Scary diseases like Zika virus and avian flu often take center stage in our travel nightmares. But the truth is, most travelers are laid low by something much more common: a stomach bug. Here, if you’re brave, is a guide to some of the most common conditions that cause traveler’s diarrhea and how to prevent it.

What Is Traveler’s Diarrhea?

Traveler’s diarrhea (TD) is an affliction almost every international traveler gets at some point, particularly in developing countries. It’s exactly what it sounds like: severe stomach upset and loose stools, sometimes accompanied by nausea, vomiting or fever. TD is usually caused by ingesting food or water that's contaminated with E. coli.¹

For most people, traveler’s diarrhea is an unpleasant experience that ends quickly. While severe cases can be treated with antibiotics, the usual recommendation is to take an anti-diarrheal medication and/or Pepto-Bismol (bismuth subsalicylate) and stay hydrated. It’s wise to tuck a few rehydration packets into your travel bag. If you become severely dehydrated, develop a high fever, or have symptoms lasting for more than a few days, you should see a doctor.² (The travel assistance team at Allianz Global Assistance can help you find one overseas.) E. coli isn’t the only nasty bug that causes traveler’s diarrhea, however. Here are three other villains you may encounter while traveling.

1. Campylobacteriosis

You may never have heard of this travel illness — “campylobacteriosis” doesn’t exactly roll off the tongue. But it’s the most common lab-confirmed intestinal bug (or “enteric pathogen,” if you want to be science-y) in travelers returning to the United States from every region of the world, according to the CDC. “The risk of infection is highest in travelers to Africa and South America, especially in areas with poor restaurant hygiene and inadequate sanitation,” the CDC says.

Campylobacter bacteria are often spread by eating contaminated foods, especially undercooked or raw chicken, or drinking contaminated water or unpasteurized milk. Farm animals, cats and dogs can also spread the disease through contact. Two to four days after being infected, travelers experience diarrhea (frequently bloody), abdominal pain, fever, and occasionally nausea and vomiting.³ Here’s the good news: The disease usually runs its course in a week or less.

2. Giardia

“After an inspiring day at Angkor Wat in Cambodia, I returned to my guesthouse to find locals sharing stories — and homemade rice wine,” travel writer Rich Beattie reminisces. He joined in, and had a great time… until he ended up contracting giardia, an intestinal parasite, from the wine.⁴

Giardia is everywhere. “Giardia-related acute diarrhea was a top-10 diagnosis in ill U.S. travelers returning from the Caribbean, Middle East, Eastern Europe, Central America, South America, North Africa, sub-Saharan Africa, and South-Central Asia,” reports the CDC.⁵ It’s easily contracted from drinking water — giardia can even survive chlorination — and contaminated food.

Giardiasis symptoms include chronic diarrhea, abdominal cramps, bloating, fatigue and weight loss.⁶ If you experience stomach problems after traveling, it may be giardiasis; symptoms usually take one to three weeks to appear after infection. It probably won’t go away on its own, but a doctor can treat you with an appropriate medication.

3. Norovirus

Norovirus is the nasty bug responsible for making people sick — and making headlines — when it hits cruise ships. Norovirus is by no means confined to cruises, however. The reason people associate the two is that many cruise ships are required to report outbreaks of gastrointestinal illness to the CDC. The truth is that norovirus can flourish anywhere people are in close quarters: hotels, restaurants, dorms, etc. It’s easily spread by touching surfaces sick people have touched and then putting your fingers in your mouth.

Symptoms of norovirus include nausea, vomiting, diarrhea, cramps and sometimes fever. If you get norovirus while on a cruise, the ship’s doctor will probably place you under quarantine, which means you have to stay in your cabin — no exceptions — until you recover fully. Fortunately, travel insurance can help: quarantine is considered a covered reason for trip interruption or cancellation.

Tips for avoiding traveler’s diarrhea

• Only eat food that’s cooked and served hot. Even raw fruits and vegetables can harbor bacteria, so peel them and wash them thoroughly in clean water.

• Only drink bottled or treated water, and avoid ice. To avoid the environmental impact of drinking tons of bottled water, consider getting an inexpensive travel water purifier. REI has a comprehensive guide to water purifiers.

• Wash your hands all the time. Something as simple as touching a salt shaker can transfer bacteria to your hand, then your mouth. Use soap and hand sanitizer liberally.

• Take Pepto-Bismol if you’re traveling to a high-risk destination. “Studies show that if adults take the equivalent of two tabs four times a day, it can decrease the incidence of travelers’ diarrhea up to 60%,” WebMD reports.

• Purchase travel insurance with emergency medical benefits. If you’re feeling under the weather, you can call the Allianz Global Assistance travel assistance hotline, and our experts can direct you to the nearest qualified medical facility. And if you’re experiencing a medical emergency, we can help arrange emergency medical transportation, if necessary, to the nearest appropriate medical facility. We can also arrange payment for covered emergency medical treatment.

We offer travel insurance plans for every budget and destination. Compare plans, get free quotes and in just minutes, you can protect your next adventure. 

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