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Traveler's Diarrhea (T.D.) is usually contracted
through ingestion of contaminated food or water. As many as 60% of
travelers staying several weeks in developing countries will develop
diarrhea. It is an acute illness characterized by three or more watery
or loose stools, cramps, nausea, urgency, bloating, fever, and malaise
usually lasting 3 - 7 days, sometimes longer. Rarely is T.D. life threatening.
By following the appropriate food and water precautions traveler's
can reduce their chances of developing T.D.
Most diarrheas are self-limiting and require replacement of fluids and
electrolytes (body salts) lost in loose stools. Travelers should begin
treatment by oral dehydration by drinking large amounts of bottled or
canned fruit juices, caffeine-free soft drinks, and Gatorade. Avoid drinking
iced or non-carbonated bottled fluids made from water of uncertain quality
and dairy products. When in doubt of water purity use boiled or bottled
water. Foods easily digested such as rice, bananas, gelatin, dry toast,
and saltine crackers can also be consumed to aid in dehydration.
Anti-diarrheal agents (Lomotil, Imodium, AD, Pepto Bismol) are often
used temporarily in treatment for T.D. However, they may be dangerous
for those who cannot tolerate aspirin, those who have abnormal kidney
function or intestinal disorders.
For severe cases, one of the four antibiotics may be prescribed: Doxycycline,
Trimethoprim-Sulfamethoxazole, Ciprofloxacin, or Norfloxacin. The recommended
duration of treatment is two - three days unless you have side effects,
which could indicate an allergic reaction.
Travelers should always consult a physician rather than attempt self-medication
if the diarrhea is severe or does not improve within several days; if
there is blood and/or mucus in the stool; if fever occurs with shaking
chills; or if there is dehydration with persistent diarrhea.
Hepatitis A is a highly contagious viral disease that
attacks the liver and is most commonly spread from person to person and
through contaminated food and water. Although hepatitis A is found throughout
the world, its incidence is highest in developing countries. Within 3
- 5 weeks after infection, an onset of symptoms that range from mild
to severe may include: fever, vomiting, abdominal pain, fatigue, jaundice,
and lack of appetite. All travelers who have not had hepatitis A infection
or vaccination for hepatitis A are at risk of developing the infection.
Travelers can prevent contracting the virus by taking the appropriate
food and water precautions, receive long-term immunity from hepatitis
A vaccine or short-term immunity from human immunoglobulin. The vaccine
is a two dose series (initial dose, then 6 - 12 months later).
Poliomyelitis is a viral illness that can cause paralysis
and occasionally death. The risk of acquiring polio is far greater in
many countries of the developing world where poor sanitation is a problem.
Polio is transmitted by contaminated food and water. Polio has been eradicated
in the Western Hemisphere.
Typhoid Fever is a severe systemic bacterial infection
and is transmitted via contaminated food and water. Immunization is recommended
for all persons traveling to areas where sanitary conditions are uncertain
or those anticipating prolonged travel. Both oral and injectable forms
of typhoid vaccine are currently available. It is important to follow
food and water precautions even after typhoid immunization.
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