Dryden
Brown Ltd
|
TRAVEL HEALTH
DIARRHOEA (FOR TRAVELLERS)
Holiday
makers and business travellers who travel to the USA, Northern
Europe, Australia and New Zealand do not usually risk contracting
travellers diarrhoea. The precautions and self-care strategies
detailed are just like those you would follow at home. In
most cases, medical help will not be required if symptoms
last less than five days.
Most travellers suffer diarrhoea at some time during their
stay in the Third World, Southern Sub Tropical Europe or
Asia.
TRAVELLERS DIARRHOEA is a form of gastro-enteritis
in people arriving in a new, usually hot country. It is
caused by a type of E. Coli bacteria, common in that country,
to which the traveller is not immune. Salmonella, amoeba/protozoa
or viral infections also cause diarrhoea.
Babies and children
Children suffer travellers diarrhoea more often than adults.
They do not have sufficient resistance (unless breast fed)
and are more likely to forget or ignore basic hygiene precautions.
Baby diarrhoea is recognised by an increase in the number
of motions that become more and more liquid. This can develop
quickly and can lead to problems if left. A baby's diarrhoea
often looks green.
Children are more susceptible to dehydration particularly
in hot countries.
What
you can do yourself
PREVENTION
PEEL IT, BOIL IT OR AVOID IT
This is a maxim that should never be forgotten in
high risk areas.
The bacteria is usually taken in from local food
and water which has been contaminated by faeces.
TO REDUCE YOUR RISK OF SUFFERING DIARRHOEA
Observe the strictest personal hygiene. Wash hands
before eating or drinking anything. Consider carrying
baby wipes/alcohol wipes or cologne for this purpose.
Eat only freshly cooked food that is still very
hot, better still if it has been cooked in front
of you.
AVOID food cooked in market stalls - however tasty
it smells or looks.
AVOID sauces, especially those made from eggs or
milk, as they are often kept for long periods at
room temperature. Milk or eggs are ideal sources
or environments for bacteria to grow.
AVOID freshly squeezed fruit juice. Peeled fruit
is SAFE.
AVOID ice and unbottled water.
Bottled water is ONLY SAFE if you see it opened
in front of you.
Alcohol is a disinfectant so it is usually SAFE.
AVOID the ice!
Bread is SAFE, even if cut and left out.
PREVENTATIVE TREATMENTS
Medicine to prevent diarrhoea is not recommended.
Antibiotics should never be used unless specifically
prescribed by a doctor. The following groups of
people are especially at risk:
Women who are trying to get pregnant.
Pregnant women.
Women taking oral contraceptives unless condoms
or another barrier method is used in addition.
Children under 12 years of age.
If your trip is important for business or personal
reasons and is of less than a week and you are prepared
to risk/accept the possible side effects, there
are a number of preventative medicines that you
can obtain from a doctor on PRIVATE PRESCRIPTION
before you travel.
Preventative medication
60g BISMUTH SUBSALICYLATE daily.
OR 1 x 100mg capsule DOXYCYCLINE daily. (This
medicine should never be used by children under
12 years of age, pregnant women or women trying
to get pregnant.)
OR 1 x 200mg tablet TRIMETHOPRIM daily.
These treatments need to be started at least 48
hours before departure and continued for 48 hours
after return.
If diarrhoea develops whilst away, DOUBLE DOSE for
three days and also follow advice below.
If you suffer from a chronic medical condition or
are taking regular medication please check with
your own doctor on their suitability before starting
medication.
TREATMENT OF DIARRHOEA
What you can do
yourself
Nearly all symptoms will clear by themselves
in two to five days, without any medicine.
Adults and children over 1
year Avoid anti-diarrhoea medicines.
Only use anti-diarrhoea medicines if there is no
fever or stomach cramps. If cramps occur stop the
medicine.
There are two different and equally good approaches.
1 Starve for 24 hours or until diarrhoea
slows, which ever is longer.
2 Eat only if hungry. Only eat plain bread,
dry crackers, boiled rice, boiled potatoes or pasta.
For both approaches ensure that you
Drink as much clear fluid as you can - if you have
any ORS (oral rehydration sachets), use them. If
not, use boiled water 250ml hourly interspersed
with fizzy, sugary drinks and dry salty crackers.
Add a pinch of salt to sugary drinks.
Avoid caffeinated drinks, including colas as these
stimulate the kidneys and cause further dehydration.
Avoid milk and all dairy products during the illness
and for at least 72 hours following improvement.
Once diarrhoea has stopped add plain foods such
as bananas, vegetables or white meat the following
day if you are feeling better.
Avoid spicy or fatty foods, acid fruit and alcohol
for 72 hours or until all symptoms have disappeared.
Remember: A woman's contraceptive pill will
not give full protection when suffering diarrhoea.
As well as taking the pill use other precautions
during this time or for at least seven days.
Babies and children under 1 year
After each dirty nappy and as often as possible
give your baby Oral Rehydration Solution (ORS) to
drink. If the baby will not take ORS from a bottle
then use a teaspoon and cup.
After the first four hours try and restart feeding.
Bottle Feeding
Give the baby ORS or a diluted soup of pureed pasta
or potato. Avoid milk products for 24 hours. If
weaned, give the child food as early as possible.
Breast Feeding
Increase the number of breast feeds. After each
dirty nappy give your baby ORS to drink. If the
baby will not take ORS from a bottle then use a
teaspoon. Be sure you get extra fluids into the
baby.
Avoid spreading infection
Wash your hands after you go to the toilet and after
you change your baby's nappy. Clean the toilet often
with disinfectant. Always clean under the toilet
seat.
When to seek medical
attention
If the child is under three months old seek medical
advice early.
If diarrhoea has failed to improve in three days.
If you have an existing bowel disorder.
If intermittent loose motions persist after your
return.
When to
seek medical attention immediately
If diarrhoea is accompanied by high fever.
If diarrhoea is so severe you cannot leave the toilet.
If you have bloody diarrhoea.
If you are also vomiting for longer than six hours.
If you are becoming more seriously ill.
If you are becoming confused or having hallucinations.
If you are having increasing abdominal pain.
Contact
a doctor
If you are losing too much fluid (dehydration).
Signs include dry skin, sunken eyes, dry tongue,
drowsiness, less urine than normal.
If you have a high temperature as well as diarrhoea.
If you have been following this self-care advice
and the diarrhoea goes on longer than a week.
Your toddler has frequent episodes of diarrhoea.
Children over 1 year
If symptoms go on longer than two days.
Babies under 3 months
If diarrhoea persists for longer than eight hours.
If the baby has a sunken spot on the top of its
head.
Contact a doctor
immediately
If there is blood in the diarrhoea or the diarrhoea
is red.
Babies and children under 1 year
If your baby is drowsy or confused.
If your baby does not want to drink for a few hours.
If your baby is also being sick all the time.
If your baby also has a high temperature.
To order
your copy of a What should I do? booklet
use one of the following methods:
On-line
Shop
Phone: +44 (0) 23 8022
9041
Fax: +44 (0) 23
8022 7274
 
|
