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Staying Healthy on the Road Medical info, e.g. malaria, vaccinations, travel medical tips, medical insurance, where to find a doctor.
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  #1  
Old 12 Nov 2014
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Food poisoning avoidance tips....

Delhi belly, bombay bottom, calcutta colon... Vietnamise volcano etc etc. We've all had it no doubt.

Before I head to South East Asia, who's got some good tips for avoiding it ??

I've got a few but please add more. I'm pretty immune to a lot of it now but that's because I've had it bad more than a few times and follow these rules.

Don't eat the meat in India.... An Indian man from London told me that he visits all over India 10 times a year and the only time he gets ill when he returns is if he eats the meat. Go Veggie. Most the country is anyway. For good reason... If I think back, it was always meat dishes that made me ill.

Brush your teeth with local water but don't drink it. Evidence shows minor exposure is the best way to acclimatise to a new variety of bacteria. Biting your nails helps also. Apparently.

Buy bottled or boil your water... Or only drink from where locals do. Giardia lives in even the cleanest of rivers.

Always carry a good strong antibiotic if you get hit. Ciprofloxicine is good. There is a specialised one for Giardia.


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  #2  
Old 13 Nov 2014
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I had read a couple suspected the ice as a cause to their attack, water was bottled.
In thailand feces is used as a fertilizer so as good as the salad may look-know this from personal experience avoid it.
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  #3  
Old 16 Nov 2014
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Having lived in Malaysia for 2 years now, I've actually rarely had any problems with food. Asians love their meat on the bone which is something westerners probably aren't used to but I would't avoid it for that reason. The usual common sense rules apply, if the place looks dirty, the food probably is too. If you're coming through Malaysia though, the food is one of the highlights (and SE Asia generally) so hit me up if you need any info.
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Old 16 Nov 2014
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heat is the answer

I adopt the theory that heat will kill pretty much anything a bit dodgy. So I try to eat only hot food which has been possible mostly. If it's not REALLY hot I send it back to be cooked some more. When cooking myself I add plenty of colour, usually black!

My biggest issue has been water ( so I reckon anyway) even buying bottled water. I have been suspicious a couple of times when opening a new bottle of water....."did that seal crack open or not, did you hear it go? " After that copious amounts of loo roll follows the next day.........

So far never had it bad on a trip .......should have kept quiet
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  #5  
Old 7 May 2015
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smell it!

I've been traveling/living in Nepal, India and some other SE countries over the last 10 years or so. Only had the acute diarrhea the first time I was in India (body temp. 40C and over, loosing consciousness, totally incapacitated for 4 days.) and since learnt the lesson.

Here are my rules:

* Only drink bottled/boiled water.
* Always have a bottle of hand sanitizer in your pocket and USE it often.
* Eat cooked food. I've eaten freshly cooked food just off a stove in some very dirty places and it was fine.
* If you're going to have a salad in a restaurant, make sure it's a decent restaurant (presence of many tourists is a good rule of thumb). At home wash your veggies in cool boiled/bottled water.
* Smell your food before eating. If it's iffy, don't risk it.

The one time I got the poisoning, it was from a Lassi (a fruit yogurt drink) in a fancy restaurant. It had a very slight smell of rotten eggs. You could just about feel it. It tasted fine, but the consequence hit me so hard, I couldn't get up to crawl to the pharmacy

Speaking of pharmacies, they are very good in India and Nepal. It is prudent to carry some sort of antibiotics, but if you do get the diarrhea, you should still go to the local pharmacy and get all the other medicines that will help you with rehydrating, etc. Local drugs IMHO fit the local bugs better.

On a brighter note, juices in SE Asia are a godsend and it would be a shame to miss the pleasure of riding up to, say a sugarcane juice stall, and not drink the wonderful nectar . Just go by your intuition If it looks fresh out of the machine, it's probably good. If it's been sitting there for who knows how long, it's not worth it. You can use your own glass too, but I never do.

Good luck ))
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Old 7 May 2015
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I got ill 5 days into my morocco tour. Was down for about 2 days, but still had to ride one of them.

There is little you can you do really.

You can take alcohol handwash for when you visit bathroom, but the chef has just cooked your food, gone to the toilet, washed his ass with is hand and water only then served your hot food.

Salad is washed in the local (contaminated) water, and left out in the open (for millions of flies to contaminate). Eggs are left on window sills with 40c of desert sun burning down on them.

Cheese, milk, ice cream are all made from unpasteurised milk.

Fruit is often contaminated by flies and insects.

You could eat pre-packed foods and drink bottled water, but really do you want to miss out on all those tastes and flavours from around the world?

