TRAVELER'S DIARRHEA
How to avoid tourista
Traveler's diarrhea or tourista is an acute diarrhea that affects a large number of travelers.
It is said that between 60 and 80% of travelers in tropical, subtropical and developing regions are affected by this distressing gastroenteritis.
Although the risk is higher in these areas, the World Health Organization (WHO) reminds us that hygiene can be poor anywhere, so it's best to take precautions.
Where is the risk of catching tourista?
What are the symptoms of traveler's diarrhea?
Tourista usually appears within the first 3 to 5 days of the stay.
It most often presents as watery diarrhea without fever or blood.
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Diarrhea
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Abdominal cramps
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Nausea and vomiting (1 in 10 cases)
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Fever (1 in 10 cases)
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General discomfort
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Signs of dehydration
What causes traveler's diarrhea?
More often of bacterial origin than parasitic or resulting from a virus, its transmission is by the oral-fecal route.
A number of bacteria are responsible for contamination, the best known and most frequent is undoubtedly enterotoxigenic Escherichia coli also known by its abbreviated form of E. coli.
The mechanism of action of the E. coli bacteria is the production of an enterotoxin (a toxic substance that targets the intestines) which causes a flow of water and electrolytes into the intestinal lumen, resulting in softening of the stool and diarrhea3.
Other bacteria that cause this condition include Salmonella, Shigella, and Campylobacter. The disease can also sometimes be caused, although less often, by parasites such as Giardia, Cryptosporidium, Cyclospora, or by viruses such as rotavirus or norovirus1,2.
Tips to Avoid Diarrhea While Traveling
Be careful with everything you consume: food or drink.
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Beware of tap water, ice cubes, and all frozen smoothies.
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Avoid street food
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Make sure food is cooked thoroughly
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Avoid seafood
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Be careful with fresh fruits and vegetables (salads), opt for foods that can be peeled (e.g. bananas)
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Avoid dairy-based foods
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Avoid eggs
WHO summarizes the guidelines as follows:
“Cook food, boil it, peel it or not eat it.”
Hygiene first
The infection can be transmitted from person to person, prevention is better than cure
Wash your hands with soap
Brushing your teeth with bottled water
Taking care of your immune system
Make sure you get adequate sleep
Probiotics
Oral vaccines
How often to take?
Take one week before departure, during the stay, and one week after returning
Take 2 doses 1 week apart no later than 2 weeks before departure
Requires a prescription?
No
No, but must be recommended with the Quebec immunization protocol with consultation of a health professional.
No for residents of other provinces
Who are these prevention methods aimed at?
Adolescents (12 years and older) and Adults.
Children's formulas are recommended for ages 1 to 3 and ages 3 and up.
Adults and children aged 2 years and over
Kept in the refrigerator?
No, does not require refrigeration
Yes, requires refrigeration
Possible side effects
Possibility of bloating and gas at the beginning of consumption
Possibility of abdominal pain, diarrhea, nausea, vomiting, fever
REFERENCES
1- Government of Canada. Travellers' Diarrhea. 2016-04-27 [Website]. Retrieved May 25, 2018, https://voyage.gc.ca/voyager/sante-safeite/maladia/diarrhea
2- Le Figaro Santé. Turista. [Website]. Accessed May 25, 2018. http://sante.lefigaro.fr/sante/maladie/turista/quest-ce-que-cest
3- Lucas F, Popoff M, Corthier G. Bacterial enterotoxins: structure, mode of action. Ann Rech Vét (1991) 22, 147-162