Dr. Stephen Blythe
http://www.travelhealth.com
The most common health disaster is traveler's diarrhea. For some destinations the incidence is as high as 40%. This is usually caused by ingestion of bacteria that we are not used to, and can be prevented by careful selection of food and avoiding tap water (including as ice and for brushing teeth). Bottled water, soda, beer, and hot coffee or tea are usually safe to drink. Food that is well-cooked and served piping hot is the safest - foods that have been handled a lot during preparation are the riskiest - this often includes peeled, sliced fruits. Vegetables that are grown close to the soil are hazardous to eat unless cooked, since these are frequently fertilized with raw animal or human waste, and may be watered with contaminated water.
If you are not sure you will have access to safe water, consider taking along an appropriate filter, purifying chemicals, or a means of boiling water. Chemicals to purify water include bleach, iodine solutions, and iodine tablets. I don't like the iodine or bleach solutions simply because if they leak in your luggage you can ruin a lot of clothes. The tablets, such as "Potable Aqua", are easy to use. These chemicals kill bacteria and viruses, although they are not as effective at killing parasites such as amoebas and giardia. Any water that may be contaminated with human or animal waste should be treated with more than just chemicals. Boiling will kill anything, so it is always the gold standard - a good rolling boil is sufficient, you don't need 20 minutes. Almost all good filters will remove parasites and bacteria. None can filter out tiny viruses. Some have an added resin that will kill viruses as the water passes through. If you will be exposed to water that is possibly contaminated with sewage runoff you will need to use one of these units (or you can pre-treat the water with iodine prior to filtering). If you will be in the Rocky Mountains and are worried mostly about giardia in stream water, you will not.
Can you become resistant to the bad bacteria? Yes - if you will be living for over four weeks in an area where the locals drink the water, you may want to go ahead and drink it - you may get sick at first, but you will build up immunity to the bad bacteria. You should still exercise food precautions.
A little prudence with what you eat and drink can go a long way in keeping you healthy on the road!
Dr. Blythe is a Family Physician experienced with health care in developing nations. He has provided individual and corporate travel health consultations for 14 years.
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