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Food Safety and Travel

Getting ready to travel nationally or abroad? Contaminated food and drink are the major sources of stomach or intestinal illness while traveling. Intestinal problems due to poor sanitation are found in far greater numbers outside the United States and other industrialized nations. You should find information below that will help you! If you need more or your topic is not covered, email us and tell us what you want to see added!

Food and Water and Traveler's Diarrhea

Reference Material

Disease Outbreaks

Additional Information

Travel to Turkey Following the Earthquake

Preventing Influenza Infection Among Travelers
Questions and Answers About Preventing Influenza Infection Among Travelers

Links to Other Sites

Geographic Health Recommendations

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The Blue Sheet Summary of Health Information for International Travel Yellow Sheet Icon
The Yellow Book
  • 1999-2000 Edition - PDF Format (1.6 MB) This file format contains hypertext links and is viewable only with the Adobe(TM) Acrobat(TM) Reader*
  • 1999-2000 Edition Purchasing Information
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    The Green Sheet
  • Summary of Sanitation Inspections of International Cruise Ships
  • About the Cruise Ship Sanitation Program
  • U.S. State Department
    Travel Information
    For information of a non-medical nature including civil unrest, crime, or natural disasters (such as, earthquakes, hurricanes, flooding, forest fires etc.) you may want to check the U.S. State Department consular information sheets or warnings by country at Vaccine Recommendations
    Overall Immunization Schedule
    (Childhood Vaccines)

    Primary Series and Booster Information
    (See Geographic Recommendations Also)

  • For persons less than 2 years of age
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  • Comprehensive Vaccination Requirements
  • Purchasing Information for International Certificate of Vaccination
  • Health-Care
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  • Spacing of Immunobiologics
    Food and Water
    Precautions Travelers' Diarrhea
  • Geographic Health Recommendations
  • Australia and the South Pacific
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  • Disease Outbreaks
  • UPDATE: Influenza A Infection Among Travelers to Alaska and
    the Yukon Territory, Summer 1999
    Outbreak of Poliomyelitis-Angola Update: Outbreak of Nipah Virus-Malaysia and Singapore, 1999
  • Kenya and Somalia: Rift Valley Fever New Independent States of the Former Soviet Union: Diphtheria Meningococcal Meningitis in Sudan

  • Additional Information

    Travel to Turkey Following the Earthquake Preventing Influenza Infection Among Travelers Questions and Answers About Preventing Influenza A Infection Among Travelers Preventing Influenza A Infection Among Travelers Important notice: Diphtheria Vaccine For Children Recalled Conditions in Honduras, Nicaragua, and Guatemala After Hurricane Mitch Hong Kong: Avian Influenza Saudi Arabia Hajj Requirements Cholera Information; description, transmission, prevention Dengue Fever Information Disinsection; Spraying for insects in Aircraft Preventing Foodborne Illness: Escherichia coli O157:H7 Hepatitis A Vaccine & Immune Globulin (IG) - Disease and Vaccine Information HIV/AIDS Prevention
    HIV Infected Traveler Precautions Japanese Encephalitis Information Malaria: General information - description, transmission, treatment Prescription Drugs for Preventing Malaria (Information for the Public) Prescription Drugs for Preventing Malaria (Information for Health Care Providers) Preventing Malaria in the Pregnant Woman (Information for the Public) Preventing Malaria in the Pregnant Woman (Information for Health Care Providers) Preventing Malaria in Infants and Children (Information for the Public) Preventing Malaria in Infants and Children (Information for Health Care Providers) Yellow Fever Disease & Vaccine Rabies Information Preventing Typhoid Fever: A Guide for Travelers Tuberculosis Risk on Aircraft

    Food and Water and Traveler's Diarrhea

    Thanks to the Center for Disease Control!

    Contaminated food and drink are the major sources of stomach or intestinal illness while traveling. Intestinal problems due to poor sanitation are found in far greater numbers outside the United States and other industrialized nations.

    In areas with poor sanitation only the following beverages may be safe to drink: Boiled water, hot beverages, such as coffee or tea, made with boiled water, canned or bottled carbonated beverages, beer, and wine. Ice may be made from unsafe water and should be avoided. It is safer to drink from a can or bottle of beverage than to drink from a container that was not known to be clean and dry. However, water on the surface of a beverage can or bottle may also be contaminated. Therefore, the area of a can or bottle that will touch the mouth should be wiped clean and dry. Where water is contaminated, travelers should not brush their teeth with tap water.

    Boiling is the most reliable method to make water safe to drink. Bring water to a vigorous boil, then allow it to cool; do not add ice. At high altitudes allow water to boil vigorously for a few minutes or use chemical disinfectants. Adding a pinch of salt or pouring water from one container to another will improve the taste.

    Chemical disinfection can be achieved with either iodine or chlorine, with iodine providing greater disinfection in a wider set of circumstances. For disinfection with iodine use either tincture of iodine or tetraglycine hydroperiodide tablets, such as, Globaline*, Potable-Aqua*, and others. These disinfectants can be found in sporting goods stores and pharmacies. Read and follow the manufacturer's instructions. If the water is cloudy then strain it through a clean cloth, and double the number of disinfectant tablets added. If the water is very cold, either warm it or allow increased time for disinfectant to work.

    The CDC has made no recommendation as to the use of any of the portable filters on the market due to lack of independently verified results of their efficacy.

    As a last resort, water that is uncomfortably hot to touch may be safe for drinking and brushing teeth after it is allowed to cool. However, many disease-causing organisms can survive the usual temperature reached by the hot water in overseas hotels.

    Food should be selected with care. Any raw food could be contaminated, particularly in areas of poor sanitation. Foods of particular concern include: salads, uncooked vegetables and fruit, unpasteurized milk and milk products, raw meat, and shellfish. If you peel fruit yourself, it is generally safe. Food that has been cooked and is still hot is generally safe.

    For infants less than 6 months of age, breast feed or give powdered commercial formula prepared with boiled water.

    Some fish are not guaranteed to be safe even when cooked because of the presence of toxins in their flesh. Tropical reef fish, red snapper, amber jack, grouper, and sea bass can occasionally be toxic at unpredictable times if they are caught on tropical reefs rather than open ocean. The barracuda and puffer fish are often toxic, and should generally not be eaten. Highest risk areas include the islands of the West Indies, and the tropical Pacific and Indian Oceans.

    The typical symptoms of traveler's 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, the Middle East, and Latin 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 themselves.

    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™ ) may shorten the length of illness. 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 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 degrees, 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.

    Links to Other Sites

    Federal Government Web Sites

  • Food and Water Precautions and Travelers' Diarrhea (CDC)
  • Food Safety While Hiking, Camping, and Boating (FSIS)
  • Handling Food Safely on the Road (FSIS)
  • Mail Order Food Safety (FSIS)
  • Safe Food To Go (FSIS)
  • State and Local Government Web Sites

  • Buffet Style Dining (Department of Public Health, Seattle & King County, Washington)
  • Food Backgrounder (Health Division, Nevada)
  • Food Safety Precautions Get No Vacation at Barbecues, Picnics (Department of Health, Texas)
  • Food Safety when You're Traveling (Cooperative Extension Service, Minnesota)
  • How to Size Up a Restaurant (Department of Health and Environment, Kansas)
  • Plan on Packing School Lunches with Food Safety in Mind (Department of Health, Texas)
  • International Government Web Sites

  • A Guide on Safe Food For Travellers (World Health Organization)