Orphans International America - W.H.O. Advice on Food Safety

A Guide on Safe Food for Travelers

-- How to Avoid Illnesses Caused by Unsafe Food and Drink
   -- What to Do if You Get Diarrhoea

When you travel, be it for pleasure, business or any other reason, contaminated food and drink are often a serious threat to health. In particular, diarrhoea affects a great number of travellers. Physical pain and discomfort, along with the problem of finding suitable medical treatment, especially when there are language barriers, can spoil your entire stay away from home.

Before Leaving Home. Consult your physician for advice on the various diseases to which you may be exposed, and the need for vaccinations or other preventive measures.
Make sure your medical kit contains Oral Rehydration Salts (ORS) and a water-disinfectant agent.
EATING SAFELY

The following recommendations apply to all situations, from food vendors on the street to expensive hotel restaurants:

   -- Cooked food that has been held at room temperature for several hours constitutes one of the greatest risks of foodborne illness. Make sure your food has been thoroughly cooked and is still hot when served.

   -- Avoid any uncooked food, apart from fruits and vegetables that can be peeled or shelled. Avoid fruits with damaged skin. Remember the dictum "Cook it, peel it or leave it."

   -- Dishes containing raw or undercooked eggs, such as home-made mayonnaise, some sauces (e.g. hollandaise sauce) and some desserts (e.g. mousses) may be dangerous.

   -- Ice cream from unreliable sources is frequently contaminated and can cause illness. If in doubt avoid it.

   -- In some countries, certain species of fish and shellfish may contain poisonous biotoxins even when they are well cooked. Local people can advise you about this.

   -- Unpasteurized milk should be boiled before consumption.

   -- When the safety of drinking-water is doubtful, have it boiled, or if this is not possible, disinfect it with a reliable, slow-release, disinfectant agent, that are generally available in pharmacies.

   -- Avoid ice unless you are sure that it is made from safe water. Beverages such as hot tea or coffee, wine, beer, and carbonated soft drinks or fruit juices which are either bottled or otherwise packaged are usually safe to drink.

WHAT TO DO IF YOU GET DIARRHOEA

Most diarrhoeal attacks are self-limiting and clear up in a few days. The important thing is to avoid becoming dehydrated. As soon as diarrhoea starts, drink more fluids, such as bottled, boiled or treated water, or weak tea. Fruit juice (diluted with safe water) or soup may also be taken. If diarrhoea continues for more than one day, prepare and drink ORS solution and continue to eat normally.

AMOUNTS OF FLUID OR ORS TO DRINK:

Children less than 2 years: 1/4 - 1/2cup (50 - 100ml) after each loose stool
2 years to 10 years: 1/2 - 1 cup (100 - 200ml) after each loose stool
Older children and adults: unlimited amount
SEEK MEDICAL HELP IF:

Diarrhoea lasts for more than 3 days and/or there are very frequent watery bowel movements, blood in the stools, repeated vomiting or fever when there is no medical help available and there is blood in the stools, a course (5 days) of cotrimoxazole may be taken. Prophylactic use of antibiotics is not recommended. Antidiarrhoeals (e.g. loperamide) are not recommended but may be used, in addition to fluids, by adults only, for symptomatic relief. They should never be used for children. If there are other symptoms, seek medical advice.

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If ORS are not available, mix 6 level teaspoons of sugar plus 1 level teaspoon of salt in one litre of safe water. Drink this as indicated above for ORS.

Dosage for cotrimoxazole (trimethoprim, sulfamethoxazole):

For adults: 160 mg of trimethoprim and 800 mg of suffamethoxazole, twice a day, for 5 days
For children: 5 mg of trimethoprim and 25 mg of suffamethoxazole per kg of body weight, twice a day, for 5 days.
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This infromation has been endorsed by the
World Tourism Organization and the International Tourist Health Association.