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Diarrhoea - prevention and advice for travellers - Management
How should I assess the risk of someone developing traveller's diarrhoea?
- Enquire about the country to be visited.
- Countries and places with generally poor standards of hygiene pose a greater risk.
- Although the risks are greater in developing countries, locations with poor hygiene may be present in any country.
- In general, the relative risk of traveller's diarrhoea can be classed as:
- Low for people travelling to northern and western European countries, the USA and Canada, Japan, Australia, and New Zealand.
- Intermediate for people travelling to eastern European countries, Russia, South Africa, and some of the Caribbean islands.
- High for people travelling to the Middle East, Africa, Central and South America, and most of Asia.
- For assessment of individual countries where travellers should practice strict food, water, and personal hygiene precautions, see the National Travel Health Network and Centre (NaTHNaC) website (www.nathnac.org).
- Assess for other risk factors known to further increase the risk of traveller's diarrhoea, such as poor accommodation and sanitation amenities — see Additional information.
- Review the person's susceptibility to traveller's diarrhoea and their risk of complications. Those at higher risk include:
- Young children and babies, and elderly or frail people.
- People with reduced immunity (such as those with HIV infection or AIDS).
- People with severe cardiac or renal disease.
- People with inflammatory bowel disease.
- People with reduced acidity in the stomach, which is a risk factor for infection with acid-sensitive organisms such as Salmonella and Campylobacter.
- Enquire about access to medical amenities — this is particularly important for those travelling to remote areas with few or no medical amenities (especially trekking, camping).
- Discuss whether journeys to high-risk areas are essential and whether the person is suitably prepared (for example if backpacking through remote areas).
- Some people may have been inadequately informed or prepared of the risks of a holiday in a high-risk area and may wish to travel to a lower risk area instead.
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