Getting Sick while Traveling: Dos and Donts to Minimize the Risk

Getting Sick while Traveling: Dos and Donts to Minimize the Risk

September 9, 2018 Plan 2

If you Google “how not to get sick when traveling”, you’re bound to get many results and each post offering their own dos and donts and some might leave you with such fear that you start to question whether or not you want to go on the trip at all! Before you call the airline or your travel agent to cancel, you need to understand that there are so many factors at play and in our experience, there is no sure way to avoid getting sick abroad, just like there is no sure way to avoid getting sick when at home. In some cases, it’s what you least expect that will make sick! In this post, we will share some of our experiences and some tips to help you stay healthy while traveling abroad.

What makes people sick?

Anything from contaminated food to water, bug bites, swimming in water with bacteria, and contact from touching things like money and food. Travel in general can weaken the immune system and make you more susceptible to contagious things like colds and the flu.

The most luxurious of toilets, the Toto

From our experience, here are the most common symptoms we’ve suffered through: chills, nausea, vomiting, diarrhea, stomach cramps and general unease, dizziness, fatigue, headaches, bloating, and confusion.

Street Food:

Jason and I love eating street food and so for us, it is difficult to avoid altogether even if some guides recommend avoiding it. We do take precautions and only eat at places where there have been positive reviews and there is high-turnover of food. It also helps to have local guides who will take you around if you’re unfamiliar and generally, cooked items are safer than raw items. I have an irrational fear of getting sick from my beloved cilantro but can you really have a banh mi or a taco without cilantro? To me, cilantro is worth the risk and I’m hoping luck is on my side as it has been so far!

Al pastor tacos with a beer at El Fogon

Al pastor tacos with a beer at El Fogon

When we were in Chiang Mai, we set out to find a local market to purchase some sua da (spicy thai sausage) to take back to our hotel for an afternoon snack. Thankfully, we had been there previously with a guide and so we felt comfortable going back on our own and ordering it. This is the type of thing that makes our parents think we’re slightly crazy but we feel that one would be crazy not to try it!

Sai ua at Mae Hia Market in Chiang Mai

Once, we were in Munich and the only thing I ate that Jason didn’t was a currywurst from the train station and then I was sick with stomach pains and diarrhea for 24 hours after. You wouldn’t think this would happen somewhere like Germany, but it can. We suspect the ketchup dispenser that was accessible to everyone but we will never know.

Hotel Food:

In many cases, people feel that hotel food is safer than street food and that might be a valid point, especially if you are staying in a luxury hotel. That being said, there are times early on in our travels when we only ate hotel food and still got sick. On a trip to Bali with family, we pretty much all ate the local food on the menu for room service except one person who ordered a Caesar salad and spaghetti and meatballs and the person who ate the non-local food got sick. One would like to think that staff get proper training in food handling and safety but when it comes to foreign food, it might be best to stay with local options since those are more familiar to staff.

Ceviche at Playa Escondida

Ceviche at Playa Escondida

On the flipside, when we visited Sayulita in Mexico, we only ate at the hotel we were staying at, Playa Escondida based on information we read about the infamous Sayulita sickness that claims more prisoners than not. At Playa Escondida, we enjoyed things we wouldn’t have been brave enough to enjoy in town, such as agua chiles (raw shrimps cooked in lemon juice and chilies) and ceviche (raw fish cooked in lemon juice and chilies). We did not get sick, thankfully!

Salad:

We are salad lovers and as much as we love to visit and travel to South East Asia and Mexico, we miss eating salads as part of our daily meals. Some of my Mexican friends even avoid eating salad in Mexico if they didn’t wash the lettuce themselves and have expressed that concern to me on multiple occasions which leads me to believe foodborne illness from salad is common. I am not saying to avoid salad together but assess the risk and choose where you will have one wisely.

Thali salad from Poonie's Kitchen in Galle Fort

Thali salad from Poonie’s Kitchen in Galle Fort

Delicious salad bowl from Sister Srey in Siem Reap Cambodia

Delicious salad bowl from Sister Srey in Siem Reap Cambodia

In my experience, small local cafes that specialize in raw and vegan food are lower risk. Jason rolled his eyes when I ordered a salad at Sister Srey in Siem Riep Cambodia but it was so good and since I didn’t get sick, we both had one a couple of days later! We also have no regrets about one of the best salad’s we’ve ever had in our lives from Poonie’s Kitchen in Galle Sri Lanka either!

