Travelers are advised not to drink the water when traveling internationally.
You've finally found time for that dream vacation in which you visit the most exotic places and live life to its fullest. You've gone to see the sites, tasted the food, and talked to the locals. Suddenly, you're stuck in your room with a really bad bout of diarrhea. Chances are, the diarrhea you're having is a result of bad food or water that you've ingested, and what you may have ended up with is a case of Traveler's Diarrhea. Because of the potential nastiness of the condition, travelers are often advised to "Avoid the water."
Whether or not you get Traveler's Diarrhea and the severity of symptoms depends entirely on the country you're visiting. Traveler's Diarrhea is more likely to occur in severity while traveling in developing countries rather than well-developed countries. According to the Centers for Disease Control (CDC), each year 20 to 50% of all travelers experience Traveler's Diarrhea. The symptoms manifest themselves within one week of international travel, but may also occur after returning home.
Water that you would normally order at restaurants without much thought at home can be detrimental to your health internationally. Tap water, bottled water, and ice in foreign countries can be contaminated with infectious microorganisms that include bacteria, parasites, and viruses. Our bodies attempt to rid our systems of these "strangers." Locals may not display symptoms because their bodies have developed mechanisms to cope. Travelers in a strange land have not developed this protection. The severity of the diarrhea that develops depends on the microorganism that's wreaking havoc with your insides.
One cause of diarrhea is a result of contamination by the bacteria Escherichia coli (E. coli). E. coli is found in contaminated soil, water, and food. Travelers experience nausea, vomiting, cramps, and watery diarrhea when drinking water contaminated with E. coli.
Dysentery is a more severe manifestation of the Traveler's Diarrhea. Dysentery will occur in countries experiencing social or natural upheavals. Shigella is the infectious micro-agent responsible for dysentery. Dysentery is found in 15% of the diarrhea cases that arise during international travel. Symptoms include bloody and mucus-ridden stools, accompanied by fevers and cramps.
The most common case of Traveler's Diarrhea is called giardiasis, caused by the parasite Giardia. Travelers with giardiasis experience 4 to 5 bloody stools over a 3 to 4 day period, or longer for more serious cases. Giardiasis is a longer-term diarrhea resulting in weight loss and exhaustion. If fever, abdominal cramping, or bloody stools appear, the traveler should seek medical attention.
Diarrhea can be caused by other pathogens. The water-borne parasite Cryptosporidium is responsible for cryptosporidiosis, which can be fatal in immunocompromised individuals. Cholera, typhoid fever, Salmonelloses, and Rotavirus infections can also occur when water sources have fecal contamination. These latter diseases are more severe and demand medical attention if present.
It is a good idea to carry bottled water from your home country with you while traveling internationally. While this may not always be practical, there are water sources that remain almost contamination-free. These include carbonated water and beverages, canned beverages, and bottled beer or wine. Carbonated water should be used to brush your teeth and clean your fruits and vegetables. The high acidity in the carbonated drinks tends to kill most bacteria. Make sure you wipe down wet cans and wipe surfaces on canned beverages that your mouth is likely to touch. Hot drinks such as coffee and tea boiled at 175 degrees Fahrenheit are generally safe to drink. Pasteurized drinks are also safe. Be wary of bottled water in foreign countries that are labeled "well water", "artesian well water", "spring water", or mineral water. Unless the bottle says "reverse-osmosis treated", "distilled", or "filtered through absolute 1 micron or smaller filter", chances are you may be drinking contaminated water.
What do you do if there aren't any other alternatives except to drink the water? Make sure you treat it. Treatment involves boiling, disinfecting, or filtering the water.
Filtering water is the least effective method to treat water since not all filters are of the same quality. Filters can prevent parasites and bacteria from passing into water, but viruses are not immune to filtering. Also, the filtered water is only as good as the filter paper; poorly made filters can still let microorganisms through. If a filter is not NSF-tested, or specific to cryptosporidium, you run the risk of being infected with cryptosporidiosis.
Chemical disinfection involves treating water with iodine or chlorine. Iodine tablets can be purchased in your local pharmacies and placed in 1 quart of water for at least 30 minutes before drinking. Iodine can often leave a bad taste, so a vitamin C powder can be added to make the taste more palatable. Chlorine can also be used to treat water, but the effectiveness of chlorine depends on the pH, temperature, and content of the water.
Boiling is the best method to treat your water before drinking. Boiling water for at least 1 minute will kill most of the bacteria and parasites that can cause diarrhea.
The best advice if you travel is not to drink the water. If you're left with no other choice but to do so, be sure to bring iodine tablets and Pepto Bismol. Also, make sure you boil the water. With the proper precautions, you can enjoy and visit all those sites without being confined to that motel room because of severe dehydration and discomfort.
