The Eighth Wonder of the World: Pacific Sea Turtles

How to Avoid these Vacation-Ruining Stomach Illnesses Knowing What Causes Salmonella, Traveler’s

By Tara Spears

Second in health series

Whether you’re a tourist or Riviera Nayarit resident, the recent hordes that enjoyed the local beautiful beaches brought lots of activity-and germs. When recently strolling the avenida, I stopped to chat with three acquaintances.  All three had been to the doctor and were diagnosed with intestinal amoebas. Humm, I thought I should check out this illness and pass along the information. Nothing is more disappointing or miserable than to arrive for a vacation to an exotic place only to have to spend days chained to the bathroom due to vomiting and diarrhea.  There are several illnesses that have similar symptoms yet different sources of infection: viral, bacteria, or amoebas; not all of them require medical care but it is wise to try to prevent catching one in the first place.

Often called the stomach bug or stomach flu, viral gastroenteritis is a short-lived, lower abdominal infection that is impossible to prevent or cure. The malady works its grotesque way through our bodies at its own spasm speed. If you're not already washing and gelling your hands several times a day to fight germs, it's a good habit to start. The microbe spreads through the feces and vomit of infected people. You can catch this virus from a handshake, and once infected, you're likely to spend a day or two in digestive-tract misery. Experts say it's possible to infect someone else even after the symptoms disappear. Some infected people never develop symptoms, which drives home the wisdom of hand-washing to ward off the colonies of unseen germs that inhabit shared surfaces.

Treatment of stomach flu:

 Viral gastroenteritis, (germ pictured left) is the most common cause of acute, rapid onset diarrhea worldwide. The symptoms of nausea, vomiting, abdominal cramps, and diarrhea –without fever- typically last only 48-72 hours. The above table suggests typical treatment that should be accompanied by lots of bottled water intake. The severity of the illness can be impacted by the amount of viral exposure, age (the very young or elderly are more susceptible), the individual’s overall health when infected, and any pre-existing immune weakening disorders (for example, diabetes, AIDS or cancer.)  Health care professionals can identify the type of stomach ailment through lab tests, as the microscopic germs have distinctive appearances.

Next in the misery spectrum are the bacterium infections.  Food poisoning is a brief illness that is caused by bacterial toxins contained in tainted or improperly handled food.  This is a big issue in all tropical countries: food kept just a couple of hours at room temperature spawns bacteria growth. The toxins cause abdominal pain (cramps), vomiting, and for the small intestine to secrete large amounts of water that leads to diarrhea.  Mercifully, the symptoms of food poisoning usually last less than 24 hours. A professional cook explained to me that food poisoning symptoms can appear within 20 minutes of eating, although symptoms may not occur for 7-12 hours.

           The bacterium that produces toxins in food before it is eaten typically is Staphyloccus aureus. This bacteria can infect salad, meat, or mayonnaise, including salad dressings.

The leading healthcare watchdogs, such as the American Center for Disease Control and the World Health Organization, recognize that there are many types of bacteria naturally present in food while other bacterium find their way into food from contaminated water, soil, air, animals, equipment, and people. By understanding bacterial ecology, in combination with recognizing many of our bad hygiene practices, it can give us the tools for the prevention of food borne disease.

Montezuma’s Revenge a.k.a. Traveler’s Diarrhea

Traveler’s diarrhea describes the digestive tract illness that frequently attacks those visiting third-world or developing countries. Bacterial toxins cause the sudden onset of diarrhea, abdominal cramps, and sometimes vomiting.  These symptoms usually occur 3-7 days after arrival in the foreign country, and generally subside within three days.

This illness is rarely life-threatening for adults.  It is more serious in children as it can frequently lead to dehydration. The bacteria and the toxins that cause traveler’s diarrhea occur in areas with contaminated water supplies, poor sewage systems, or improper food handling. Be cautious when selecting possibly contaminated foods such as fruits, vegetables, seafood, raw meat, or ice cubes. Some experts contend that the people living in these areas often don’t get sick because their bodies have developed some degree of immunity.  As a foreigner to these types of conditions, you can decrease your risk of developing this illness by avoiding water and food that may be contaminated. If you can’t see into the kitchen, ask if the food is prepared with bottled water; if in doubt, don’t eat or drink it!

 The diagram, left, illustrates all the possible ways that food may get contaminated.  The industrialized nations have government regulations that oversee all phases, including enforcing safe procedures and inspections of harvesting and processing food products.  Where the problems occur in the developing countries is that the small subsistence farmers are direct suppliers to the local markets (tiendas) which is not inspected:  they frequently sell any condition animal, fruit, or vegetable in order to survive. 

 The Bacteria Bad Boys: E. coli and Salmonella       

Most adults are familiar with the digestive-tract illnesses, E. coli and Salmonella, either from having suffered through a bout of infection or from the media reports. Escherichia coli  is just one of the hundreds of strains of the bacterium with the same name.  Most types of E. coli are harmless and live in the intestines of healthy animals and humans.  E. coli, however, produces a powerful toxin that can cause a severe infection of the small intestine and colon.  These bacterium cause all the symptoms of the above viral infections plus occur with fever and signs of digestive tract inflammation (blood or pus in the frequent stools.) Another indicator of one of this type of infections is the duration of the miserable symptoms. One can acquire this bacteria by drinking contaminated water or eating contaminated foods such as vegetables, poultry and dairy products.

