Traveler's Diarrhea
Traveler's diarrhea (turista) is characterized by diarrhea, nausea, and vomiting that commonly occur in travelers to areas of the world with poor water purification.
Traveler's diarrhea occurs when people are exposed to bacteria in food and water to which they have had little exposure and thus no immunity. It occurs mostly in developing countries where the water supply is inadequately treated. The organisms most likely to cause traveler's diarrhea are the types of Escherichia coli (E. coli) that produce certain toxins and some viruses such as the Norwalk virus.
Symptoms and Diagnosis
Nausea, vomiting, intestinal rumbling, abdominal cramping, and diarrhea can occur in any combination and with any degree of severity. Vomiting, headache, and muscle pain are particularly common in infections caused by the Norwalk virus. Most cases are mild and disappear without treatment within 3 to 5 days. Diagnostic tests are rarely needed.
Prevention and Treatment
Travelers should patronize only those restaurants with a reputation for safety and should not purchase any food or beverages from street vendors. Cooked foods that are still hot when served are generally safe. Salads containing uncooked vegetables should be avoided, and all fruit should be peeled by the traveler. Travelers should drink only bottled carbonated beverages or beverages made with water that has been boiled. Even ice cubes should be made with water that has been boiled.
Preventive antibiotics are recommended only for people who are particularly susceptible to the consequences of traveler's diarrhea, such as those whose immune system is impaired. The antibiotic most commonly recommended is ciprofloxacin. Bismuth subsalicylate, a nonprescription drug, can help.
When symptoms occur, treatment includes drinking plenty of fluids and eating a bland diet (for example, cooked cereals, bananas, rice, applesauce, and toast). In addition, antibiotics (such as ciprofloxacin) and antidiarrheal drugs (such as loperamide or bismuth) are usually recommended. Travelers are encouraged to seek medical care if they develop fever or blood in the stool.
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