Handling traveller’s diarrhoea
By Rotimi Adesanya
Traveller’ s diarrhoea is usually defined as at least three loose bowel movements occurring within a 24 -hour period , often accompanied by cramps , nausea , vomiting, fever and /or blood in the stools .
It is a kind of diarrhoea that is common when travelling to other countries especially the less developed ones . Many countries in Africa, Asia and Central and South America are risky places for travellers ’ diarrhoea . It’ s usually caused by eating food or drinking water that is contaminated with bacteria . Traveller ’ s diarrhoea can turn a great vacation into a bad one .
About 10 years ago , I travelled to another African country with two other colleagues for a workshop on current trends in malaria treatment . On the second day of arrival in the country, the first day of the workshop , I visited the bathroom more than six times during the day and six times at night .
At this juncture I had to apply the principle of “Physician Heal Thyself ’’ by taking these few simple precautions and and they helped a lot to relief the pain and discomfort .
Traveller’ s diarrhoea is caused by eating food , or drinking water , containing certain germs or their poisons ( toxins ). These include bacteria ( Escherichia coli , Campylobacter , Salmonella, Shigella) , viruses (norovirus and rotavirus) , parasites: (Giardia , cryptosporidium and Entamoeba histolytica )
Frequent watery /loose stools , blood in the stools , the illness may also cause nausea , vomiting and cramps . Fortunately , travellers ’ diarrhoea is usually mild , and recovery is usually quick .
See your doctor four to six weeks before travelling out of the country. You can help to prevent traveller ’ s diarrhoea by being very careful about the food eaten and the beverages taken while travelling . Unsafe food include salads , unpeeled fruits , raw or undercooked meats, seafood and unpasteurised dairy products .
Coffee and tea made with boiled water are safe . Carbonated soft drinks ( without ice ), beer and wine are safe .
Tap water that has been boiled , filtered or purified with iodine is safe to use . Most of the time , it’ s easier to buy purified bottled water for drinking than to purify the tap water . It’ s safe to eat foods that are thoroughly cooked and served piping hot .
Fresh breads and most dry foods are safe to eat . Always clean your hands before you eat , but use pre- packaged hand wipes or antiseptic gel / sanitisers to clean the hands , not just tap water .
Things to avoid
Don ’ t drink tap water , don ’ t use ice unless you know it was made from boiled or filtered water . Don ’ t eat raw vegetables or salads , don ’ t eat unpasteurised dairy products . Don ’ t eat any fruits unless you peel them yourself , don ’ t buy or eat food and drinks from street vendors .
Don ’ t go swimming in streams and lakes because of the risk of water pollution.
Non – antibiotic interventions : Loperamide usually stops diarrhoea quickly and it has to be taken as prescribed after each episode of diarrhoea . Don ’ t take more than four tablets a day .
Antibiotic prophylaxis : If loperamide doesn ’ t stop the diarrhoea, one may need an antibiotic to get rid of the infection. Your doctor might prescribe antibiotics for you to take with you on your trip . Antibiotics commonly used for traveller ’ s diarrhoea is of the quinolone group . Often , only a few doses are needed to clear up the infection. (You shouldn ’ t take quinolone if you ’ re pregnant or under 18 . ) If the diarrhoea stops 12 hours after taking the first dose of the antibiotic , you probably don ’ t need to take any more of the medicine . But see a doctor if your diarrhoea hasn ’ t stopped after you ’ ve been taking antibiotics for three days .
Oral rehydration solution : One of the biggest problems caused by diarrhoea is dehydration. Dehydration can be prevented by drinking lots of clear liquids, such as water , juices or oral rehydration solution .
Parents should seek immediate medical attention if their child shows signs of moderate to severe dehydration , bloody diarrhoea , or persistent vomiting. The use of oral rehydration solutions is essential, and parents should include ORS sachets in their travel kits .
Immunisation: It plays little practical role in the prevention of TD and the only potentially relevant vaccines are those against rotavirus ( for infants ) , the oral cholera vaccine , typhoid , hepatitis A ( for adults ).
Meanwhile , July 28 every year has been designated World Hepatitis Day. The elimination of viral hepatitis is not just a public health goal – it is an individual goal for millions of men , women and children across the world . Every single person could be affected by viral hepatitis and we all have a part to play to achieve its elimination . Join in curbing the scourge by contributing and liking the ’ Hepatitis B ALERT GROUP ’ on Facebook .
Culled from The Punch