Most water-borne illnesses are bacterial, caused by E. coli, cholera or salmonella, or viral, caused by hepatitis A or rotavirus but can also be caused by protozoa, like giardia or cryptosporidium.
In most cases, a traveler becomes ill because the bacteria in the local water supply are foreign, and our bodies have not built up the immunity that the locals have acquired over a lifetime of consumption.
If you’re traveling to an exotic location, or if you’re traveling to an area known for contaminated water supplies, your safest bet is to avoid drinking local water and opt for bottled water instead. While boiling local water is a good way to kill nasty microorganisms, it’s not always an easy option for hotel-based tourists. You can also bring along travel water filters or purchase water purification tablets that can minimize your risk of contracting a water-borne illness.
Traveling to exotic locations doesn’t have to be all scary. Follow these five simple tips to minimize your risks while on vacation:
Learn the Lay of the Land
Most people who have traveled to Mexico have been warned about the unsafe water, but there are high risks for waterborne illnesses in Central America, most of Africa and Asia, and parts of the Middle East. Water quality also varies, depending on where you stay/visit: In some countries, tap water may be perfectly safe in major metropolitan areas, but you’ll need to boil it or avoid it altogether when visiting a remote village. When in doubt, always err on the side of caution and opt for bottled water from a reputable brand instead of drinking tap water. You can research reputable brands online in advance of your trip and be sure to stock up on water in major hubs prior to traveling to more “off the beaten path” destinations, even if you find yourself somewhat weighed down. The extra weight is certainly a better trade-off than finding yourself without a source of safe water at your final destination (or worse, finding yourself falling ill in a remote village with limited healthcare options!).
In addition to being aware of general dangers, you can check the Centers for Disease Control and Prevention (CDC) website prior to your departure for up-to-date, region-specific information on any current outbreaks. The World Health Organization also offers an International Travel and Health guide that offers advice on a range of topics.
Know the Hidden Water Dangers
In addition to skipping local tap water and buying (reputable) bottled water, travelers need to be aware of all of the sources of possible contamination that we don’t always consciously think of. When traveling to an area with questionable water, one should use bottled water to brush teeth or dentures. Foods that may have been rinsed with contaminated water may pose a threat -- such as salads and fresh fruit (as tempting as those beautiful fruit displays may be).
While drinking juices, beer, wine and alcoholic beverages is typically safe, remember that freezing water doesn’t kill bacteria or pathogens in the same way that boiling does. A margarita on the rocks or strawberry daiquiri may sound like a perfect beverage to sip on a hot tropical beach, but may put you at risk as much as a cup of local tap water.
Showering and swimming also can pose a threat. Tropical, fresh bodies of water have a risk for several parasites, amoebas and protozoa that you should research ahead of your trip, especially if you are planning on bathing in these bodies of water. Be sure that you don’t inadvertently
The CDC has several useful infographics on the types of food and beverages that pose the lowest risks, including:
● Dry foods like bread and crackers
● Hot beverages, like coffee or tea
● Cooked food that’s served hot from a reputable establishment
● Well-done meat
● Factory-sealed foods
● Fruit and vegetables that have been washed in clean water or that can be peeled
Come Prepared
While boiling water is a great way to ensure that you’re removing bacterial or parasitic contamination from drinking water, it isn’t always a feasible option for travelers. If you’re traveling to a destination with questionable water quality, you can bring along iodine or chlorine tablets that kill bacteria and viruses - but are not effective against protozoa. Camping stores also sell portable water filters that may be suitable for your needs, or you can purchase a SteriPEN ultraviolet light to treat water for bacteria, viruses and protozoa.
Ask the Locals
Even if you think the drinking water is safe at the five-star resort where you’ll be staying during your vacation, it’s always best to ask the hotel staff. Not only will they be likely to give you honest feedback (remember, they earn a large part of their wages in gratuities, and sick customers typically don’t tip well), but they also can be helpful in steering you toward safe water options and pointing out dangers that we don’t consider, like swimming in a local hot spring or hiking to a landmark waterfall, where we may inadvertently swallow some water. If you’re traveling to a country where English isn’t a common language, you may want to consider bringing along a phrase book or writing out a few notecards with useful phrases, so that even if your pronunciation isn’t the best, you can show the card to a staff member and ask for a head nod or shake (Keep in mind cultural differences. In India, for example, a head “wobble” that would look somewhat like a “no” in the United States actually indicates a “yes” or “good.”)
Know the Signs of Illness
No one wants to interrupt their vacation to visit a medical clinic or emergency room, but it’s important to know the signs of waterborne illnesses so that you can act quickly if you become sick. When traveling in remote areas, early detection may buy you the time you need to get to a larger city and better medical facility, or it may allow you to seek treatment before serious complications, like dehydration, aggravate your condition. Among the symptoms of waterborne illness, many patients experience:
● Diarrhea
● Nausea
● Vomiting
● Fever
● Chills
● Body Aches
While some illnesses have symptoms with a sudden onset that resolve themselves after a few hours without medical intervention, these symptoms can be the indicators of life-threatening, serious diseases. If you suspect that you are falling ill, seek medical treatment quickly so you can get back out on the beach to enjoy the rest of your vacation.