Research highlights traveller's diarrhoea 'hotspots'

14 December 2010

With the winter sun holiday season now upon us, research published today by the Health Protection Agency (HPA) has revealed that the top five countries where travellers from England, Wales and Northern Ireland are most likely to acquire gastrointestinal infection following their visit are Egypt, India, Thailand, Pakistan, and Morocco.

The report called Foreign travel-associated illness - a focus on travellers' diarrhoea also revealed that half of the 24,322 laboratory confirmed cases of gastrointestinal infection reported in those who had recently travelled abroad between 2004 and 2008 were caused by salmonella. Other bacteria such as campylobacter and shigella and organisms such as giardia and cryptosporidium were also reported. 

There are several factors which can affect a person's risk of acquiring travellers' diarrhoea while abroad:

• Destination of visit. Although gastrointestinal infections occur worldwide, some are more common in countries or areas where there is a lack of sanitation and access to clean water. The world can be divided into three different risk zones for risk of travellers diarrhoea:
  - Low risk: western Europe, USA, Canada, Japan, Australia and New Zealand. 
  - Medium risk: southern Europe, Israel, South Africa, some Caribbean islands and the Pacific. 
  - High risk: Africa, Latin America, the Middle East and most parts of Asia.
• Hygiene standards at accommodation (including swimming pools)
• Hygiene standards at eating establishments
• The personal hygiene of the traveller and the individual's health or susceptibility to infection - underlying ill health or certain illnesses may increase the risk of infection and make illness more severe.

Dr Jane Jones, a travel health expert with the HPA said: "There are measures people can take to protect themselves while they are away and it is also important that travel health specialists and the travel industry work together to increase awareness of travellers' diarrhoea and to actively promote prevention strategies in high risk destinations. 

"We know from studies that travellers may not follow health advice consistently while abroad. Personal hygiene and precautionary measures against food and water borne illness are important at all times anywhere, but particularly when travelling to countries with less robust sanitary infrastructure than the UK. Taking sensible precautions such as avoiding tap water and ensuring food is properly cooked will help to keep a holiday at any time of the year both enjoyable and healthy."

Ends

Note to Editors

Estimated rates of laboratory-confirmed gastrointestinal illness per 100,000 visits abroad by residents of England, Wales and Northern Ireland: 2008

Country of travel	Cases of GI illness	Visits by EWNI residents	Rate/100,000 visits
ONS top ten
Spain	398	12,355,463	3.22
France	63	10,036,285	0.63
United States	16	3,533,399	0.45
Italy	30	3,022,893	0.99
Ireland	7	2,784,490	0.25
Germany	8	2,429,168	0.33
Greece	140	1,984,125	7.06
Portugal	130	1,970,281	6.60
Netherlands	4	1,843,086	0.22
Turkey	379	1,722,029	22.01
Other popular destinations
Egypt	519	633,541	81.92
India	581	895,943	64.85
Thailand	231	358,158	64.50
Pakistan	226	375,667	60.16
Morocco	164	406,789	40.32
Kenya	63	157,093	40.10
Tunisia	115	334,445	34.39
Mexico	38	283,807	13.39
Malta	41	477,450	8.59
Cyprus	75	1,154,658	6.50

Foreign travel-associated illness - a focus on travellers' diarrhoea - the full report is available from: http://www.hpa.org.uk/Publications/InfectiousDiseases/TravelHealth/ 

Advice for travellers on avoiding gastrointestinal illness

• No vaccine is available in the UK to prevent travellers' diarrhoea.
• Wash your hands after using the toilet and before eating or preparing food; if soap and water is not available, carry alcohol hand gel with you.
• Investigate the destination before you go; is the tap water safe to drink? If it is not, then do not drink it or use it for cleaning your teeth. Avoid ice in drinks.
• Make sure any food you eat has been recently prepared, is properly cooked and piping hot. Avoid raw fruit and vegetables unless you know they have been washed in clean water or peeled yourself. More information about food and water hygiene is available from the National Travel Health Network and Centre (NaTHNaC): http://www.nathnac.org/travel/misc/travellers_food.htm.
• Practise good swimming pool hygiene. Do not swim if you have diarrhoea and make sure any babies and young children wear suitable swimwear while in the pool. Take care not to swallow any swimming pool water.
• See the NaTHNaC health information sheet on travellers' diarrhoea for more information about prevention and options for treatment: http://www.nathnac.org/travel/misc/travellers_dir.htm#preve

For media enquiries please contact the HPA press office on 020 8327 6647/7098/7751 or out of hours the duty press officer on 020 8200 4400.

 

Updated 12 January 2011 14:07

Last reviewed: 25 February 2011