Travel-Related Illness: Montezuma's Revenge (cont.)
I've made it a habit of going to pharmacies around the world and asking them how they would treat common problems and I haven't been very impressed with the quality of their advice as a whole.
The most important vaccine-preventable disease of travelers is Hepatitis A. The chance of getting hepatitis when a traveler goes to a country like Guatemala is 1-5/1000. There's a vaccine available for Hepatitis A that's taken in two doses, rendering protection for more than 20 years, so we recommend for all travelers to any developing country to take this vaccine.
The other problem, as you suggest, is diarrhea. It is actually not the water that's the problem, but it's contaminated food. Food in countries like Guatemala can be categorized as usually safe or often unsafe. The usually safe items are:
The often-unsafe foods are the ones that are served at room temperature that contain moisture. So this would be vegetables and things that haven't been properly washed and other foods that are sitting in warmers that are not maintained at high temperature. The causes of this common diarrhea are bacterial agents found in these food items.
While Imodium will treat the symptoms very effectively, it may not cure the infection. We have known for at least 23 years that antibiotics are the mainstay of treatment of this diarrhea. Probably the best treatment is to combine a drug like Imodium with an antibiotic, where you get the immediate effect of the Imodium and the curative effect of the antibiotic.
Xifaxan is taken in a dose of one tablet three times a day for three days. This antibiotic and others are used for traveler's diarrhea, but not for cruise-related Norwalk gastroenteritis.
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