Preventing Traveller's Diarrhoea

By adhering to a few simple hygiene rules, you can greatly reduce your risk of contracting traveller's diarrhoea. At present, there are no vaccines available that would offer preventative protection, however some medicines can be prescribed prophylactically so you've got them with you when you need them.

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Here are some handy tips for you to remember while on holiday:

1. Use of water: If you are unsure about the quality and purity of the local tap water, do not drink or use it to brush your teeth, use bottled water from a previously unopened container for this purpose and also if you wish to make ice cubes. Be cautious as in some countries, what is sold as bottled water (mostly by street vendors) really is tap water that has been filled into an empty bottle before being resealed. Make sure you've got enough safe drinking water supplies on you for the day so you do not have to risk buying contaminated water from a dubious source if you are desperate for a drink. Especially in hotter countries you should not underestimate the necessity for an increased fluid intake, particularly if you are active.

2. Beverages: Carbonated sugary fizzy drinks, hot coffee or tea are generally considered to be safe and the same goes for water you have boiled yourself for several minutes or for treated water – you can buy water purification tablets specifically designed for holidays in most outdoor and camping shops.

3. Food consumption: Refrain from consuming raw fruit and veg unless you have peeled it yourself before eating. Be very wary of salads and their dressings.

4. Avoid uncooked meats, poultry, seafood and only eat them when thoroughly cooked and while still hot. Do not eat any cold leftovers, especially rice dishes as ingestion of rotten foods can cause botulism, a bacteriaborne intoxication. Remember that a lot of meat and fish will have been on display out in the hot weather all day before ending up on your plate.

5. Be careful with local dairy products such as cheese, milk, mayonnaise, cake icing and ice cream.

6. As a general piece of advice refrain from buying any produce or foods from street vendors as these usually display the most unhygienic conditions. Have a look at the cleanliness of the food place – if it is heaving with flies and other insects, the kitchen looks dirty or if any of the staff display open wounds or similar, you should find somewhere else.

7. Personal hygiene: Always wash your hands thoroughly with soap before eating or touching your mouth and let them airdry unless you have got a clean towel to wipe them with – towels harvest bacteria, especially in warm and humid weather conditions. Never use towels in public facilities unless they are disposable paper towels dispensed by a closed container.

8. Stock up on essentials before you go on holiday - Take some antiseptic wipes and disinfectant hand sanitiser with you. You can also buy toilet seat disinfectant which is a good idea as Salmonella can be passed on via a contaminated toilet seat.

Opinions differ on whether or not it is advisable to take prophylactic antibiotics to avoid getting TD while on holiday. While some healthcare professionals recommend it, others strongly advise against it arguing that at this point evidence to suggest preventative treatment significantly reduces the risk is insufficient. A further drawback are avoidable sid effects as well as a chance of developping resistance which would make the drug ineffective when it is needed acutely, especially if the medicine contains penicillin derivatives.

Probiotics in yoghurt and other dairy products may help in preventing traveller's diarrhoea thanks to their beneficial effect on the intestinal flora supporting the good bacteria in the gut, which is especially important during times of dietary change commonly associated with holidaying.

Local residents seem to be unaffected despite eating the same contaminated foods as travellers. This is because the body develops immunity against a pathogens if exposed to it repeatedly or at the long term, however the ins and outs of the process of autoimmunisation have not yet been established and as such it is for example unclear how long it takes and how much exposure to the pathogen is necessary.

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