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JAMA Patient Page
January 6, 2015

Traveler’s Diarrhea

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Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2015;313(1):108. doi:10.1001/jama.2014.17152

Traveler’s diarrhea is the most common illness among persons visiting lower-income countries. In some places 1 in 3 visitors may develop the illness during a 2-week stay.

What Is Traveler’s Diarrhea?

Traveler’s diarrhea is an illness mostly caused by bacteria in food or water. If you have traveler’s diarrhea, your main symptom will be loose stools. Stomach cramps and nausea are also common. You also might have vomiting or fever.

If you are a healthy adult, traveler’s diarrhea will probably not be serious. But you might have to change your travel plans until you recover. Without treatment, most people recover within 4 days.

How Can I Avoid Traveler’s Diarrhea?

To avoid getting traveler’s diarrhea, you should

  • Wash your hands often. This is especially important after you use the bathroom or before you eat. Use lots of soap and water.

  • Be careful what you eat or drink.

    • Try to choose restaurants that are busy and clean. Try to avoid buffets. Food should be recently cooked and served very hot.

    • Avoid raw fruits and vegetables. (But these might be safe if they are peeled or washed in clean water.)

    • Avoid undercooked meats, fish, and seafood.

    • Avoid tap water and ice. (Ice might have been made with unclean water.)

    • Choose beverages in factory-sealed containers. Bottled water is a good example. Beverages made using boiling water are also safe. Tea is a good example.

How Can I Treat My Traveler’s Diarrhea?

If you develop traveler’s diarrhea, you should drink lots of fluids. This is especially important for young children. It is also especially important if you are older or have a chronic illness.

Make sure the fluids are safe (see above). Tea with some sugar is a good choice. Soup is another good choice. If you are dizzy, eat salted crackers. In serious cases, you can drink a solution made from a powder you can buy in drugstores worldwide. These solutions can help prevent dehydration. They are also helpful in children or in adults with medical conditions.

You might also consider packing an antibiotic. The choice of antibiotic will depend on where you are going. You should ask your doctor or travel clinic for help choosing.

Drugs are available that can stop diarrhea for a short time (for example, loperamide). Because these drugs stop diarrhea, you can board a bus or plane until an antibiotic starts working.

What If I Still Have Traveler’s Diarrhea After I Get Home?

You should see your doctor or travel clinic if you still have traveler’s diarrhea for more than 72 hours after you get home. This is especially important if you are seriously ill or if you have a fever or blood in your stool.

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Article Information

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Steffen reports receipt of consulting fees/honoraria and support for travel from Dr Falk Pharmaceuticals and payment for lectures/speakers bureaus and support for travel from various vaccine producers unrelated to traveler’s diarrhea. Dr DuPont reports consultancy for Salix Pharmaceuticals and Cubist and payment for lectures/speakers bureaus from Merck, Cubist, and Salix Pharmaceuticals (paid to him) as well as consultancy for Merck and GlaxoSmithKline and grants from Satarus, Sanofi Pasteur, GlaxoSmithKline, and Viropharma (paid to his institution). Dr Hill reported no disclosures.

Source: Centers for Disease Control and Prevention

Topic: Infectious Diseases