take no for an answer,” Ratner said. — The New York Times
Oman Observer is now on the WhatsApp channel. Click here
