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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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  #16  
Old 26 May 2015
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Very sound advice from Tim. There is lots of evidence that probiotics help recovery from D&V and also that they help to replace good bacteria in the Gut.
Overuse of antibiotics is a worldwide problem, which is why countries with responsible healthcare systems don't let you buy them over the counter! They are not required in most cases of food poisoning, or lots of other infections!! Over use of antibiotics has directly led to the rise of resistant bacteria.

Even if you are vomiting, keep drinking water, you will absorb some.

When we and my dad drove down through West Africa to the Gambia we did all the things you shouldn't do, ate from roadside stalls, etc etc etc and never got sick. when we got back to the UK we went for a pub meal to celebrate and both got viscous food poisoning. Like someone said, you can get food poisoning anywhere!!

As I think I said before and as Tim has said, alcohol wipes are not a substitute for handwashing. Some bugs are only removed by soap and water. Norovirus for example is not killed by alcohol handrub.

Only take loperamide etc if you really need to get somewhere. it's just holding the bugs in, better to let it all out.

Using common sense. I had a prawn cocktail in a hotel in The Gambia and had to spend the next week within 10 yards of the toilet. Really stupid mistake, especially for a healthcare professional!!
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  #17  
Old 27 May 2015
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Originally Posted by moggy 1968 View Post
Very sound advice from Tim. There is lots of evidence that probiotics help recovery from D&V and also that they help to replace good bacteria in the Gut.
Overuse of antibiotics is a worldwide problem, which is why countries with responsible healthcare systems don't let you buy them over the counter! They are not required in most cases of food poisoning, or lots of other infections!! Over use of antibiotics has directly led to the rise of resistant bacteria.

Even if you are vomiting, keep drinking water, you will absorb some.

When we and my dad drove down through West Africa to the Gambia we did all the things you shouldn't do, ate from roadside stalls, etc etc etc and never got sick. when we got back to the UK we went for a pub meal to celebrate and both got viscous food poisoning. Like someone said, you can get food poisoning anywhere!!

As I think I said before and as Tim has said, alcohol wipes are not a substitute for handwashing. Some bugs are only removed by soap and water. Norovirus for example is not killed by alcohol handrub.

Only take loperamide etc if you really need to get somewhere. it's just holding the bugs in, better to let it all out.

Using common sense. I had a prawn cocktail in a hotel in The Gambia and had to spend the next week within 10 yards of the toilet. Really stupid mistake, especially for a healthcare professional!!
That's some great advice there Moggy! I'm no health care pro but traveled enough to prove out most of what you say through empirical evidence! Spot on!

Staying hydrated so important. I worked with UNICEF/World Vision in Cambodia filming their hydration stations in small rural villages. They gave kids a powder like Pedia-lite, mixed with clean water. Free and distributed widely. Not a bad thing to pack for travelers too.
Plus one on probiotics too for gut health/resistance and recovery.

So many kids die from untreated Diarrhea, don't drink enough or drink more tainted water. They then become dehydrated. Even with I.V.'s. too late for many.

In 7 years in Latin America (on and off) I got sick every time I moved to a new region. Most people can adapt to local bacteria once in an area for a while, but as said, common sense should prevail. Don't get cocky!

But certain things will nearly ALWAYS nail you: Not so fresh Shrimp, fresh picked berries and a few other tempting delights. That said I've eaten a ton of Shrimp in Mexico, but always fresh, sold at reputable place with lots of trade.

I too ate in local markets, rarely got sick. But once moved to another country or area I'd usually have a "period of adjustment", then after a week or two, I'd be OK again. Constantly on the move is tough for your system to keep up and deal with constant onslaught of bugs.

Another good reason for hand washing is Hepatitis. I got Hep C in Bolivia, very mild case. I believe due to several shots of Gamma Globulin the previous year. Seemed to help with quick recovery. (just 2 weeks!!)