Another thing that makes it more difficult is that you can't buy strong antibiotics in the UK, so you just have to ride it out.
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Old 24 May 2015
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I have toured around Thailand Vietnham Laos Cambodia etc and just eat in busy local places with a fast turn over and never a problem interestingly Egypt always seems a problem but best to try local food
Safe riding
Paul
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Old 24 May 2015
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No ice
No salads
Wash your hands
Make every other c*** wash their hands
Hot food comment above very sensible
Bottled water filtered through lifesaver filter or puritabbed.
Pray.
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  #9  
Old 25 May 2015
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Getting others to wash hands always challenging but great if it happened
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  #10  
Old 25 May 2015
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Originally Posted by c-m View Post
Another thing that makes it more difficult is that you can't buy strong antibiotics in the UK, so you just have to ride it out.
You can go to your doctor before a trip and get a prescription for some broad-spectrum antibiotics. While you're at it, get the strongest painkillers they'll let you have.
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Old 25 May 2015
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Originally Posted by docsherlock View Post
Hot food comment above very sensible
Bottled water filtered through lifesaver filter or puritabbed.
Pray.
Praying is probably your best bet. Unless you have the iron willed determination to avoid every possible source of infection and travel round in a kind of drug reinforced sanitation bubble something will get you - even if it's only dehydration from not being able filter drinking water fast enough. The first time I ever flew to The Gambia you had to queue up outside in the sun for immigration and after half an hour or so the tourist authority started offering glasses of water to those still waiting. Everyone took them - including me - only realising afterwards what they'd done. And yes, I spent the next couple of days sat on the toilet.

Adding puritabs to a bottle of water in a restaurant near Bamako got me into a somewhat heated discussion with the manager who thought it was insulting that I didn't trust his hygiene stds and much laughter from the other diners who concluded I was some kind of effete Westerner too weak even to cope with water
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Old 25 May 2015
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There's lots of mention of antibiotics in the posts above but I would suggest you avoid them as far as possible. Using antibiotics, especially broad spectrum, before your trip actually wipes out the good bacteria in the gut, read How antibiotics destroy your immune system

In the past I've tried to supplement the good bacteria by using probiotics before a trip, read Probiotics vs antibiotics

If you have travellers diarrhoea the best course of action is to take lots of water with some small quantity of light, mild food. You should only take an antibiotic such as ciproflaxin if stool testing reveals the need for this, read Traveller's Diarrhoea, Loose Stools When Travelling

I carry a supply of loperamide (slows the bowel movement) in case I really have to travel, but it's better to just 'sit it out' and let nature take its course.

There's a world of difference between travellers diarrhoea and food poisoning. The last time I had food poisoning was in Peru and I thought I was dying. And didn't care. Every half hour there would be an explosion from one end of the body or the other. I spent the night lying on the toilet floor hoping the explosions didn't coincide.

I was on a trekking holiday in Morocco a few years back when 9 of the party of 16 came down with stomach upset (so clearly a restaurant problem). We quickly ran out of rehydration salts so I made up some using a mix of 1 litre of water to 5 teaspoons of sugar and 1 teaspoon of salt. I put in more salt than normal as it was extremely hot and I reckoned they were low on salts anyway.

I agree poor personal hygiene can lead to stomach upsets. Washing your hands before eating is vital and in Morocco (for example) every snack place and restaurant has a sink in the corner to wash your hands. But I would question the use of alcohol wipes, there's nothing better than soap and water, read Soap and water is superior to alcohol rub and antiseptic wipes

In India I avoid meat, but then I've spent most of my time in the south where it tends to be vegetarian anyway.

I confess I only drink bottled water in India, but in Morocco I always drink the local tap water which is fine for me (note however that some people have a more delicate stomach and would be upset by drinking water from a different part of their own country). The Moroccan water company (ONEP) has won awards for its water treatment technology and exports its know-how to other countries.

Despite spending several months a year in foreign climes I can't remember the last time I had an upset stomach. As Paul15 writes above, high turnover street food outlets are a good bet for avoiding trouble.

.
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  #13  
Old 25 May 2015
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I too avoid major antibiotics, on my first visit to Thailand in March last I had a bad case of the squirts and I took Imodium and electrolyte drinks to keep myself hydrated. On my trip I drank those bacterial yoghurt drinks every couple of days and up till now (as I am still over here) I have not had a problem since

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  #14  
Old 25 May 2015
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Getting others to wash hands always challenging but great if it happened
If traveling with others it is a discussion worth having. I wouldn't be traveling very long with anyone who did not regularly and appropriately wash their hands.
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Old 25 May 2015
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Originally Posted by backofbeyond View Post
Praying is probably your best bet.
Nope, the rest of the advice is your best bet....
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