Travellers’ Diarrhoea Abroad

Every year more than 60 million business trips or holidays are made by British residents travelling abroad. Even holidays can be stressful though, and there are risks associated with international travel. You may be concerned because you have heard stories or read blogs about your destination and the possibility that you can fall ill with diarrhoea or food poisoning there. This article will provide an outline of the risks associated with a few countries or regions, as well as what risk factors you may find it helpful to look out for.

Cholera in Central Africa and the Caribbean

Africa has the highest number of cases of cholera, 94% of reported cases between 1995 and 2012. In 2006, 31 out of 46 countries on the African continent reported outbreaks of cholera. This makes Africa a high-risk area for cholera and cases of travellers’ diarrhoea. High numbers of cholera cases can be explained by the fact that many countries in Africa do not have appropriate sanitation. Drinking water or food becomes contaminated with infected people’s stools through contact with raw sewage. This is especially common after natural disasters or conflict in the area. There are vaccines which can prevent you from contracting cholera.


A couple of recent examples of cholera following a natural or human disaster are in Central Africa and Haiti. Outbreaks of cholera have occurred along the Congo River in the provinces of Bandundu, Equateur, Kinshasa and P Orientale. In the Democratic Republic of the Congo there has been conflict due to land shortages and potential profits to be made from mineral resources. Haiti suffered a massive earthquake on 12th January 2010, by the 25th October of the same year the Haitian Ministry of Health had reported 259 deaths from cholera. These two areas are not the most popular tourist destinations, but they are a good example of how low-income or developing countries are at a higher risk of a cholera epidemic after conflict or natural disaster. If you are planning a holiday abroad, keep an eye out for reports of flooding, earthquakes, internal conflict etc. as these can be early indicators of a cholera epidemic being on its way.

Rotavirus, travellers’ diarrhoea and dysentery in India

There have been multiple outbreaks of rotavirus diarrhoea in India, which is one of the most densely populated countries in the world. The problems of diarrhoea caused by viral infections or bacteria are especially prominent in this are of the world for two main reasons. High-density urban populations with sub-standard sanitation and water treatment facilities make it easier for infectious waterborne or food borne diseases to spread. Additionally, sparsely populated rural areas are at risk due to poverty and the fact that people living in these areas get their water from wells or lakes. These water sources are more likely to contain infected human faeces.

A high number of tourists report returning from India having suffered from travellers’ diarrhoea or similar symptoms. This can be explained by several environmental factors: visitors to India are not used to the diet and foods available there, high population density increases the spread of infectious diseases, additionally; poor sanitation makes water unsafe for drinking or the preparation of food.

Travellers’ diarrhoea in Brazil

Brazil is a country with a significant proportion of its urban population living in poverty. The ‘favelas’ or slums of Brazil’s major cities are infamous for overcrowding and poor sanitation, making them areas where you may be at risk from getting travellers’ diarrhoea. In such areas it is important to note where the water which you use to drink or bathe is coming from. The ‘favelas’ of Brazil are often built on slopes and high land above the rest of the urban area. Therefore, you should be note whether water is running off or through these areas into the area in which you are staying (bearing in mind that sanitation, plumbing or sewage systems are often not provided for settlements which local governments might classify as ‘temporary’). This could be contaminating your water supply.

Remember when you are planning a trip abroad that travellers’ diarrhoea, food poisoning and other infections can occur anywhere in the world, even in your home country. Therefore, rather than avoid travel to high risk areas, you should be prepared instead by knowing how to avoid infection and what treatments to take if you do fall ill.   

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