Traveller's diarrhoea: Must-knows for Aussies before your next holiday! 

This blog is for educational purposes only and does not replace professional medical advice or diagnosis. If you have health concerns, consult an AHPRA-registered telehealth doctor or request a medical certificate online if clinically appropriate. Please note: Hola Health does not currently offer Mental Health Care Plans.

---

Travelling is one of life’s greatest pleasures, allowing us to experience different cultures, savour diverse cuisines, and create enduring memories. However, for many Australians, the thrill of a holiday can be diminished by a typical, yet unpleasant condition known as traveller’s diarrhoea. It is estimated to affect nearly 40 to 60 per cent¹ of travellers and is the most common travel-associated condition. Understanding this ailment is essential for a smooth and hassle-free trip. Let’s dive into the key points every Aussie should know before heading off on their next adventure! 

What causes traveller’s diarrhoea? 

Traveller’s diarrhoea typically arises from ingesting contaminated food or water while travelling, particularly in areas with inadequate sanitation. The most frequent offenders include Escherichia coli (E. coli), Salmonella, Shigella, and Campylobacter. Occasionally, viruses such as norovirus and rotavirus and parasites like Giardia or Entamoeba histolytica can also be responsible. 

Consuming raw or improperly cooked foods, drinking unsafe water, and having poor hygiene habits increase the risk. Symptoms often include loose stools, stomach cramps, nausea and vomiting. To avoid the condition, it’s recommended to consume bottled water, avoid street food, and practice proper handwashing hygiene. In more serious instances, treatment may involve antibiotics or oral rehydration solutions. 

What is the difference between traveller’s diarrhoea and diarrhoea?

The primary distinction between traveller’s diarrhoea and standard diarrhoea is found in their origins and circumstances. 

Origin:

• Traveller’s diarrhoea: This condition results from the intake of contaminated food or water while travelling, frequently involving bacteria such as E. coli or parasites in areas with inadequate sanitation. 
• Standard diarrhoea: Can arise from various factors including infections (viral, bacterial, or parasitic), food intolerances (like lactose intolerance), medications, or chronic conditions (such as irritable bowel syndrome). 

Circumstances:

• Traveller’s diarrhoea: Typically happens when travelling to areas where food and water safety standards vary, often in developing nations. 
• Standard diarrhoea: This can happen at any time and place and is not necessarily linked to travel. 

Management and prevention: 

• Traveller’s diarrhoea: Prevented by steering clear of unsafe food and water, treated with oral rehydration solutions and, in some instances, antibiotics. 
• Standard diarrhoea: Handled according to its cause, typically with hydration, dietary modifications, and, if required, medications. 

Both types can lead to similar symptoms, such as loose stools, cramps, and dehydration, but traveller’s diarrhoea is generally short-lived and travel-related, whereas standard diarrhoea might signal a range of underlying issues. 

Traveller’s diarrhoea symptoms

The symptoms of traveller’s diarrhoea can vary from mild to severe and usually start within 1 to 3 days after consuming contaminated food or water. The most prevalent symptoms consist of: 

• Frequent loose or watery stools (three or more daily) 
• Abdominal cramps and discomfort 
• Nausea and vomiting 
• Fever (in some situations) 
• Bloating  
• An urgent need to have a bowel movement 
• Dehydration (if severe or prolonged) 

In most instances, symptoms clear up within 3 to 5 days without the need for major treatment. However, if diarrhoea occurs with blood, a persistent fever, or any signs of dehydration, it is advisable to seek medical assistance.

How to treat traveller’s diarrhoea naturally?

 Here are some ways to address traveller’s diarrhoea: 

1. Hydration: Consume a lot of fluids to replenish lost water. In severe situations, utilise oral rehydration solutions (ORS) to help restore lost electrolytes. 
2. Diet: Begin with bland foods such as rice, bananas, toast, or crackers. Steer clear of dairy, fatty foods, and alcohol, as these can aggravate symptoms. 
3. Rest: Allow your body to unwind by ensuring you get enough rest and steering clear of intense activities. 
4. Probiotics: Taking probiotics might assist in restoring the natural balance of the gut and facilitate recovery. 

How long does it last?

Traveller’s diarrhoea typically lasts between 3 to 5 days. In many mild instances, symptoms tend to improve naturally without the need for medical treatment. However, if it’s due to more serious infections (such as parasites or bacteria), symptoms might last for a week or more if not treated. 

