El Tigre Journeys
in the heart of the Amazon

Health and Wellness
for travelers to the Peruvian Amazon
From the CDC Travel Page
Division of Quarantine, National Center for Infectious Diseases
Centers for Disease Control and Prevention, Atlanta, Georgia U.S.A.
updated October 10, 2001

Traveler's Diarrhea

The typical symptoms of travelers’ diarrhea (TD) are diarrhea, nausea, bloating, urgency, and malaise. TD usually lasts from 3 to 7 days. It is rarely life threatening. Areas of high risk include the developing countries of Africa (Central, East, North, Southern, and West), the Middle East, and Central America. The risk of infection varies by type of eating establishment the traveler visits—from low risk in private homes to high risk for food from street vendors.

TD is slightly more common in young adults than in older people, with no difference between males and females. TD is usually acquired through  ingestion of fecal contaminated food and water.

The best way to prevent TD is by paying meticulous attention to choice of food and beverage. CDC does not recommend use of antibiotics to prevent TD because they can cause additional problems.

For treatment, oral fluids should be administered to sufferers of diarrhea. Fruit juices, soft drinks (preferably without caffeine), and salted crackers are advised. For severe dehydration, the use of an oral rehydration solution (ORS) is advised (see below). Avoid dairy products and all beverages that contain water of questionable quality.

Antimicrobial drugs such as doxycycline, and trimethoprim/sulfamethoxazole (Bactrim®, Septra®), and fluoroquinolones (Cipro®, Noroxin®) may shorten the length of illness and may especially benefit persons with severe abdominal cramping, fever, and/or bloody diarrhea. Notably, high levels of resistance in many parts of the developing world to doxycycline and trimethoprim-sulfamethoxazole now limit the utility of these drugs for persons traveling to such areas. Consult your physician for prescription and dose schedules. Antidiarrheals, such as Lomotil®* or Immodium®*, can decrease the number of diarrheal stools, but can cause complication for persons with serious infections.

It is important for the traveler to consult a physician about treatment of diarrhea in children and infants because some of the drugs mentioned are not recommended for them. The greatest risk for children, and especially for infants, is dehydration. Prevention of dehydration through administration of soups, thin porridges, and other safe beverages is advised. Infants with diarrhea who exhibit signs of mild dehydration, such as thirst and restlessness, should be given an oral rehydration solution (ORS) to drink. This is a packet of salt and carbohydrates that should be prepared following the package instructions and using boiled or treated water. It is widely available abroad. If bloody diarrhea, dehydration, fever in excess of 102° F, or persistent vomiting occurs, seek immediate medical help.

Most episodes of TD resolve in a few days. As with all diseases it is best to consult a physician rather than attempt self-medication, especially for pregnant women and children. Travelers should seek medical help if diarrhea is severe, bloody, or does not resolve within a few days or if it is accompanied by fever and chills or if the traveler is unable to keep fluids intake up and becomes dehydrated.

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updated 04/22/02