Travel Health

What To Do if You Get Ill

If you become seriously ill while travelling, your country's embassy or consulate can help you find medical care. For a complete list of embassies and consulates, see the Consular Affairs Bureau of the Canadian Department of Foreign Affairs and International Trade Web site at www.voyage.gc.ca. You can also obtain contact information for local doctors and medical clinics. If you become ill with a fever or flu-like illness while travelling, seek medical attention immediately.

Travellers' diarrhea is the most common illness when travelling. It typically begins abruptly with watery stools, vomiting, cramping, and a low fever. Most doctors recommend trying to keep to your normal diet as much as possible. If you are vomiting, this may be hard. Try drinking clear liquids. Watch for signs of dehydration, such as a dry mouth and dark -coloured urine. If possible, drink rehydration drinks to replace lost fluids and electrolytes. Before you go, buy dry packets of oral rehydration mix at a drugstore.

The over-the-counter remedy bismuth subsalicylate (such as Pepto-Bismol) can sometimes prevent traveller's' diarrhea.¹ For diarrhea, take 1 fluid ounce or two tablets every 30 minutes for up to 8 doses in a 24-hour period, which can be repeated.

Products such as Pepto-Bismol have several side effects, including causing your tongue and stools to turn black. These products should not be taken by people who should not take ASA, such as people who have gout or those younger than age 20 who are recovering from chicken pox or another illness with flu-like symptoms. Read the label directions carefully before taking. If diarrhea persists for more than 48 hours, travellers should be evaluated by a doctor.

Antidiarrheal medications, such as Imodium A-D (non-prescription) and Lomotil (prescription), offer relief from cramping and frequent stools. But you should not take them if you have a fever or blood or pus in your stools. Be aware that they can cause a serious complication called toxic megacolon, in which the colon swells to many times its normal size.

Most cases of travellers' diarrhea resolve within 1 to 3 days without medical treatment. See a doctor if diarrhea doesn't subside or you have a high fever, blood or pus in your stools, or signs of dehydration. Watch closely for signs of dehydration in children, because with diarrhea they can quickly become seriously dehydrated.

If you are travelling to an area where modern medical care is not readily available, your doctor may give you antibiotics to take in case of diarrhea. Azithromycin (Zithromax), ciprofloxacin (Cipro), ofloxacin (Floxin), or rifaximin (Xifaxan) can be taken at the onset of diarrhea to reduce the number of days you have it. But some bacteria that cause diarrhea have developed resistance to some of these antibiotics and others, including trimethoprim-sulfamethoxazole and doxycycline. This may limit how well these antibiotics work. In Canada and some other countries, an oral vaccine (Dukoral) that protects against traveller's diarrhea caused by E. coli and cholera bacteria is available for anyone age 2 or older.

Because antibiotics can increase a traveller's' susceptibility to resistant bacteria and they provide no protection against either viruses or parasites, they should not be taken to prevent traveller's' diarrhea. Antibiotics should only be taken if you have symptoms.

For more information, see the topics Traveller's' Diarrhea, Food Poisoning and Safe Food Handling, Giardiasis, Diarrhea, Age 11 and Younger, and Diarrhea, Age 12 and Older.

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Author:	Douglas Dana Monica Rhodes	Last Updated: July 9, 2007
Medical Review:	Wajeeh E. Nasser, MD - Family Medicine Anne C. Poinier, MD - Internal Medicine W. David Colby IV, MSc, MD, FRCPC - Infectious Disease
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