A young hardworking couple, they were more than ready to take a vacation . . . especially after all the stress that COVID had put on their lives. Overseas travel beckoned.

They weren’t alone. According to AAA, international trips are on the rise this year —up more than 200 percent compared to 2022.

“Travelers are making up for lost time and willing to spend more to see the world,” said Paula Twidale, Senior Vice President of Travel at AAA.

But that doesn’t mean that caution should be thrown to the wind especially when it comes to food safety. Quite the opposite. Travelers actually need to be diligent about avoiding foods and drinks that could make them sick and ruin their overseas vacation.

Unfortunately, this young couple weren’t diligent enough. They were thrilled to be able to sample and dine on foods they didn’t ordinarily eat at home. After all, wasn’t that one of the best parts of travel — eating food grown in foreign countries and prepared by chefs in fancy restaurants or quaint sidewalk cafes. Or even buying interesting foods from sidewalk vendors or outdoor markets. 

Unfortunately, they paid the price for that trust. After only several days, they came down with diarrhea, vomiting, and abdominal cramps. This left therm trapped in their hotel room. Seeing all of the sights of the city they were visiting, enjoying its night life, or even dining out weren’t in the cards for them. At least not for several days.

“Montezuma’s revenge,” said the doctor they went to, explaining that according to the Centers for Disease Control, traveler’s diarrhea affects 30 to 70 percent of travelers. And while the highest-risk destinations are in most of Asia, the Middle East, Africa, Mexico and Central and South America, it can occur anywhere.

The doctor advised them to get plenty of rest and drink a lot of clear fluids, not apple or pear fruit juice though. “You’ll be as good as new in a couple of days,” he told them. But he also gave them some food-safety advice from the Centers of of Disease Control (https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/food-and-water-precautions), which they heartily welcomed, They definitely didn’t want to get sick again.

Tips for travelers from CDC
As a starter, travelers should choose food with care and follow basic food-safety practices recommended in the United States when abroad. 

°Stay away from “raw.” Raw food is especially likely to be contaminated with foodborne pathogens such as E. coli, salmonella, and Listeria. That includes raw or undercooked meat, fish, shellfish and produce, all of which can be contaminated. Foods of animal origin, including meat and eggs, should be cooked thoroughly. In general, fully cooked foods that are served hot and foods that travelers carefully prepare themselves are the safest. 

In the case of dairy products, travelers should select pasteurized milk and milk products. That means steering away from unpasteurized, raw milk or cheeses made from raw milk.

°In areas where hygiene and sanitation are inadequate, or unknown, travers should avoid eating salads, uncooked vegetables, raw unpeeled fruits and unpasteurized fruit juices. Fruits that can be peeled are safest when peeled with a clean knife by the person who eats them. As healthy as fresh fruits and vegetables may be, if they’re contaminated with foodborne pathogens, they can make you sick — very sick.

°Be “water safe.” In many parts of the world, especially where water treatment sanitation and hygiene are inadequate, tap water can contain disease-causing bacteria, viruses, parasites or even chemical contaminants. Bottomline: it might not be safe to drink or use it for preparing food and drinks, making ice, cooking and even brushing teeth. And using questionable water to wash fresh produce won’t remove foodborne pathogens that might be on it.

Then, too, travelers should avoid drinking or even putting tap water into their mouths, unless they have assurances that it’s safe. Along these same lines, travelers should also avoid ice since it may have been made with contaminated tap water. In places where the safety of the tap water is questionable, travelers should opt for only unopened commercially factory-sealed water. And they should also ask that all beverages, even alcoholic drinks, be served without ice. The alcohol content of alcoholic beverages will not kill bacteria in ice made from contaminated water.

However, when served in unopened, factory-sealed cans or bottles, water, carbonated beverages, commercially prepared fruit drinks, alcoholic beverages, and pasteurized drinks generally can be considered safe. That’s also true for beverages made with water that has just been boiled — tea and coffee, for example.

When soap and water are not available, travelers should use an alcohol-based hand sanitizer containing at least 60 percent alcohol, then wash hands with soap and water as soon as possible. Hand sanitizer is not as effective as handwashing for removing some germs, like Cryptosporidium or norovirus, and does not work well when hands are visibly dirty or greasy. The Centers for Disease Control and Prevention (CDC) website Handwashing: Clean Hands Save Lives provides additional information.

About those babies. CDC says that for infants 6 months and younger, the safest way is to breastfeed exclusively. For infants on formula, parents should consider using liquid-ready-to-feed formula, which is sterile. When preparing formula from commercial power, the manufacturers instructions are usually sufficient. In addition, travelers should consider packing enough for their trip because manufacturing standards vary widely around the world. 

Some tips from AAA
Dr. Kyle Staller, a gastroenterologist at Harvard-affiliated Massachusetts General Hospital, understands that the tendency to arrive somewhere new is to embrace it in all aspects.

But instead, he says, travelers should keep their food choices more in line with what they eat at home, drink plenty of clean water, and eat moderate portions.

He advises travelers to plan ahead when eating out. Check the restaurants and menus ahead of time to make sure at least one item will not only be delicious but also easy to digest. And in line with what CDC suggests for avoiding a foodborne illnesss.

In the event that you’re worried that some food where you’re going will disagree with you or you’re wary about it how safe it is to eat, pack some familiar snacks or even a meal substitute. Examples would be granola bars, nuts, trail mix or dried fruit. Whatever the case, they should be filling.

And just in case, take along a variety of over-the-counter products to counteract digestive woes while you’re traveling. Examples of this would be antacids, such as Tums for heartburn; Pepto-Bismol or Kaopectate for indigestion or diarrhea; Colace, Surfak, Metamucil, or Dulcolax for constipation; and Imodium for diarrhea. However don’t use Imodium if you also have signs of infection such as fever or blood in your stool. In that case, said Staller, go see a doctor.

Street food beware. Food from food trucks is more likely to contain harmful bacteria such as E. coli, salmonella and Listeria, especially in developing regions.

“This isn’t fun because some of the tastiest food is street food,” said Staller. “But if you indulge, know that you’re taking that risk. If you’re easily derailed by digestive issues, street food is a “no-go.”

Travelers insurance. AAA recommends that people research and purchase travel insurance since it does cover a variety of things, oftentimes foodborne illnesses.

Destinations. Go here (https://wwwnc.cdc.gov/travel/destinations/list) for a list of  health-related information that travelers should know about the countries they’re planning to travel to. This would include required vaccinations, common diseases and how they’re spread (water plays a big part in this), and how to eat and drink safely.

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