Tourist's diarrhea

Tourist's diarrhea

Tourist's diarrhea is an acute diarrheal disease, and is the most common health problem among Norwegians who travel. Tourist diarrhea is mainly caused by contaminated food or drinking water and poor hand hygiene. The chance of getting tourist's diarrhea varies depending on where in the world you travel.

What is tourist diarrhea?

Tourist diarrhea is a collective term for all forms of acute diarrhea that occur in connection with stays abroad. Abroad, we are exposed to a completely different bacterial flora than the one we are used to, and the stomach therefore easily becomes unbalanced. The risk of getting tourist diarrhea is greatest in South Asia, Africa, the Middle East and Latin America.

Causes

Tourist sickness is usually caused by bacteria, especially E.coli (Escherichia coli). Viruses and parasites can also cause tourist diarrhea. Young children who are affected have an increased risk of serious infection. Stomach acid kills bacteria and therefore people with reduced acid production, and people who use antacids, have a greater risk of getting tourist's diarrhoea.

Cholera

Cholera is a type of tourist diarrhea caused by infection with the cholera bacterium Vibrio cholerae. The cholera bacterium attaches itself to the small intestine in humans and secretes toxins (poisons), which cause large amounts of fluid and salts to be excreted from the body. Cholera can be fatal if left untreated.

Typhoid fever

Typhoid fever (formerly called typhus) is another disease that causes, among other things, very severe diarrhoea. Worldwide, approximately 16 million are infected with the disease annually. Untreated, typhoid fever can be fatal.

Symptoms

Loose stools (more than three times in a day)
Abdominal pain
Fever
Nausea and vomiting
Some people may have blood in their stools

How to avoid tourist diarrhea?

Tourists' diarrhea cannot be guaranteed, but much can be done to reduce the risk of infection.

Do not drink tap water, buy bottled water or boil the water for 3-5 minutes. Iodine or chlorine treatment of water can help. Remember to avoid ice cubes, they are usually made from tap water.
Be careful with hand hygiene. Use disinfectant if you do not have access to clean water and soap.
Avoid certain foods such as undercooked or undercooked meat, fish, shellfish and poultry, uncooked eggs and egg dishes, unpasteurized milk products, salad, uncooked vegetables and unpeeled fruit.

Vaccines

There are vaccines against cholera and typhoid fever, two very serious forms of diarrhea that tourists can contract. None of the vaccines provide complete protection, so you should still follow the advice above. Both vaccines are prescribed and must be taken well in advance of departure.

How to treat tourist diarrhea?

Tourist diarrhea usually goes away on its own within a couple of days, with adequate rest and plenty of fluids.

Drink a lot; little at a time, but often. Eating salty snacks can also be helpful. At the pharmacy, there are also over-the-counter medicines that will help maintain the fluid balance in the body.
Avoid a lot of soft drinks, sports drinks and juices as they can worsen the diarrhoea. Such drinks should then be mixed with equal parts water.
Eat easily digestible food for the first few days and let your appetite control what you eat.
Stopping drugs provide an immediate effect against diarrhoea, but be aware that they do not remove the cause of the diarrhoea. Such medicines should only be used by adults and children over the age of 12, and are only for short-term use.
Watch out for small children! Children are both more often and more severely affected by tourist's diarrhea than adults.

Activated charcoal has no documented effect against diarrhoea, and can also prevent you from getting the effect of other medicines you take (among other things anti-malarial medicines, birth control pills and the stopping medicines mentioned above).

Women who use birth control pills must be aware that the contraceptive effect can disappear with diarrhea and/or vomiting. Other contraception, for example condoms , should be used in addition.

Antibiotic treatment is often not necessary for mild to moderate diarrhoea, with the exception of typhoid fever which must be treated with antibiotics.

When should you contact a doctor for tourist diarrhoea?

In case of blood, pus or mucus in the stool.
In case of diarrhea that does not go away after 4-5 days of self-treatment.
Diarrhea in combination with poor general condition and fever.
With symptoms of dehydration (dark urine, lethargy, thirst and dry mouth).
In case of severe abdominal pain.
Weight loss.
Children who do not improve within 1 day; a doctor must be contacted immediately if one or more of the points above appear.
In case of signs of dehydration (dehydration) that do not improve despite a good supply of fluids.

Sources: Norwegian medical handbook, Norwegian health informatics, Institute of Public Health, Norwegian Medicines Agency, Store Norske Lexikon, and the Common Catalogue.