It’s that time of year again. You’re sick of the snow and ready to escape to a beach somewhere near the equator! If you’re anything like me, you’ve already started planning, and are probably thinking about the essential steps… booking your travel and accommodation, packing the right clothes, ensuring you have enough spending money, planning excursions, etc. However, if you want to avoid any unexpected illnesses while on vacay – you should add chatting with your healthcare professional for pre-travel health advice to your to-do list!
The majority of Canadians are not as travel-savvy as they should be when it comes to the potential causes, symptoms and risks of a gastrointestinal infection. Approximately seven out of every ten Canadians may experience travelers’ diarrhea while on vacation. This makes it one of the most common travel-related diseases. If you’ve had diarrhea during travel before – you know this is NOT how you want to be spending your time on vacay!
The most detrimental risk factor for the development of travelers’ diarrhea is the destination. Developing countries all over the world represent the highest risk of diarrheal disease. Those being the Caribbean, Latin America, Africa, the Middle East, and Asia.
Travelers’ diarrhea is typically contracted by ingesting bacteria-contaminated food or water, with food being the primary cause. Approximately 80% of reported cases of travelers’ diarrhea are caused by bacteria, specifically Escherichia coli (E. coli).
There are six unique classes of E. coli that can cause inflammation of the stomach and bowels and are termed enterovirulent E. coli (EEC). Brace yourself, you may not be able to pronounce these classes, but it doesn’t mean you won’t get them! They include:
The most common bacterium that causes diarrhea in travelers is enterotoxigenic E. coli (ETEC).
Enterotoxigenic E. coli (ETEC) causes up to one-third of the cases of diarrhea in travelers and is characterized by a sudden onset of not-so-pleasant symptoms including:
These symptoms can occur 1-3 days after ingesting contaminated food or water.
The effects of diarrhea during travel can be very serious, especially for children and older adults. ’ Diarrhea during travel is uncomfortable, inconvenient and can lead to severe dehydration which can be life-threatening.
Clinical findings also strongly suggest that ETEC infections in travelers can increase the risk of subsequent functional bowel disorders. For example, 10–14% of travelers recovering from ETEC diarrhea may go on to develop irritable bowel syndrome (IBS), further highlighting the importance of preventative measures including vaccination.
Men and women are at equal risk for developing diarrhea during travel, but some individuals are more commonly afflicted.
Certain groups of people are also more likely to develop diarrhea during travel.
At-risk groups include:
If you’re like us, you’ve probably skipped right to the part about how to protect yourself from getting ETEC diarrhea while on vacation.
You should pay close attention to diet as it is of foremost importance in the prevention of travelers’ diarrhea. We’ve compiled a list of things to keep in mind while on vacation:
Knowing how to manage food and water intake, and personal hygiene, is so important while on vacation. Before you head on vacation, sit down with your health care professional to discuss preventative measures. These may include:
Certain over-the-counter medications and probiotic supplementation may be beneficial. Antibiotics can be effective in preventing travelers’ diarrhea but are not recommended for most people due to possible side effects, including photosensitivity and additional diarrhea which can be major problems.
Antibiotics can be considered for the ‘at higher risk’ individuals mentioned previously, who have underlying medical diseases where diarrhea is more likely to occur or who may be profoundly affected by diarrhea.
On the vaccine front, in addition to cholera protection, Dukoral® is indicated for the prevention of and protection against diarrhea caused by heat-labile toxin (LT)-producing enterotoxigenic E.coli in adults and children two years of age and older who will be visiting areas where there is a risk of contracting diarrhea caused by ETEC.
With ETEC being the most common bacterium responsible for diarrhea in travelers in many parts of the world coupled with a well-established safety profile, the Canadian Digestive Health Foundation (CDHF) recommends considering Dukoral® as an option to prevent LT-ETEC diarrhea during travel. It should be noted that Dukoral® should not replace standard hygienic measures. Like any vaccines, Dukoral® may not protect 100% of susceptible people.
If you are interested in learning more about Dukoral®, please visit: DukoralCanada.com
You can order their patient brochures through CDHF.ca at: https://cdhf.ca/health-lifestyle/dukoral/
Are you a health care professional? Order resources for your office/clinic here.