Food poisoning - Matförgiftning

This is not a travel guide but a travel-related article. More articles that deal with other aspects of travel can be found under travel-related topics.

Food poisoning - and its most common symptoms diarrhea - is without a doubt the most common disease for travelers. In many ways it is inevitable: no matter how fanatically clean you are when cooking, it is still exposed to millions of airborne bacteria. At home, where you are constantly exposed to the local bacteria, the odds are low that you are already immune to them. But in other parts of the world, where the bacterial flora is new, there is an even greater risk of encountering problems. Hence expressions such as Delhimage, The curse of Pharaoh, Montezuma's revenge, etc.

Prevention

There is an old saying for eating food in the third world:

Boil it, peel it or forget it.

This seems simple, but in practice it is a tough road to go, as the problem is not so much about the risk of an accident as the risk of temptation. For example, the following products are most likely to cause problems:

• tap water
• is
• milk
• fresh fruits and vegetables

Test: It's another terribly hot day in Delhi and the curry that just slimmed down is still burning in my throat. Why not buy a good strawberry milkshake to soothe? If you follow that intention, you have just sentenced your stomach to a guaranteed death penalty: a milkshake contains all of the four high-risk sources of infection. The ice that cools it has either been made from the water or, even worse, from large factory-made ice blocks that have been delivered by literally being dragged on the street to the store. Milk is spoiled incredibly quickly in tropical climates. The yummy vegetables and / or fruits have, if rinsed at all, been cleaned in the same parasite-contaminated water.

If this now causes you to panic and immediately head to the nearest expensive, air-conditioned tourist trap to the restaurant, this is not a particularly wise choice. They probably use the same ingredients stored with the same hygiene requirements (or the same lack of requirements), but since it is a tourist restaurant, the business idea depends on trying to catch a few tourists a day, rather than feeding a number of natives. This in turn says that the above mentioned ingredients have probably been stored under one long time.

What do you do then? It's a lottery, but there are some guidelines for raising your odds of getting away with it:

• Choose a popular restaurant (or fast food). Many customers (especially locals!) Mean that the food is not left for too long, and it probably also means that the food is good and prices are at the right level.
• Choose food that is cooked to order. Foods like fried rice and fried noodles are popular in the tropical countries for a special reason. Buffet-like meals, on the other hand, may seem cheap but are (unless extremely popular) very risky.
• Dishes that are kept very hot - in practice it means hot drinks and soups - are also a pretty good option. Spicy curries and similar dishes are not as good, but they are usually OK due to the bactericidal properties of most spices. On the other hand, too much spice can also upset the stomach, so it is best to avoid these at least for the first few days.
• Avoid meat, fish and especially seafood; visit eb market to find out why. Eating minced meat (meatballs among other things) or something that has not been cooked properly entails particularly great risks, not only due to food poisoning but also for the risk of suffering from trichina poisoning. In addition to this, you should avoid grilled food and fried chicken that has been prepared in advance, and who knows how long the food has been lying around?
• Drink only beverages from bottles and jars that have not been opened by anyone else, and check the closure first! Do not let waiters pour the drink into the kitchen, because you do not get what you expect. Restaurants with a good reputation open the drinks at the table for that very reason.
• Boil fresh milk thoroughly before drinking, or use powdered milk or condensed milk instead.

The good news is that within a few days you acclimatize to the local bacterial flora and the odds of getting sick start to drop. The bad news is that it only takes one fly at the wrong place at the wrong time to destroy all one's precautions, and if one stays on the spot for a while, food poisoning is more or less inevitable.

Treatment

So one day happiness ends and you realize that you are clearly feeling bad. Diarrhea alone is not enough to qualify it as food poisoning, but if you ...

• feels unwell and is dizzy
• gets fever
• starts to feel like you need to vomit

... so, yes, then you are reading the right article right now. The first thing to do is to get through the acute phase: go to a toilet, kneel in front of it and let it out. You do not start to feel better until you start vomiting, and you do not get out of it until your stomach is empty, so just do it. Do not try to eat anything, and drink nothing but water yet. When there is nothing left, wash your mouth, brush your teeth and go to bed. You feel healthier in the morning. But if...

• the acute symptoms persist for more than two days, or
• there is blood or where in the stool, or
• you get chills and fever, or
• the pain increases beyond nausea, or
• other strange symptoms appear, such as marks on the skin

...so it may be slightly worse and one should seek medical attention. Attempt not to get rid of it on your own.