Water/Ice:

Since we need water for so many different reasons, this is the by far the one most likely to make you sick; from using water to brush our teeth and wash our bodies to it being used to clean the food we eat and the dishes they’re served in, it’s hard to be 100% careful. I think some of us remember that famous scene when Charlotte opens her mouth in the shower and feels the pain from that mistake after!

Ice is also a concern as you can never really know if it’s been made from “safe” filtered water. I’ve even used napkins to wipe off any drink containers that were stored in a cooler with ice as a precaution and/or have used a disposable straw sometimes. I recall a particular meltdown when I ordered a mojito at a fancy hotel in Bangkok and was scared to drink it because of the ice in it, which Jason thought was entertaining and a little over-the-top (guilty-as charged!).

Ais Tingkap at the Window Sherbet

Ais Tingkap at the Window Sherbet (Penang, Malaysia)

At home, we usually use reusable water bottles for water but in places where it is not safe to drink the tap water, we often opt for plastic bottles because we’d need to buy water from a plastic bottle to properly clean the reusable bottle anyways. Thankfully, some hotels now have filtered water machines which makes it easier to refill reusable bottles and clean them.

Margarita 90 pesos and a Corona was 55 pesos at the beach bar

Margarita with ice and Corona with lime

Even in places where it is safe to drink tap water like Barbados, we opt for bottle water most of the time because you never know what’s in the pipes. In Barbados and other places where tap water is safe, we use the tap water for tooth brushing, and washing (dishes and produce). I have on occasion drank tap water and was fine though!

Airline/Hotel Lounges:

One would assume that airline lounge food is safe, right? Well, it should be but it isn’t always the case and you should exercise some caution. When in doubt, we don’t eat it and stay away from things that are just left out and can be known to cause problems, i.e. salads, things with fish in them like sushi, and deli meats. We often just stick to the warm dishes like soup, rice, and noodles if possible. There will never be any way to know if the jicama sticks I ate at the lounge in Los Cabos Airport caused me to experience severe symptoms of food poisoning but it’s not a risk I’ll be taking again anytime in the future.

Cold buffet

Cold buffet at the Sky Team Lounge at YVR

Dan-dan noodles at The Pier at HKG

Dan-dan noodles at the Cathay Pacific Pier Lounge in HKG

When we were in Nha Trang, Vietnam, we ate at the hotel lounge daily for breakfast and dinner and by day 2, I was not feeling well and had to cancel a whole day’s worth of activities to hang out in the bathroom on the floor to be close to the toilet (thankfully, we were upgraded to a suite and had a second bathroom for Jason to use). Obviously, we cannot pinpoint what it was exactly but I ate raw vegetables every day, including salads which is the likely culprit but it could have been anything else.

Cooking for Yourself:

Cooking for yourself is generally a safer option if you have basic knowledge of food safety and handling. We’ve picked up fish, meat, produce and other items to make meals in Mexico, Argentina, Barbados, Australia, St Maartens, and France. In some cases, we went to local markets and other times more conventional grocery stores. For the most part, we have been fine and only experienced mild symptoms in Barbados and Mexico, most likely to herbs and vegetables or sprouts that should have been cleaned/washed better.

Grocery store purchases

Grocery store purchases in Barbados

Tips:

Based on our experience, it’s almost 100% impossible to avoid getting sick or experiencing discomfort as a result of food and beverage while traveling because it is also impossible to do so when you’re at home. If there is any silver lining in all of our years of travel, it’s that we seem to be doing better now than we have in the past (*knock on wood). Here are some theories:

