The month of May with its many bank holidays has many thinking about a trip to the south. Travelers look forward to pleasant temperatures, good food and maybe even the first ice cream of the season. Unfortunately, such trips sometime have very unpleasant consequences in the form of a so-called traveler’s diarrhea. This results from eating foods that have not been properly refrigerated or by drinking inadequately clean water and the associated ingestion of germs.
A hallmark of traveler’s diarrhea is that the illness presents from as early as a few hours up to a few days after infection, with the following four symptoms of varying severity:
Diarrhea – abdominal pain – vomiting – fever
Diarrhea is, subject to a few exceptions, a self-limiting illness (i.e. it will pass naturally), but it will take a little longer to recover without treatment.
If symptoms of diarrhea and fever occur one week or later after the start of a trip to a region where malaria is prevalent, consideration must be given to the possibility of that malaria has been contracted and the patient should seek immediate medical help.
What should you do if it happens?
With the onset of diarrhea, replacement of fluid and electrolytes should be carried out continuously by drinking a pharmaceutically available soluble solution: the amount of fluids required over 24 hours should be calculated based on 40ml per kilo of body weight, e.g. for a 70kg person, just under 3 liters of fluid.
Even at the first sign of nausea a suitable antiemetic (a drug that suppresses nausea) should be taken. This may benefit the patient in certain circumstances by enabling the intake of further liquids while preventing fluid loss through vomiting.
Antibiotics? Yes, but only in consultation with the doctor and for diarrhea accompanied by fever
Antibiotic therapy is recommended only in cases of feverish diarrhea. Since there are now many antibiotic-resistant germs, the patient should seek medical advice before taking antibiotics. Incorrect self-medication may lead to an aggravation of the illness.
Antibiotics from the group of macrolides, (e.g. Azithromycin) are universal remedies in such circumstances. Again, their use must always be clarified in advance with a doctor!
This medication paralyzes intestinal activity and therefore intestinal diarrheal symptoms. For that reason, it should only be taken in cases where travel is necessary, which is clearly incompatible with diarrhea (longer bus or air travel, etc.) The medication should never be taken for more than 2 days and the maximum dosage is 3 capsules per day.
If the patient suffers a blood pressure or blood sugar deviation (in the presence of existing diabetes mellitus), a local doctor at the holiday destination should be consulted immediately.
Travel insurance protects against unplanned holiday costs
Being sick abroad can be expensive, even in Europe and despite the E-Card system. A traveler holding an E-Card is automatically insured in all EU countries and EEA states, but not when the services are claimed in a private hospital or a private doctor’s practice.
To use an Austrian example, whether at home or traveling abroad, an Austrian citizen can submit the receipt for a private medical service for a partial reimbursement through the Austrian health system. Therefore, when an Austrian travels abroad and uses a private doctor or hospital within the EU/EEA, they are only entitled to have the rate refunded which an Austrian public doctor would have received for the same service.
Therefore, an additional health insurance is recommended for each trip abroad. Even for illnesses such as diarrhea, adequate travel insurance can protect you against unplanned expenses.