The highest priority in all types of food poisoning must be to restore fluid balance. You constantly lose fluid from the various body openings and the symptoms get worse if you start to become dehydrated. Drink plenty of water. Solutions that contain salt and sugar are also useful, but beware of beverages that contain caffeine, as they aggravate diarrhea. A bottle of water with a pinch of salt and a generous portion of sugar stirred into it is ideal, even if it does not taste very good.

Ta inga medicines for diarrhea or antiemetics. These medications will only keep the disease in the body and you risk turning (relatively) harmless food poisoning into something much worse. A doctor may prescribe antibiotics in severe cases, but this is usually excessive.

In the coming days, it is noticeable that the appetite has largely disappeared. You should not force food, but you must make sure to refill with liquid: water (boiled, if not bottled), weak tea (sweetened), soda without carbonation and a little diluted fruit juice are all good (but avoid C- vitamin). Drinking a glass or two until it stops flowing out the other end should prevent dehydration. You can buy fluid replacementsolutions from the pharmacy, but they are basically the same as a teaspoon of sugar, a teaspoon of salt and a little seasoning that you pour into a glass of water. Choose drinks that are at room temperature.

If you want to eat something, you should stick to mild, stomach-friendly foods such as rice, porridge, biscuits and bread. Keep in mind, however, that food for the body is also food for the bacteria that have created the problems, so you have to take it easy and stop if you feel worse. Dairy products should be avoided in the beginning as these delay recovery. Under no circumstances should alcohol be drunk. You should also not eat large amounts of food to compensate for the last few days, but instead eat small portions spread throughout the day. You should also avoid fatty products.

Some people notice that - to counteract or treat mild forms of food poisoning - yogurt helps. It is a bacterial culture; the hope is that the benign yogurt bacterium overpowers the bad. Do not test for acute illness; you will just vomit up the yoghurt and feel even worse.

Complications

Sometimes ordinary food poisoning can turn into (or be) something worse. If you have reason to suspect any of these alternatives, you must seek medical attention, because each of the following conditions requires medical attention.

Cholera

Cholera is an extreme form of diarrhea caused by Vibrio choleraethe bacterium, and is identified by streams of watery stools with white splashes of mucus ("rice water stool"), up to 20 liters (20% of one's body weight) in one day. The skin and lips may turn blue or black and the eyes may sink. Failure to treat the disease can lead to death within 24 hours, but with proper treatment and restoration of fluid balance, the risk of death is below 1%. The disease is uncommon, but occurs more on the Indian subcontinent and usually breaks out in epidemics. A vaccine is available, but is not very effective.

Dysentery

Dysentery is an inflammation of the intestines that results in severe diarrhea with blood or was in the stool, often accompanied by fever or severe stomach cramps. This disease is most often found in tropical climates and is closely linked to poor hygiene. It is still a terrible and deadly disease in much of the Third World, but can be easily treated with modern medicine. There are two major causes of the disease:

• Bacterial dysentery (shigellosis), caused by Shigellathe bacteria. It is transmitted by contact with feces and has an incubation period of 12-50 hours.
• Amoebic dysentery (amoebiasis), caused by Entamoeba histolytica. It is transmitted through contaminated water and can linger in the body for a long time. It only occurs after several weeks or months.

Dysentery can be identified by a stool test, but distinguishing between the amoebic and the bacterial variant can take 48 hours, so you often start medication for both at once. The condition can usually be cured within five days of antibiotic treatment (for bacterial) or treatment with metronidazole (for amoebic), and hospitalization is usually only necessary if you have lost extremely much fluid. The feces of dysentery patients can be highly contagious, so regular hand washing for caregivers is necessary.

Gastroenteritis

This is a viral infection of the stomach tissue (gastric catarrh) or in the small intestine (intestinal catarrh) that causes abdominal pain and frequent watery stools. The disease is spread through contaminated water, including shellfish in that water, and typical causes include rotavirus, norovirus, adenovirus, sapovirus, and astrovirus. The main treatment is to restore the fluid level and most cases resolve themselves. Antibiotics work not, but can in severe cases be used to prevent further complications.

Giardia infection

Also known as beaver fever this disease can be described with explosive diarrhea and foul-smelling gas in the stomach, which often begins 1-2 weeks after the infection and reappears in cycles. The reason is Giardia lamblia, a protozoan (unicellular animal), which is infected through contact with feces, and often affects people who have drunk untreated water.

Two thirds carry the infection without it breaking out. A clue to becoming infected may be that you start belching, smelling gas reminiscent of rotten eggs. Once the disease has been identified, it can be treated with a single dose of tinidazole, and the symptoms usually go away after just 24 hours.