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Health A to Z  —  6 minutes

Planning for healthy travels

December 9th, 2019
Biron Team

For many of us, winter means escaping the cold by travelling to warmer climates. But travel, whether to unfamiliar or developing countries, or to destinations you’ve been to many times, comes with inevitable health risks, from everyday traveller’s diarrhea to more serious viral infections. You can take the first steps toward staying well and having a great trip, and avoiding long-term consequences, through good advance planning and, where necessary, appropriate vaccination.

Local safety and security conditions

Even if you’re travelling to countries with which you’re familiar, it’s always worth checking the latest travel advisories for your destination from the Government of Canada or from your travel agent. These advisories will contain the latest reliable information on safety and security conditions. You’ll find updated advice for every country in the world which recommends a normal or high degree of caution or, in some cases, simply avoiding all travel to a particular country or region. Alongside this high-level advice, you should pay attention to health precautions, including recommended vaccines. Travelling means exposure to a variety of often unfamiliar and sometimes dangerous health risks, including:

  • Hepatitis A and B
  • Yellow fever
  • Dengue
  • Marburg virus disease

A large number of microorganisms are also responsible for common cases of traveller’s diarrhea also known as “turista”.

Read more: Transmission, symptoms and screening for hepatitis A, B and C

Travel vaccination

Many travel-related diseases can be prevented by vaccination. A visit to a local travel health clinic will indicate what vaccines are available or required, depending on your destination. You should keep in mind that the immune system needs a couple of weeks and in some cases a repeat shot to exert full protection, so plan ahead: it’s recommended to consult a clinician at least six weeks before departure.

As with all vaccines, they’re never 100% effective. In fact, in some cases their effectiveness may be below 50%. However, 50% protection against a disease that can seriously affect your health, if not ruin your vacation, is better than no protection at all. Preventive health measures you can take before leaving Canada also include buying good travel insurance and ensuring it has appropriate medical coverage for your destination. When you’re there, don’t forget to take basic precautions such as eating in popular places and watching how your food is prepared to ensure adequate hygiene standards. Fully cooked food and peelable fruits are the safest, and regardless of what the locals do, drink only bottled water.

Is traveller’s diarrhea inevitable?

Traveller’s diarrhea affects more than half of all visitors from developed to developing countries. It’s defined as three or more unformed stools per day, with at least one accompanying symptom such as:

  • Fever
  • Nausea
  • Vomiting
  • Abdominal cramps
  • Blood in the stool

Most cases occur within the first two weeks of travel and last less than a week with no need for treatment. Contamination occurs by absorbing (eating, drinking, bathing, etc.) food, drinks or water contaminated by fecal matter and is easily spread from person to person.

Traveller's diarrhea usually goes away on its own within three to seven days in adults and children [1]. Signs and symptoms may last longer and be more severe if it’s caused by organisms other than common bacteria. In such cases, you may need prescription medications to help you get better [2].

How do I tell if my traveller’s diarrhea is serious?

If symptoms persist longer than a week [3] or, more importantly, if severe symptoms such as the following are present, you should consult a doctor immediately [4]:

  • Dehydration
  • Severe abdominal pain
  • Bloody or black stools
  • Fever above 39 °C

Back home, part of the diagnostic process will be to identify if an uncommon microorganism is responsible. Most diagnostic workouts will concentrate on identifying fecal bacteria or parasites. There are multiple diarrhea-causing viruses, but they have been traditionally very difficult to identify. Typically, stool cultures for bacteria or parasite identification are cumbersome and need to be repeated three times.

Read more: When should you worry about abdominal pain ?

Newer analytical techniques designed to identify the genetic material (DNA, RNA) of the culprit micro-organism can provide a definitive result in one day on a single stool sample. This currently available system allows the identification of 22 targeted pathogens in a single assay including bacteria, viruses and four parasites [5].

The treatment of traveller’s diarrhea will be partly based on relieving symptoms with anti-motility agents (loperamide, bismuth subsalicylate), avoiding dehydration and foods that worsen diarrhea (dairy products, caffeine, etc.), and the administration of antibiotics. Specific anthelmintic and anti-parasitic agents are available for parasite and amoeba infections.

Dealing with the post-travel blues

The post-travel blues are a real condition and a frequent consequence of coming back home. Although it will generally dissipate within a few days, post-vacation depression tends to be more severe with longer trips. Generally of short duration, some symptoms of post-travel blues are similar to seasonal depression [6]:

  • Sadness
  • Low energy
  • Difficulty concentrating
  • Loss of appetite
  • Sleep problems

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  1. “How Long Does Traveler's Diarrhea Usually Last?” WebMD. Accessed November 2019.
  2. “Traveler's Diarrhea.” Mayo Clinic. Mayo Foundation for Medical Education and Research, May 16, 2019.
  3. “Gastro-Entérite (Gastro).” Gouvernement du Québec. Accessed November 2019.
  4. Yates, Johnnie. “Traveler's Diarrhea.” American Family Physician, no. 71 (June 1, 2005): 2095–2100.
  5. “Clinical Need and Practice: Integrated Multiplex PCR Tests for Identifying Gastrointestinal Pathogens in People with Suspected Gastroenteritis (XTAG Gastrointestinal Pathogen Panel, FilmArray GI Panel and Faecal Pathogens B Assay): Guidance.” NICE. Accessed November 2019.
  6. “Séjour à L'étranger: Le Choc Du Retour.” Centre d'aide aux étudiants. Accessed November 19, 2019.
Biron Team