Salmonella is the medical name for over 2,500 types of bacteria. This ubiquitous microscopic bacteria is known to cause disease in humans, animals, and birds (especially poultry) worldwide. According to Melissa Conrad Stoppler, M.D., virtually any food can become contaminated with one of the many species of Salmonella. This bacterial infection is passed to humans from animals: eating undercooked poultry and drinking unpasteurized milk are among the ways humans can acquire the infection.

 But increasing media coverage has focused on vegetable products as the source of many Salmonella outbreaks. When vegetables or fruits are the source of an outbreak, it means that these products have been handled unsafely, such as processing or preparation on surfaces that have become contaminated with animal feces or raw poultry. Another way for vegetables to become contaminated is by an infected food handler.  Several professional cooks said that they use a separate cutting board for only poultry, and wash it with bleach and hot water to eliminate the potential bacteria.  The symptoms of Salmonella include fever (over 101), nausea, abdominal pain, and diarrhea, all usually lasting several days.

It’s best to contact your health-care professional if you suspect you have acquired Salmonella food poisoning. Even though most cases of Salmonella resolve on their own without the need for antibiotics, treatment may be required if the infection spreads outside of the gastrointestinal tract or if you become severely dehydrated.

What’s the deal with dehydration?

Dehydration is common among adults suffering with acute diarrhea that have passed large amounts of watery stool, especially if the replacement of fluids is limited by lethargy or nausea and vomiting. The extreme loss of fluids leads to a deficiency in minerals (electrolytes) and sodium, besides abnormal levels of chloride and bicarbonate.

The last of the troublesome micro-organisms that cause significant pain and digestive-tract illness is the intestinal amoebae. I had not heard of this parasite until moving to Mexico, but because it is transmitted to humans via contaminated water and food, this infection is fairly prevalent. The medical term is amebiasis or intestinal entamoeba histolyticac, which is in the dysentery family of germs.  What makes it so painful is the inflammation of the intestines and possible ulceration of other organs. The severe diarrhea frequently has blood and mucus.  The common treatment includes lots of liquids, a course of strong antibiotics that contain quine components and antiprotozal drugs.  Some permanent Mexican residents take Vermox mebendazol tabletas (available in most farmecias) once a year as a preventative measure.

Using common sense and following good hygiene practices are the easiest way to enjoy your stay in a beautiful, exotic country. The table that follows provides excellent advice to take the worry from preventing food borne illnesses.

Here are five major tips recommended by the Centers for Disease Control and Prevention (CDC) to prevent contaminating food.

Use caution when buying food.

When at the grocery store, pick up perishable food such as meat, eggs, and milk at the very end of your shopping, so they will stay cool.

Take food home right away so that it does not spoil in a hot car.

Avoid raw or unpasteurized milk.

Because eggs, meat, seafood, and poultry are most likely to contain bacteria, do not allow their juices to drip on other food.

Store food properly.

Store eggs, raw meat, poultry, and seafood in the refrigerator.

A refrigerator should be set at 40° F.

A freezer should be set at 0° F.

Regularly clean and disinfect the refrigerator and freezer.

Use containers to prevent contaminating other foods or kitchen surfaces. Do not store food uncovered in the refrigerator or freezer.

Use special precautions when preparing and cooking food.

Wash your hands and clean and disinfect kitchen surfaces before, during, and after handling, cooking, and serving food.

Defrost frozen food on a plate either in the refrigerator or in a microwave, but not on the counter.

Cook food immediately after defrosting.

Use different dishes and utensils for raw foods than you use for cooked foods.

Wash raw fruits and vegetables before eating them.

Cool and promptly store leftovers after food has been served.

Because harmful bacteria grow at room temperature, keep hot food hot at 140° F or higher, and keep cold food cold at 40° F or cooler. This is especially important during picnics and buffets.

Do not leave perishable foods out for more than two hours.

Promptly refrigerate or freeze leftovers in shallow containers or wrapped tightly in bags.

Since foods of animal origin pose the greatest threat of Salmonella an E.coli contamination, do not eat raw or undercooked eggs, poultry, or meats. Remember that some sauces and desserts use raw eggs in their preparation, so be cautious of these, particularly in foreign countries.

Make sure poultry and meat, including hamburgers, are well-cooked, not pink in the middle.

Do not consume raw or unpasteurized milk or other dairy products.

Thoroughly wash produce before eating it.

Avoid cross-contamination of foods. Uncooked meats should be kept separate from produce, cooked foods, and ready-to-eat foods.

All utensils, including cutting boards, knives, counters, etc., should be thoroughly washed after handling uncooked foods.

Thoroughly wash hands before handling foods and between handling different food items.

Thoroughly wash hands after contact with feces.

Thoroughly wash hands after handling any reptiles, since reptiles are particularly likely to have Salmonella.

Email Tara:  tara.sprs@yahoo.com