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Managing Infectious Disease

Don’t Let Your Southern Dream Vacation Become a Gastric Nightmare

Dr. Vivien Brown

Family Doctor & Assistant Professor, Department of Family and Community Medicine, University of Toronto

Michael Boivin

Pharmacist Educator

To get maximum enjoyment out of your southern vacation, know the risks for traveller’s diarrhea and take appropriate precautions. 

As the weather cools, Canadians are planning their winter escapes to warmer southern climes like the Caribbean and Latin America. But travellers beware! “These areas also have high levels of Enterotoxigenic Escherichia coli (ETEC)  bacteria, one of the most common causes of traveller’s diarrhea,” says Dr. Vivien Brown, Family Doctor, and Assistant Professor in the Department of Family and Community Medicine at the University of Toronto. 


Prevention starts with what you drink and eat

People contract ETEC mostly from contaminated water and food. ETEC is estimated to cause 200 million diarrheal episodes annually and approximately 380 ,000 deaths worldwide. Common symptoms include diarrhea, vomiting, cramping, and loss of appetite. “Most cases will go away without treatment in three to five days, but it can disrupt a trip. In severe cases where patients have fever and blood in the stools, they need to see a healthcare professional immediately,” says Michael Boivin, Pharmacist Educator in Barrie, Ontario.

Prevention starts with being careful with what you drink and eat. Avoid drinking beverages with ice cubes or crushed ice and brushing your teeth with tap water. “I recommend my patients go with carbonated or sparkling water because that way you know it’s not recycled. If drinking alcohol, a beer out of a bottle is a safer bet than a cocktail mixed by a bartender that may have crushed ice added to it,” says Dr. Brown. Travellers should also avoid salads, uncooked fish, meat, vegetables, and eating fresh fruits which cannot be peeled. It’s important that vegetables and fruits are washed in potable water. If not, it’s best to avoid. 

A drinkable dose of prevention 

Another way travellers can reduce their risk of diarrhea when travelling is through an oral vaccine that protects against cholera and a particular strain of bacteria called heat-labile toxin producing Enterotoxigenic Escherichia coli (LT-producing ETEC). Available without prescription in most provinces, “The oral vaccine causes your body to produce its own protection against cholera and LT-producing ETEC diarrhea. After getting the vaccine, your body will create antibodies which fight the cholera and LT-producing ETEC bacteria and toxins. If a vaccinated person comes into contact with cholera or LT-producing ETEC bacteria the body is usually ready to destroy it.” says Boivin. 

It is a drinkable vaccine that’s taken two weeks ahead of their trip. “It’s a relatively simple vaccine that’s has to be taken with a powder and water mixture and drink, and it decreases your risk significantly,” says Dr. Brown. 

While nothing is 100 per cent guaranteed to prevent you from getting LT-producing ETEC, your doctor or pharmacist can make you aware of the risks, the precautions to take, what to do if you do get sick, and when to seek medical attention. The ideal time to consult with a healthcare provider is six to eight weeks before departure. “Your healthcare provider can help you make the most of your vacation without getting ill. The last thing you want is to be stuck in the bathroom for several days feeling miserable,” says Dr. Brown. 

To learn more, please talk to your health care provider.  


This story was created by Mediaplanet on behalf of a Canadian biopharmaceutical company.

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