  • We’re becoming more immune: Perhaps our stomachs have been subjected to more bacteria and have developed a better immunity as a result of all our illnesses. We’ve often joked about exposing ourselves to as much sketchy stuff as possible to hopefully survive and emerge stronger and more resilient but on short trips, this is not an option!
  • Dukoral Vaccine: Dukoral is an oral vaccine that helps “provide protection against diarrhea caused by heat-labile toxin producing enterotoxigenic E. coli”. We take a booster of Dukoral once or twice per year.
  • Probiotic and Fermented Foods: We have also increased the amount of probiotic foods we eat/drink as I make kombucha, kimchi, sauerkraut and we have apple cider vinegar, kefir, tempeh, and yogurt almost daily.
  • Better Habits: I’m not saying we’ve been negligent but we’ve gotten better at not handling money before touching food. Not using the reusable water bottle may also have helped. I also don’t eat salad anywhere and everywhere to follow my meal plan from home abroad. After not eating vegetables for a week in Chile, I cooked and ate a bag of frozen broccoli in Argentina to satisfy the veggie craving vs making a salad with raw veggies.
  • Risk vs Reward: When in doubt, don’t eat it or drink it. When were stranded at a makeshift bus stop in Malaysia for hours without food, we chose to starve rather than purchasing the food that was sitting there in the heat and sun, uncovered and being devoured by flies as it seemed risky and not worth the risk. We have also decided not to eat at restaurants and food stalls on our list upon getting there, scoping it out and feeling uncomfortable even in cases where the place got good reviews.
  • Pack Emergency Snacks: Jason makes fun of me, but 1/3 of my bag is now dedicated to snacks such as protein bars and packets, fig bars, electrolyte powder, individual servings of nuts, and instant oatmeal to have something to eat at all times as a mitigation to avoid impulsive and risky food decisions out of hanger and anxiety.

Final Thoughts:

When we were Istanbul, we weren’t as brave as Anthony Bourdain who after eating mussels with rice from a street vendor made the comment that “People don’t stay in business long if they make their neighbors sick”. In the end, we would have probably been fine but mussels and rice wasn’t something we were that interested in having so we didn’t take a chance.

Banh Mi 37

Banh Mi 37 in Ho Chi Minh City

I’ve also had many friends lament about getting sick from eating food and drinking fruit juice on a certain airline and it’s really hard to check the validity of those claims but it does have me hesitant to eat and drink freely when we fly on this airline. It should be noted that we’ve flown on this airline 5 times and any illness or discomfort we have felt would be very difficult to attribute to them due to all the other things we ate and drank before and after the flights.

Mercan's Balikcilik: balk ekmek stand on a boat in Istanbul

Mercan’s Balikcilik: balk ekmek stand on a boat in Istanbul

Sometimes, it might not be what you ate or drank or how your stomach and system respond to it; over-consumption of alcohol, salty, and fatty foods can make you feel terrible, especially if you’re on an airplane. Add eating spicy foods, jet-lag, and being dehydrated to the list and you are left with a plethora of suspects, with no real clues as at what happen but a theory. Another less talked about culprit is how the pressurization of the cabin can make gas expand in the GI tract and cause severe cramping in some individuals and the effects can bother people for up to 24 hours after you’ve landed.

Babi Guling and Bintang Beer at Ibu Oka in Ubud Bali

Babi Guling and Bintang Beer at Ibu Oka in Ubud Bali

We would be lying if we said we don’t worry but in the end, we’ve had some unique meals and experiences that are truly memorable and a big part of why we travel. If there is one trend that seems common, especially in the Newsweek interview with Anthony Bourdain in 2016 it’s that eating local food in busy places does seem to be less risky and anyone wanting a Caesar salad or cheeseburger should wait until they are back home!

Have you gotten sick while traveling? If so, do you know what it was? Do you stick to local food? Do you only eat at the hotel? Any tips or stories to share?

Relevant Posts:

2 Responses

  1. Erin says:

    Somehow my husband and I were able to spend 3 weeks in India and not get sick! I was shocked frankly, I just took it as a given despite our precautions, we still would. But perhaps our tricks worked this time around. We mostly follow the same rules you do – I hate not having fresh vegetables, but try to avoid anything raw if the water isn’t clean. But I agree it’s hard not being able to experience the local food (or cocktails!) when you’re afraid of the safety – it’s all about the risk/reward trade off. The only other thing we have for water is bringing with us a Steripen, just in case we don’t have access to bottled water. Good tips!

    • Maxine says:

      3 weeks in India without getting sick is impressive!! We thought we’d get sick in Sri Lanka and didn’t. Thanks for the tip about then Steripen, might be a good item to pack in our hiking bag!

Leave a Reply

Your email address will not be published. Required fields are marked *