If diarrhoea persists beyond 7 days, becomes more severe, or is accompanied by symptoms like fever, blood in the stool, or significant dehydration, it’s crucial to seek medical attention, as these could signify a more serious infection. 

How long is traveller’s diarrhoea contagious?

Traveller’s diarrhoea can be infectious as long as the individual has the pathogens (such as bacteria, viruses, or parasites) in their system. The duration of contagiousness differs: 

• Bacterial causes (e.g., E. coli): Spreading is possible while the bacteria are present in the stool, generally lasting 1-5 days, although it may persist longer in some instances.   
• Viral causes (e.g., norovirus): The virus can be transmitted for several days after symptoms subside.   
• Parasitic causes (e.g., Giardia): Parasites may be expelled in stool for weeks, even after symptoms have ceased.   

Practising good hygiene, like frequent handwashing, helps decrease the likelihood of transmitting the infection. 

Essential tips for prevention

To avoid traveller’s diarrhoea, adhere to these important guidelines: 

1. Steer clear of raw vegetables and peel fruits yourself. Be cautious with buffet items since they may not be kept at safe temperatures.
2. Brush your teeth with bottled water. This includes rinsing your mouth after brushing. This is frequent source ingesting of contaminated water.
3. Refrain from consuming ice as it is frequently made from unsafe tap water. 
4. Carry hand sanitisers containing alcohol for situations where soap isn’t available. 
5. Be wary of street vendors, as their hygiene practices can be inconsistent. 
6. If bottled water is not available, purify water by boiling, using iodine tablets, or portable filters
7. Avoid consuming undercooked meats and seafood, as well as sauces that could have contaminated ingredients.
8. In certain instances, cholera vaccinations (which can also protect against some causes of Traveller’s diarrhoea) may be advised for specific destinations. 

Risk factors

Risk factors for traveller’s diarrhoea include: 

1. Geographical destination: Visiting developing nations, especially in Africa, Latin America, the Middle East, and Asia, heightens the risk of encountering contaminated food and water. Areas with lower sanitation practices present a greater threat. 
2. Food and water consumption: Consuming street food, raw dishes, or meals from unsanitary sources elevates your chances of getting sick. Unpeeled fruits, tap water, and ice made from dirty water are frequent offenders. 
3. Weakened immune system: Those with diminished immunity are more susceptible to infections. 
4. Age: Young adults and children might be at increased risk due to less careful food choices or immature immune systems. 
5. Underlying conditions: Individuals with inflammatory bowel disease (IBD) or other gut health issues are more prone to experiencing severe symptoms. 
6. Duration of travel: Extended stays in high-risk regions can lead to increased exposure to harmful bacteria, viruses, or parasites that cause diarrhoea. 
7. Type of accommodation: Living in local homes or hostels without access to safe water sources or proper hygiene facilities increases the likelihood of coming into contact with contaminated food and water. 

When to consult a GP?

If you notice any of the following symptoms while experiencing Traveller’s diarrhoea, it’s important to consult a GP: 

• Diarrhoea that persists for more than two days.   
• Significant dehydration (such as extreme thirst, dry mouth, or very little urination).   
• Presence of blood in your stools, or stools that are black and tarry.   
• A fever exceeding 39°C.   
• Vomiting that makes it impossible to retain fluids.   
• Intense pain in the abdomen or rectum.   

If you are pregnant, have a long-term illness, or are travelling with young children, it’s advisable to seek medical attention sooner. 

How Hola Health may be able to help

Hola Health is an Australian telehealth platform that connects you with registered doctors and nurse practitioners — from the comfort of your home, at a time that suits you. Depending on your situation, a Hola Health clinician may be able to help with:

• 24/7 General medical advice via telehealth doctor consult – talk through symptoms or health concerns with a registered doctor or medical practitioner
• Telehealth medical certificate – for work or personal leave, when clinically appropriate
• Referrals to specialists – or in-person services when needed
• Get Instant script online (if clinically appropriate) – at a clinician’s discretion and where clinically suitable
• Pathology or imaging requests – when assessed as appropriate by your treating clinician

Hola Health clinicians are AHPRA-registered Doctors and medical practitioners in Australia. They will always recommend an in-person consultation, specialist referral, or emergency care if that is in your best interest.

Note: Telehealth is not suitable for all conditions. Hola Health does not replace your regular GP, specialist, or emergency services. If you are unsure whether telehealth is right for your situation, we recommend speaking with your usual healthcare provider. In emergencies, call 000.