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Traveler's Diarrhea is Worst Enemy of Trekkers | |
By SPORTS AFIELD Traveler's diarrhea is the worst enemy of trekkers to exotic or wilderness destinations - and its seriousness ranges from briefly irritating to downright threatening. Nervous tension and-or a change in one's normal diet can induce minor and usually short-lived problems, Anthony Acerrano wrote in an article in the current issue of Sports Afield, but about 80 percent of the time true TD syndrome results from bacterial infection. E. coli, shigella and salmonella are a few common agents that can enter your system through contaminated food or water. The resulting TD can be intense and can last, without treatment, an average of five to seven days, possibly accompanied by minor-to-moderate fever, abdominal pain and fatigue. The symptoms generally occur within one to three days of infection, and the onset can be gradual or sudden. Debilitating diarrhea also can be caused by various protozoan parasites, Giardia lamblia being one of the most common in North America. G. lamblia and other parasitic infections take about two weeks to incubate, and the symptoms can be intense: severe, explosive diarrhea; abdominal cramping; and in some cases, fever, vomiting, weakness and chills. Prevention is the best defense. With both bacteria and parasites, the main mechanisms of transfer are contaminated food or water. Raw vegetables and fruits, undercooked eggs and fish, raw shellfish and unpasteurized milk and dairy products are the most common food sources of TD, particularly, but not only, in less-developed regions and in tropical and subtropical climates. In temperate wilds, even wilderness areas, all untested water should be properly treated before drinking. Clean cold water in pristine settings may need only filtration against protozoan organisms such as G. lamblia. Otherwise all standing water should be disinfected by boiling for a minimum of five minutes plus one minute for each 1,000 feet of altitude above sea level, or by chemical treatment. Travelers should avoid drinking from any local water source unless it is guaranteed to be disinfected. This warning extends to the use of ice cubes and water used to clean foods and brush your teeth. Canned beverages and bottled carbonated water are safe to drink. Eat only hot, thoroughly cooked foods, baked goods and fruits with thick skins that you can peel yourself. In far-flung locations, it is wise to avoid street-vendor fare. Clinical tests have shown that preventive doses of bismuth subsalicylate can reduce your chances of "catching" an otherwise diarrhea-causing infection. Two tablets or the equivalent liquid dose four times a day is suggested. Bismuth remedies, however, should not be taken in quantity by anyone sensitive to aspirin. Antibiotics, on the other hand, should not be used preventively. They can have negative side-effects and overusing them can create strains of drug-resistant bacteria, which them become increasingly difficult to kill. Minor diarrhea can be effectively treated with regular doses of bismuth subsalicylate. Another common over-the-counter remedy is loperamide which, along with Lomotil, is considered an anti-motility agent. Such remedies relieve symptoms but don't attack the source of the problem. They should be used carefully, if at all, in severe cases. Diarrhea is the body's way of getting rid of an intestinal irritant. Anything that slows this process also prolongs the illness. Sufferers should be sure to replace lost fluids and electrolytes by drinking bottled soda water, clear fruit juices or sport drinks such as Gatorade. Anyone who has suffered severe TD on a trip, Sports Afield advised, should consult a doctor after returning home in case further treatment is required. Copyright 1996 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. | |