Overview of Travel Health and Safety

Food Precautions

Guaranteeing the safety of food and beverages is difficult if not impossible when traveling, especially in developing countries. Without strict public health standards, bacteria or parasites in food or water may go undetected and cause illness, such as travelers' diarrhea.

However, travelers can continue to enjoy local foods, which is part of the pleasure of international travel. Just be sure to observe food and beverage precautions and concentrate on eating the types of food that tend to be safest. Although some evidence suggests that where food is eaten is more important than what food is eaten, observing food and beverage precautions can still help decrease the number of organisms ingested and decrease the severity of travelers' diarrhea if contracted. These precautions also help reduce the risk of other infections, such as dysentery, hepatitis A and E, giardiasis, typhoid, and paratyphoid.

Although it may not be possible to avoid diarrhea in certain high-risk destinations, even with the strictest adherence to preventive measures, the risk can be minimized by following the guidelines below when traveling through areas with less than adequate sanitation.

Hand hygiene (frequent, thorough handwashing with soap and water for 20 seconds [or using a hand sanitizer containing 60% alcohol]) is essential before eating and after using the bathroom. Choose establishments that are known to cater to foreigners or that are specifically known by other foreigners to be safe. Foods that are safer to eat include breads, tortillas, crackers, biscuits, and other baked goods, as well as canned foods and fruits, nuts, and vegetables with thick skins, peels, or shells that can be removed. Food should be well-cooked and served steaming hot.

Avoid food from street vendors or market stalls. Avoid leafy or uncooked vegetables and salads. Some organisms in soil and water are not destroyed by normal cleaning methods. Beware of garnishes, typically uncooked vegetables, fruits, or herbs.

Avoid undercooked, raw, or cold meat, seafood, and fish, including large carnivorous fish (especially from reef areas because many contain concentrated toxins).

Avoid unpasteurized dairy products such as cheese, yogurt, and milk. Be particularly wary of ice cream and other frozen confections that may have been made or stored in contaminated containers. Also avoid creamy desserts, custards, or sauces that may not have been adequately refrigerated, as well as cold sauces such as mayonnaise, salad dressing, chutneys, or salsas, which are usually raw and made by hand.

Avoid buffet foods such as lasagna, casseroles, and quiches, unless they are known to be fresh (not reheated) and have been kept steaming hot. Avoid buffets with no food covers or fly controls.