I consumed LOTS of fresh squeezed juices while traveling: Ginger, Carrot, Apple, Beet, Orange. Juices will keep you alive and speed recovery from whatever ails you ... just make sure the place is clean, veggies washed and bring your own GLASS! Mega Food!

Many long time travelers get ill once home. A fairly common thing.
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  #18  
Old 27 May 2015
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Hep C is blood and body fluid borne, nothing to do with hand-washing - that is A, E. As you say, you most likely got it from globulin shots....
Oral re-hydration salts good for kids, not so much for adults.
Antibiotics have their place in suspected bacterial diarrhea - the old, the young, the febrile, bloody stool, raised white blood cell count, chronic illness, immune compromise.

Quote:
Originally Posted by mollydog View Post
That's some great advice there Moggy! I'm no health care pro but traveled enough to prove out most of what you say through empirical evidence! Spot on!

Staying hydrated so important. I worked with UNICEF/World Vision in Cambodia filming their hydration stations in small rural villages. They gave kids a powder like Pedia-lite, mixed with clean water. Free and distributed widely. Not a bad thing to pack for travelers too.
Plus one on probiotics too for gut health/resistance and recovery.

So many kids die from untreated Diarrhea, don't drink enough or drink more tainted water. They then become dehydrated. Even with I.V.'s. too late for many.

In 7 years in Latin America (on and off) I got sick every time I moved to a new region. Most people can adapt to local bacteria once in an area for a while, but as said, common sense should prevail. Don't get cocky!

But certain things will nearly ALWAYS nail you: Not so fresh Shrimp, fresh picked berries and a few other tempting delights. That said I've eaten a ton of Shrimp in Mexico, but always fresh, sold at reputable place with lots of trade.

I too ate in local markets, rarely got sick. But once moved to another country or area I'd usually have a "period of adjustment", then after a week or two, I'd be OK again. Constantly on the move is tough for your system to keep up and deal with constant onslaught of bugs.

Another good reason for hand washing is Hepatitis. I got Hep C in Bolivia, very mild case. I believe due to several shots of Gamma Globulin the previous year. Seemed to help with quick recovery. (just 2 weeks!!)

I consumed LOTS of fresh squeezed juices while traveling: Ginger, Carrot, Apple, Beet, Orange. Juices will keep you alive and speed recovery from whatever ails you ... just make sure the place is clean, veggies washed and bring your own GLASS! Mega Food!

Many long time travelers get ill once home. A fairly common thing.
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  #19  
Old 27 May 2015
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Originally Posted by docsherlock View Post
Hep C is blood and body fluid borne, nothing to do with hand-washing - that is A, E. As you say, you most likely got it from globulin shots....
Oral re-hydration salts good for kids, not so much for adults.
Antibiotics have their place in suspected bacterial diarrhea - the old, the young, the febrile, bloody stool, raised white blood cell count, chronic illness, immune compromise.
Yea, I screwed up ... in those days the version I got was called "infectious" Hepatitis ... I've forgotten the current letter designation ... but you mainly get it from contact with feces. (the needle/blood one we called "Serum" Hep)

Quite an epidemic of Gringos getting infectious Hep back then... from Guatemala to Bolivia ... it was everywhere.

As I understand it .. gamma glubulin is meant to prevent Hep ... or increase your resistance to it?? Doc's are divided on effectiveness. But NO ONE ever saw someone go from Yellow Eyes, Gray poop, root beir brown pee ... to NORMAL in two weeks. (Minimal recovery time from Hep is two months for most)

No one has ever been able to explain why I recovered so quick ... and most don't believe it's possible. But I had the lab work that showed Red cell vs. White cell count and all that, and full report on my condition when diagnosed.

