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Traveller's diarrhea is a common medical problem for people travelling from developed, industrialized countries to developing areas of the world.
High-risk areas for traveller's diarrhea include developing countries in Africa, Asia, the Middle East, and Latin America. Low-risk areas include the developed countries of North America, Central Europe, Australia, and Japan.
Traveller's diarrhea is usually caused by a bacterial infection. Bacteria such as Escherichia coli (E. coli), Campylobacter, Shigella, or Salmonella are the most common causes. These bacteria are in water contaminated by human or animal stools. Drinking water, water used to wash food, or irrigation water may be affected. When the traveller drinks this water or eats contaminated food, he or she is likely to get diarrhea.
Common sources of bacteria that cause diarrhea are undercooked or raw foods, contaminated food, or contaminated water (including ice cubes).
Traveller's diarrhea can be mild to severe. Most people who develop traveller's diarrhea have symptoms within the first 2 weeks, and often within 3 to 4 days, of arriving in a developing area. Symptoms include:
Treatment for traveller's diarrhea includes drinking fluids so you don't get dehydrated, taking non-prescription medicines, and sometimes antibiotics and intravenous (IV) fluids.
Children 2 years old or younger are at high risk of dehydration from diarrhea. If your child has diarrhea:
Non-prescription medicines may help treat diarrhea. Use non-prescription antidiarrheal medicine if you do not have other signs of illness, such as fever, abdominal cramping or discomfort, or bloody stools. If you have fever, bloody stools, or vomiting, antibiotics may be needed.
Bismuth subsalicylate, or BSS (such as Pepto-Bismol or Kaopectate), has been shown to be effective in preventing and treating traveller's diarrhea.
Non-prescription medicines to slow diarrhea, such as loperamide (for example, Imodium), may be used to treat diarrhea but should not be used to prevent traveller's diarrhea because they can cause constipation.
Talk to a travel health professional about traveller’s diarrhea
Talk to a travel health professional about traveller’s diarrhea before your trip. They will tell you about treatment options, including antibiotics. Knowing your options is especially important if you:
The best way to lower your risk of traveller's diarrhea is to avoid food or water that may be contaminated. A good rule of thumb for food safety is, "If it's not boiled, well-cooked, or peeled, don't eat it."
Avoid drinking local water where you're travelling. Drinks that are usually safe include:
Water can be boiled, treated, or filtered to make it safe to drink. Talk to your travel health professional about the best options for your trip.
Also, be aware that contaminated water may be used to wash fruits and vegetables, clean utensils and plates, and make ice cubes. Brushing your teeth with untreated water also may increase your risk of infection.
Foods and drinks to avoid:
Good handwashing is important in preventing the spread of infectious diseases. Washing with treated water or using alcohol wipes or antibacterial gels to disinfect your hands are good ways to lower your risk of getting an infectious disease.
Talk with your doctor or travel health professional about antibiotics you can carry with you on your trip and instructions on when to use them just in case you get diarrhea.
Dukoral vaccine is a cholera vaccine. There is little proof that it helps prevent traveller's diarrhea, so it is usually not recommended for travellers.
Adaptation Date: 5/21/2020
Adapted By: Alberta Health Services
Adaptation Reviewed By: Alberta Health Services
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