Travel Reference
In-Depth Information
Traveller's Diarrhoea
Traveller's diarrhoea is by far the most common problem affecting travellers - up to 50% of people will suffer from
some form of it within two weeks of starting their trip. In over 80% of cases, traveller's diarrhoea is caused by a bacter-
ia (there are numerous potential culprits), and responds promptly to treatment with antibiotics.
Here we define traveller's diarrhoea as the passage of more than three watery bowel movements within 24 hours,
plus at least one other symptom such as vomiting, fever, cramps, nausea or feeling generally unwell.
Treatment consists of staying well hydrated; rehydration solutions such as Gastrolyte are the best for this. Antibiotics
such as Norfloxacin, Ciprofloxacin or Azithromycin will kill the bacteria quickly.
Loperamide is just a 'stopper' and doesn't get to the cause of the problem. It can be helpful, for example if you have
to go on a long bus ride. Don't take Loperamide if you have a fever or blood in your stools. Seek medical attention
quickly if you do not respond to an appropriate antibiotic.
Giardia lamblia
is a parasite that is relatively common in travellers. Symptoms include nausea, bloating, excess gas,
fatigue and intermittent diarrhoea. 'Eggy' burps are often attributed solely to giardiasis. The treatment of choice is Tin-
idazole, with Metronidazole being a second-line option.
Amoebic dysentery is very rare in travellers but may be misdiagnosed by poor-quality labs. Symptoms are similar to
bacterial diarrhoea. You should always seek reliable medical care if you have blood in your diarrhoea. Treatment in-
volves two drugs; Tinidazole or Metronidazole to kill the parasite in your gut and then a second drug to kill the cysts. If
left untreated complications, such as liver abscesses, can occur.
Environmental Hazards
Food
Eating in restaurants is the biggest risk factor for contracting traveller's diarrhoea. Ways to avoid it include eating only
freshly cooked food, and avoiding food that has been sitting around in buffets. Peel all fruit and cook vegetables. Eat in
busy restaurants with a high turnover of customers.
Heat
Many parts of Thailand are hot and humid throughout the year. For most people it takes at least two weeks to adapt to
the hot climate. Prevent swelling of the feet and ankles as well as muscle cramps caused by excessive sweating by
avoiding dehydration and excessive activity in the hot hours of the day.
Heat stroke is a serious medical emergency and requires immediate medical treatment. Symptoms come on suddenly
and include weakness, nausea, a hot dry body with a body temperature of over 41°C, dizziness, confusion, loss of co-
ordination, fits and eventually collapse and loss of consciousness.
Insect Bites & Stings
Bedbugs live in the cracks of furniture and walls and then migrate to the bed at night to feed on you. You can treat the
itch with an antihistamine. Lice inhabit various parts of your body but most commonly your head and pubic area.
Transmission is via close contact with an infected person. They can be difficult to treat and you may need numerous
applications of an anti-lice shampoo such as Permethrin. Pubic lice are usually contracted from sexual contact.