I attribute my luck to the Gamma Glob ... but I ain't no Doc. (but what else could it be?)
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  #20  
Old 27 May 2015
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Originally Posted by mollydog View Post
Yea, I screwed up ... in those days the version I got was called "infectious" Hepatitis ... I've forgotten the current letter designation ... but you mainly get it from contact with feces. (the needle/blood one we called "Serum" Hep)

Quite an epidemic of Gringos getting infectious Hep back then... from Guatemala to Bolivia ... it was everywhere.

As I understand it .. gamma glubulin is meant to prevent Hep ... or increase your resistance to it?? Doc's are divided on effectiveness. But NO ONE ever saw someone go from Yellow Eyes, Gray poop, root beir brown pee ... to NORMAL in two weeks. (Minimal recovery time from Hep is two months for most)

No one has ever been able to explain why I recovered so quick ... and most don't believe it's possible. But I had the lab work that showed Red cell vs. White cell count and all that, and full report on my condition when diagnosed.

I attribute my luck to the Gamma Glob ... but I ain't no Doc. (but what else could it be?)
Sexual contact, intravenous drug abuse, blood transfusion, shared razor or toothbrush.....and that's just for starters!
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  #21  
Old 28 May 2015
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Originally Posted by tornado View Post
Only drink water taken from the HOT water tap, let it run very hot , fill a glass and let it cool.
It would take a strong bug to survive a hotel boiler...
.
wouldn't really agree with that, bugs love a warm moist environment, so even if the hotel boiler kills them, which is unlikely, they'll be in the pipework. Also more chance of nasties like legionnaires.

The 'boiler' is unlikely to actually boil water, which is whats required for killing bugs. 10 minutes preferably.
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  #22  
Old 28 May 2015
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Originally Posted by docsherlock View Post
Sexual contact, intravenous drug abuse, blood transfusion, shared razor or toothbrush.....and that's just for starters!
Hep B can live on a surface for upto 2 weeks. It's an extremely tough bug and can easily be passed by means other than sexual contact. I don't generally shag my patients! but because I work in ED, I still have to be vaccinated because it is classed as a high risk area with frequent contact with bodily fluids. It really pisses me off when I see blood splashed on peoples notes etc because Hep will easily survive on there. All you need is a route of access, like a cut on your hand, and away you go!

There is a big thing here at the minute about not eating canned fruit because of hep A contamination because the pickers don't wash their hands after going to the toilet!
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Last edited by moggy 1968; 30 May 2015 at 23:32.
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  #23  
Old 28 May 2015
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Originally Posted by docsherlock View Post
Hep C is blood and body fluid borne, nothing to do with hand-washing - that is A, E. As you say, you most likely got it from globulin shots....
Oral re-hydration salts good for kids, not so much for adults.
Antibiotics have their place in suspected bacterial diarrhea - the old, the young, the febrile, bloody stool, raised white blood cell count, chronic illness, immune compromise.
I did say not required in MOST cases of food poisoning. of course they have their place, just not as much as a lot of people think!
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  #24  
Old 28 May 2015
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Originally Posted by docsherlock View Post
Sexual contact, intravenous drug abuse, blood transfusion, shared razor or toothbrush.....and that's just for starters!
you've misread me mate. I KNOW how I got the HEP, what I'm talking about is WHY I recovered from it so quickly.

(BTW, in my case no sexual, blood or needle exposure ... just nasty conditions in dirty communal bathrooms in funky Hotels and restaurants with very low cleanliness standards)
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  #25  
Old 28 May 2015
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Originally Posted by mollydog View Post
Yea, I screwed up ... in those days the version I got was called "infectious" Hepatitis ... I've forgotten the current letter designation ... but you mainly get it from contact with feces. (the needle/blood one we called "Serum" Hep)

Quite an epidemic of Gringos getting infectious Hep back then... from Guatemala to Bolivia ... it was everywhere.

