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Diarrhoea - prevention and advice for travellers - Management
How should I manage someone at high risk of traveller's diarrhoea?
For people at high risk of traveller's diarrhoea:
- Emphasize the importance of personal hygiene, as well as food hygiene and safe drinking water, to reduce the risk of traveller's diarrhoea.
- Warn travellers about the risk of food- and water-borne infections and how to avoid potentially contaminated recreational water.
- Do not routinely offer prophylactic treatment for prevention of traveller's diarrhoea, as it is not indicated for most travellers.
- Antibiotic prophylaxis may be appropriate for certain high-risk travellers (see Prophylactic or empirical antibiotics).
- The use of bismuth subsalicylate and probiotics for prophylaxis is not recommended.
- Antidiarrhoeal drugs (such as loperamide) should not be taken prophylactically.
- Consider whether a prescription for empirical antibiotic treatment (to use if affected) is a suitable alternative if prophylaxis is not indicated, and the person is travelling to particularly high-risk locations where medical assistance is poor or unavailable (see Prophylactic or empirical antibiotics).
- Inform the person that there are no universal vaccines to cover all the infections which may cause traveller's diarrhoea. However, travellers to risky areas must seek advice about appropriate vaccination against other intestinal infections such as cholera, hepatitis A, and typhoid. For further information on vaccines recommended for overseas travel, and extended holidays or for people working overseas, see the CKS topic on Immunizations - travel.
- Offer advice regarding self-management and when to seek medical advice if the person develops diarrhoea during their trip.
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