special subjects
Problems at the Destination
Traveler’s Diarrhea
 Traveler’s Diarrhea (turista) is the most common health problem among international travelers. It is caused by bacteria or viruses that have contaminated food or water. The risk of traveler’s diarrhea may be reduced by the following measures: Drinking and brushing teeth with bottled, filtered, boiled, UV-treated, or chlorinated water Avoiding ice Eating freshly prepared foods only if they have been heated to steaming temperatures Eating only fruits and vegetables that people peel or shell themselves Avoiding food from street vendors Washing hands frequently Avoiding all foods likely to have been exposed to flies Taking certain antibiotics can also prevent traveler’s diarrhea. However, such use has a risk of side effects and may increase the chances that bacteria will develop resistance to antibiotics. Thus, doctors recommend preventive antibiotics only for people who have an immune deficiency disorder. In most cases, traveler’s diarrhea subsides by itself in about 3 to 5 days and requires only the steady intake of fluids to prevent dehydration. Ordinary clear liquids (withoutcaffeineor alcohol) are adequate for most people. Young children and older people may benefit from powdered rehydration mixes or an oral rehydration solution. People who have moderate to severe symptoms (symptoms severe enough to disrupt activities) should consider taking an antibiotic, especially if they have vomiting, fever, abdominal cramps, or blood in the stool.Azithromycinis appropriate for most countries and is recommended for children and pregnant women. People should contact their doctor for an antibiotic prescription before travel. If people are 6 years of age or older and have no bloody stools, fever, or abdominal pain, they can also be treated with the antidiarrheal drugloperamide(which is available without a prescription). For older adults and young children, powdered rehydration mixes are available for travel. If these mixes are unavailable, rehydration solutions can be made by adding 6 teaspoons of sugar and 1 half teaspoon of salt to 1 liter of water. However, solutions should be prepared carefully because young children can become seriously ill or die if they drink much of a solution that has been incorrectly mixed (for example, if a rehydration mix has not been fully diluted). 