Contaminated food and beverages often pose the biggest health risk for travellers in developing countries, causing serious diseases like cholera, typhoid, hepatitis A and, most commonly, travellers’ diarrhoea.
The golden rule is to NEVER trust the local water supply in a developing country without first treating it effectively.
Travelvax advises that even if the water is relatively safe for the locals, it may contain bacteria and organisms you have never experienced before, and these could make you ill. Remember, at least half the people visiting a developing country will experience travellers’ diarrhoea at some point.
Effective treatment of water includes boiling (which is not always practical), disinfection using iodine tablets or chlorine (not very palatable) and purification/disinfection using a water purifier (usually the most common and simplest method). A water purifier really comes into its own when you're off the beaten track and reputable, sealed bottled water is either unreliable, hard to find or expensive.
Beverages which are safest include:
- Carbonated drinks: the acid pH of carbonated beverages inhibits bacterial growth. While not absolutely safe, they are generally safer than the non-carbonated variety. Insist that the bottle is opened in front of you and drink from it, preferably using a straw.
- Coffee or Tea: served and drunk hot (without milk) are generally safe. Tap water: tap water must at least be disinfected and preferably purified before being consumed. Find some way to consistently remind yourself not to drink tap water (some string tied on the taps is a simple method).
Take care when selecting:
- Cold drinks, fruit juice or ice: these are almost always made from the local water supply, or supplemented with it, then served in a glass washed in water.
- Milk: Don't drink unpasteurised cow, sheep or goat's milk. If in doubt, bring it to the boil first.
- Caffeine, alcohol and aspartame (found in diet drinks): these can aggravate diarrhoea, especially in people susceptible to stomach upsets.
- Keep your mouth shut when showering (swimming in chlorinated swimming pools is okay). Use carbonated mineral water, boiled or treated tap water to brush your teeth.
Contaminated food is a common source of infections.To minimise risks:
- Wash all fruit, salad ingredients and vegetables before eating. Salads are best avoided, but if you must eat them, wash items well and leave to soak in clean water heated to 60°C for five minutes. Alternately, for washing food, use water treated by your water purifier, or water disinfected using household bleach or tincture of iodine* (drops or tablets).
- Peel all fruit and vegetables to be eaten raw. Avoid them in public restaurants.
- Protect food being left out by covering it with a fly net.
- Always wash your hands before eating.
- If living abroad, ensure that your household and kitchen staff follow hygienic food-handling practices. Instruct them in these procedures.
- Do not eat undercooked or raw meat, fish or shellfish - even if they are the local delicacy.
- Avoid dairy foods (ice cream, butter and cheese).
- Do not eat food which has been left unrefrigerated for more than three or four hours.
- Boiling: boiling water kills almost all tummy bugs. Boil vigorously for three minutes and if you are at higher altitudes, a further minute of boiling should be allowed for every 300 metres above sea level.
- Filters: Water purification devices such as Fill2pure™ remove over 99% of water-borne bacteria and protozoan cysts using microfiltration technology. Steripen™ products use UV technology to purify water.
- Iodine*: 8 drops of iodine antiseptic (1% available iodine) to a litre of water. For clear water, you must leave the water to stand for 30 minutes before drinking. In cloudy water, the iodine is less effective and it may take an extended time to work. While it's safe to drink, the water may be rather unpalatable.
- Chlorine: adding 2 drops (1.1ml) of 5% chlorine bleach to each litre of water is effective, but, again, the water may be rather unpalatable.
* Iodine should be avoided if the consumer is pregnant, allergic to iodine or has a thyroid condition. Toxicity (short or long term) may occur.