As I understand it .. gamma glubulin is meant to prevent Hep ... or increase your resistance to it?? Doc's are divided on effectiveness. But NO ONE ever saw someone go from Yellow Eyes, Gray poop, root beir brown pee ... to NORMAL in two weeks. (Minimal recovery time from Hep is two months for most)

No one has ever been able to explain why I recovered so quick ... and most don't believe it's possible. But I had the lab work that showed Red cell vs. White cell count and all that, and full report on my condition when diagnosed.

I attribute my luck to the Gamma Glob ... but I ain't no Doc. (but what else could it be?)
Quote:
Originally Posted by mollydog View Post
you've misread me mate. I KNOW how I got the HEP, what I'm talking about is WHY I recovered from it so quickly.

(BTW, in my case no sexual, blood or needle exposure ... just nasty conditions in dirty communal bathrooms in funky Hotels and restaurants with very low cleanliness standards)
Chill brother, I was pulling your leg.....
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  #26  
Old 28 May 2015
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It was the other stuff he got through his dodgy sexual activities
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  #27  
Old 29 May 2015
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Originally Posted by tornado View Post
Don't believe you mate,
too fast to opinate...
the OP was about Delhi belly...
not all known causes of death



.
yes, it was, but there is no value in offering advice on enteritis through contaminated water and ignoring all other risks which you may be increasing exposure to, although it might be going a bit off topic, such as legionella, which is classically found in hot water supplies. Whilst it is not a gastric infection (it's more like a pneumonia) it is found in water systems. actual contamination is commonly from ones that have a degree of misting such as showers, hot tubs etc and it can lead to diarrhoea as well as respiratory symptoms.It can be effectively controlled by maintaining a circulating temp of greater than 50C, but this will not be possible throughout the system, which is why it tends to be found around outlets such as showers where the temperature has dropped.

You will not maintain a temperature of greater than 60C thoroughout the water system, and cannot guarantee that temperature will be maintained at all. Whilst it is a UK requirement that hot water is stored above 60C, for the control of legionella, the same is not true of other countries.

I'm not sure about why you say clostridium is not an intestinal pathogen, it most definately is, but is not caught from contaminated water. it's spore forming bacteria which causes infectious diarrhoea so is most likely to be passed through poor hand hygene. Usually though it is only a risk to those with compromised gut flora. It typical starts after the guts normal flora has been compromised, for example by antibiotic therapy so not that relevant to a discussion of water disinfection

Here is the UK guidance on drinking water, which advises NOT drinking from the hot tap, due to the risk of legionella and bacteria growth, despite the quality of UK water supplies

http://www.gov.scot/Resource/Doc/158461/0042948.pdf

All the resources I have ever seen (including WHO guidelines) recommend boiling water as the only method for heat decontamination of drinking water. This then needs to be followed by correct storage if re contamination is to be avoided.
The part of the above text you have put in quotes is unreferenced so no one is able to verify your source material. You have supplied an incomplete reference to the Mayo clinic, but their site confirms what I have already said about travelers diarrhoea and advises against drinking tap water (it makes no distinction between hot or cold)

http://www.mayoclinic.org/diseases-c...n/con-20019237

I have never seen any recommendation to drink warmed water or water from the hot tap. I have seen a number of recommendations that you do not drink water from the hot tap!!
I shan't be drinking water out of the hot water supply thanks!
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Last edited by moggy 1968; 30 May 2015 at 00:19.
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  #28  
Old 29 May 2015
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rather than unsubstantiated opinions on a forum, people may like to look at the WHO guidance on travelers diarrhoea and how to make drinking water safe, which is drawn from properly researched sources!!



http://www.who.int/water_sanitation_.../sdwtravel.pdf

and here is a link to the Mayo clinics advice on travelers diarrhoea

http://www.mayoclinic.org/diseases-c...n/con-20019237
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Old 30 May 2015
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self edit as the offending post this referred to has been removed
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Last edited by moggy 1968; 30 May 2015 at 23:30. Reason: Staying focused
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  #30  
Old 30 May 2015
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OK.....

No personal attacks. Stick to the topic at hand. Thanks.
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