Traveler’s Diarrhea

Often colloquially known as turista, the classic traveler’s diarrhea (TD) rarely lasts longer than a week. Besides “the runs,” symptoms include nausea, vomiting, bloating, and general weakness. The usual cause is the Escherichia coli bacterium from food or water; in some cases E. coli infections can be fatal.

Fluids, including juices, plus small amounts of bland foods such as cooked rice or soda crackers, may help relieve symptoms and restore strength. Dehydration is a serious problem, especially for children, who may need an oral rehydration solution (ORS) of carbohydrates and salt.

Over-the-counter remedies such as Pepto-Bismol, Lomotil, and Immodium may relieve symptoms but can also cause problems. Prescription drugs such as doxycyline and trimethoprim/sulfamethoxazole can also shorten the cycle. These may not be suitable for children, and it’s better for everyone to avoid them if possible.

Continuing and worsening symptoms, such as bloody stools, may mean dysentery, which requires a physician’s attention.

Dysentery

Bacterial dysentery, resembling a more intense form of TD, responds to antibiotics, but amoebic dysentery is more serious, sometimes leading to intestinal perforation, peritonitis, and liver abscesses. Like diarrhea, its symptoms include soft and bloody stools, but some people may be asymptomatic even as they pass on Entamoeba hystolica through unsanitary toilet and food preparation practices. Metronidazole, known by the brand names Flagyl or Protostat, is effective treatment, but a physician’s diagnosis is advisable.

Cholera

Resulting from poor hygiene, inadequate sewage disposal, and contaminated food, contemporary cholera is less devastating than its historic antecedents, which produced rapid dehydration, watery diarrhea, and imminent death (without rapid rehydration). While today’s cholera strains are infectious, most carriers do not even come down with symptoms. Existing vaccinations are ineffective, so health authorities now recommend against them.

Treatment can only relieve symptoms. On average, about 5 percent of victims die, but those who recover are immune. It is not common in Chile, but it’s not unheard of either.

Hepatitis A

Usually passed by fecal-oral contact under conditions of poor hygiene and overcrowding, hepatitis A is a virus. The traditional gamma globulin prophylaxis has limited efficacy and soon wears off. New hepatitis A vaccines, however, are more effective and last longer.

Typhoid

Typhoid is a serious disease common under unsanitary conditions, but the recommended vaccination is an effective prophylaxis.

© Wayne Bernhardson from Moon Chile, 2nd edition