Embrace your travel bug without getting sick

So you’ve recently been bit by the travel bug – don’t let your summer travel get ruined by a bug of another sort. An infectious diseases expert at Baylor College of Medicine explains how to avoid getting traveler’s diarrhea on your next trip.

“Traveler’s diarrhea is when you develop gastrointestinal symptoms like loose stool and bloating and make frequent trips to the bathroom, and these symptoms arise in the context of travel,” said Dr. Stacey Rose, assistant professor of medicine in the section of infectious diseases at Baylor.

While traveler’s diarrhea is very common, the types of bugs that are causing it can vary depending on where you’re traveling – most are bacterial but some also can be viral.

According to the Centers for Disease Control and Prevention, traveler’s diarrhea can occur in any destination, but the highest risk of getting it is in the Middle East, Africa, Mexico, Central and South America and most of Asia.

However, there are some things that increase your risk of exposure no matter where you travel. Rose recommends keeping the following tips in mind to minimize exposure:

• Make sure that the food you’re eating is fully cooked – do not eat uncooked or undercooked food.

• Only drink bottled or boiled water – bugs can live in the water but most organisms can’t survive the hot temperatures of boiled water. This also means you should avoid drinking beverages containing ice, since the ice may be contaminated. Bottled / boiled water should also be used for brushing teeth.

• Don’t forget that fruits are washed with the local water and could potentially be contaminated. Eat fruits that you can peel yourself so that you can get to the meat of the fruit without being exposed to the water that was used to wash it. Wash the fruit yourself with bottled or boiled water.

• Wash your hands frequently using bottled or boiled water.

“The more we learn, the more we realize that prevention is key,” Rose said.

One effective way to prevent and treat traveler’s diarrhea is to take an over-the-counter medication that contains bismuth subsalicylate with you on the trip. This has been shown to have powerful antimicrobial properties that can reduce the risk of getting traveler’s diarrhea.

Plan to take it a couple of times a day or with meals to reduce the risk of developing traveler’s diarrhea, Rose said. It also helps with the symptoms of diarrhea if you do develop it.

While traveler’s diarrhea usually resolves in a couple of days, be aware of the danger of dehydration. Many people require rehydration therapy because they are not able to keep anything in their system, and this can cause additional complications. Be sure to drink bottled or boiled water regularly.

While it was previously advised that you should not take an antidiarrheal drug to treat traveler’s diarrhea for fear that you would keep the bacteria in your body and cause additional health issues, Rose said that it’s usually ok to take an antidiarrheal drug and that it can even shorten the course of the illness.

Rose said that because the use of antibiotics as prevention has led to increased antibiotic resistance, physicians try not to give travelers antibiotics to carry with them during their trip. In fact, international travelers who have taken antibiotics on a semi-regular basis to prevent traveler’s diarrhea have higher rates of carriage of resistant organisms.

“We want to minimize antibiotic use because from a public health perspective, the number of people who are harboring resistant bugs has increased. One reason for this is that too many antibiotics have been prescribed as a preventive mechanism,” Rose said.

If you get to the point where you do need antibiotics, a single dose often is effective and the antibiotic choice will vary based on the part of the world you are visiting.

However, if you have bloody diarrhea, it could be a more serious bug and you should seek medical care immediately.

Once you have returned from your trip, if you continue to have diarrhea that is not responding treatment, reach out to your doctor, who will need information on where you traveled as well as your antibiotic usage history. If you have a fever or persistent or bloody diarrhea, get your doctor involved immediately.

“Every once in a while it will be something other than the usual bugs,” Rose said.

Travelers who are immunocompromised due to HIV, cancer, chemotherapy or a recent transplant should speak with their doctor before they travel, she said. The doctor may prescribe an antibiotic to carry during the trip because there is an increased likelihood of complications escalating before these travelers can get to the hospital.