Eating and Drinking Safely


Food Safety

One of the pleasures of travel is enjoying the local cuisine. On the other hand, travellers diarrhoea, Giardia, Salmonella, Shigella, Campylobacter, Cryptosporidium, Hepatitis A, Hepatitis E, typhoid fever, cholera…all these infections & more can come from consuming contaminated food & drink.

The first important preventative measure is to be meticulous with your own personal hygiene when travelling in less developed countries. Bacteria can be carried to the mouth on hands & cutlery, always wash your hands before eating & avoid putting fingers & thumbs anywhere near your mouth.

The second important measure is to be selective in what you eat & drink. You cannot avoid risk altogether, but you can at least avoid the obvious sources of trouble. Here are some general ‘do’s & don’ts’.

One of the pleasures of travel is enjoying the local cuisine. On the other hand, travellers diarrhoea, Giardia, Salmonella, Shigella, Campylobacter, Cryptosporidium, Hepatitis A, Hepatitis E, typhoid fever, cholera…all these infections & more can come from consuming contaminated food & drink.

The first important preventative measure is to be meticulous with your own personal hygiene when travelling in less developed countries. Bacteria can be carried to the mouth on hands & cutlery, always wash your hands before eating & avoid putting fingers & thumbs anywhere near your mouth.

The second important measure is to be selective in what you eat & drink. You cannot avoid risk altogether, but you can at least avoid the obvious sources of trouble. Here are some general ‘do’s & don’ts’.

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 DRINKING

 

YES

  •  Boiled water is safe. You do not need to boil it for minutes as was once said. Just bringing it to the boil will kill most organisms.
  •  Bottled water is usually safe but do check that the seal is unbroken, as refills from the tap are not unknown!
  •  Purified Water Modern water purifiers such as the Pur Voyageur are transportable & very effective. Used correctly, they will eliminate any organic material & organisms from water & render it about as safe as you can possibly get.
  •  Chemically disinfected water The simplest way to do this is to use iodine-based tablets drinking water tablets, which are added to water before drinking. The instructions must be followed correctly. You cannot rely on these to work if the water is cloudy or contaminated with organic material such as leafy matter. Only a water purifier could render such water drinkable.
  •  Cans of soft drink, especially international brands, are low risk. Local beer is similar in risk.
  •  Wine & spirits are usually imported & safe but do not order your whisky ‘on the rocks’, as ice is to be avoided. (And no, the alcohol will not kill the germs in the ice!)

NO

  •  Any other water. Presume all other sources of water are contaminated. This includes brushing the teeth. Use bottled water for this.
  •  Ice. Freezing preserves germs; it does not kill them.

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 EATING

YES

  • Freshly cooked (fried, boiled, steamed) food
  • Peelable fruits -bananas, citrus fruits, etc
  • Food of acceptable brands in cans or sealed packs
  • In well patronised, busy restaurants serving local food
  • Off clean plates with clean cutlery (consider taking your own cutlery)
  • Food prepared by you.

NO

  • Uncooked, undercooked food or reheated food
  • Salads or unpeelable fruit & vegetables
  •  Ice cream (unless it is an internationally packaged & labelled brand) & dairy products
  •  Oysters, clams, mussels, barbecued prawns or mudcrabs
  •  Food that has been left around exposed to flies
  •  Dishes requiring a lot of food handling to prepare.

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Travellers Diarrhoea

Everyone seems to have a favourite traveller’s diarrhoea story. The Mexican Two Step, Bali Belly, the Rangoon Runs; it almost sounds fun! But don’t be fooled. While it may seem funny in the retelling, traveller’s diarrhoea is the most common cause of spoiled holidays or business trips, & it is anything but funny at the time.

The cause is contaminated food & water. There are three types of problems, & these are important to distinguish because they have different causes & different treatments.

  • Common travellers diarrhoea. This is the one most travellers to developing countries experience sooner or later, with watery diarrhoea & sometimes vomiting. It is caused by bacteria, such as E.coli, Campylobacter, Salmonella & Shigella. It is treated with rehydration, & if persistent, with an antibiotic called norfloxacin.
  • Giardia. This protozoon is found in tap water in many cities around the world, as well as river water & contaminated food. It gives trouble that can drag on & on, sometimes long after returning home. Cramping stomach pain, belching, wind; all round Giardia doesn’t make the sufferer very pleasant company! It requires treatment with a different antibiotic called tinidazole.
  • Dysentery. This is the severe end of the spectrum, with blood or mucus in the motions. Bacterial dysentery will usually improve with norfloxacin. Amoebic dysentery will not respond to norfloxacin but may respond to tinidazole. Dysentery can be a real medical emergency while travelling, & needs medical follow up on return home.

TREATMENT FOR ADULTS

All travellers to higher risk destinations are advised to take treatment for traveller’s diarrhoea with them. A good kit will contain the following treatments:

  • Rehydration is the most important thing. The last thing you want to do is to end up on a drip in hospital, so you must replace the fluids & salts that you lose. Not eating for a day does not matter so much, but if you do not drink you can become very unwell quickly, especially in a hot country. Drink at least 3 litres of fluid a day. The ideal fluid is bottled water with ORS (Oral Rehydration Salts) Hydralyte correctly added.
  • Antibiotics. Norfloxacin or tinidazole depending on the type & duration of symptoms. (See The Diarrhoea Treatment Chart) These are very useful as they actually treat the cause of the problem, i.e. the infection.
  • Loperamide. This is simply a ‘stopper’…a sort of pharmacological cork. It may be convenient to use if you are about to get on a train or plane or give an important presentation, but it is not a treatment, & it is not generally recommended. Loperamide keeps the infection in the body, which means you will have the infection for, longer. Imodium, Lomotil, Codeine & other ‘stoppers’ all do the same thing.
  • Nausea treatments. Common brands are Stemetil & Maxolon. These come in tablets, suppositories or injections & can help with nausea & vomiting.
  • Food. If you are hungry, eat a little. There is no need to ‘rest the stomach’, but try bland foods initially, especially carbohydrates such as rice, pasta, biscuits, bread or potato. Avoid too much dairy food, alcohol, fatty or spicy food while recovering.
  • Special cases. Travellers with diabetes, HIV/AIDS, kidney disease, peptic ulcer, colitis, or other medical problems, are advised to discuss the treatment of traveller’s diarrhoea further with the travel doctor. They are strongly advised to have a treatment kit with them on their travels.

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Information obtained from:

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Links last checked : / /2015


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