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Diarrhoea following consumption of contaminated food or water is the most frequent health problem encountered by travellers. It can be caused by a wide range of infectious agents and may affect up to 80% of travellers to high-risk destinations. Measures to minimise infection by eating and drinking safely are effective if applied rigorously and consistently. However, even with high awareness, travellers usually have problems adhering to these guidelines. A useful rule of thumb for travellers is 'boil it, cook it, peel it or forget it'.^1,49

Most cases of traveller’s diarrhoea are mild and resolve in 1–2 days without treatment. However, even a brief episode of severe diarrhoea may spoil a holiday or ruin a business trip. Typically, a traveller experiences four to five loose or watery bowel movements each day. Other symptoms may include abdominal cramps, fever or vomiting.⁵⁰

Transmission^49,50
Transmission usually occurs following consumption of food, drinks, or drinking water contaminated with diarrhoea-producing microorganisms.

Geographic Distribution⁵⁰
Worldwide. High-risk destinations are the developing countries in:

• Latin America
• Africa
• Middle East
• Asia

Precautions and prevention^49,50

• Avoid consumption of potentially contaminated food or drink. (See Eating safely and Drinking safely.)
• Avoid contact with potentially contaminated recreational waters.
• Carry oral rehydration salts (e.g. Gastrolyte) and water-disinfecting agents.
• Know how to treat diarrhoea (talk to your doctor before you leave)
• Travellers should seek medical assistance if their diarrhoea is severe, bloody, if they are unable to keep up their fluid intake and become dehydrated, or if the diarrhoea does not resolve within a few days.

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