Pina colada, hot sand, cool ocean and... diarrhea? Vacations are definitely a time to splurge and relax, but all too often ignorance paves a one-way road to the emergency room. With a few precautions, illness from unsanitary water or ill-prepared food can be avoided.
In countries where hygiene and sanitation are poorly maintained or absent, it is best to stay away from foods that may be contaminated. Raw foods are most at risk, particularly salads, uncooked fruits and veggies and unpasteurized milk products.
As is true here in the States, make sure fish, meats and shellfish are cooked thoroughly when traveling. And remember, even well-cooked food can quickly become a bacterial playground if left out at room temperature for more than four hours. To prevent this, be sure that the cooked food is straight from the frying pan or has been thoroughly re-heated. If something does not look, taste or feel right, avoid it.
Drinking water is particularly hazardous when traveling. While most water in the United States is safe to drink thanks to chlorination, this is not always the case in other parts of the world. In places where water is scarce, cross contamination of bathing and drinking water is likely - setting the stage for the most common path of infection, fecal to mouth.
Fecally contaminated food or water is the leading cause of traveler's diarrhea, an illness that affects roughly 10 million international travelers each year, according the Centers for Disease Control and Prevention. Onset is likely within the first week of travel and is more common in developing countries, but particularly Latin America, Africa, the Middle East and Asia.
Bacterial enteropathogens are the most likely source of traveler's diarrhea, although viral and parasitic pathogens are also to blame. Symptoms include watery diarrhea, abdominal cramping and fever. Sufferers are at risk for dehydration, so be particularly aware of fluid intake. Safe fluid intake, that is - if you cannot be assured by a reliable source that the water from a tap is safe and drinkable, you must boil it.
Water needs to be brought to a good boil for at least one minute (higher altitudes require a longer boiling time). Before drinking, cool water to room temperature - just be sure not to add unsanitized ice cubes to speed cooling.
Perhaps a more realistic option is to drink bottled beverages, although there is a slight catch. While the liquid inside the bottles is most likely pathogen-free, you can't be sure that the outside of the bottle or can is clean. Be sure to dry the container and clean the area that your mouth may come into contact with. Remember to use safe water while brushing your teeth as well.
So you don't leave totally discouraged, there is some good news... liquor, beer and wine are all considered safe choices! But as with all beverages, be sure your drinks are delivered without the ice.
International travel can be fun and safe, but when it comes to food and water, don't let your guard down. And remember to consider the food on the plane ride home: Airlines often load the galley with food from the area of departure, so bring a pre-packaged snack to be safe.
Mary Keyes is a graduate student in nutrition communication at the Friedman School of Nutrition Science and Policy.
