2. CDC information on making water "safer" is here. Additionally, one of the participants found these tablets which say they will purify the water and kill microorganisms. Sodium dichloroisocyanurate is the active ingredient. You can also find these at other online stores as well as some brick & mortar establishments. This post is purely for informational purposes and is not an endorsement of this product.
3. Here's another website with information about traveler's diarrhea.
4. Below is information on ways to prevent/treat stomach issues that may arise on the trip.
In regions where invasive pathogens
are responsible for a significant proportion of traveler’s diarrhea, quinolones
should be used. Azithromycin (Zithromax) is recommended in places where
quinoloneresistant Campylobacter is prevalent (e.g., Thailand). Antibiotics used for the treatment of traveler’s diarrhea are listed in below. Trimethoprim-sulfamethoxazole (Bactrim, Septra) and doxycycline are no longer
recommended because of the development of widespread resistance.
Antibiotics Used for the Treatment of Traveler’s Diarrhea
Antibiotic
|
Dosage
|
Comments
|
Ciprofloxacin (Cipro)
|
500 mg twice daily for one to
three days
|
Other quinolones (e.g., ofloxacin
[Floxin], norfloxacin [Noroxin], and levofloxacin [Levaquin]) are presumed to
be effective as well.
|
Rifaximin (Xifaxan)
|
200 mg three times daily for three
days
|
Not effective in persons with
dysentery
|
Azithromycin (Zithromax)
|
In adults: 500 mg daily for one to
three days or 1,000 mg in a single dose In children: 10 mg per kg daily for three days
|
Antibiotic of choice in children
and pregnant women, and for quinolone-resistant Campylobacter
|
Information from references
Therapy that involves an antibiotic
with loperamide (Imodium) often limits symptoms to one day. Loperamide has antimotility and antisecretory effects and is taken as two 2–mg
tablets after the first loose stool, followed by one tablet after each
subsequent loose stool (maximum of 8 mg in 24 hours for two days). The use of
loperamide in dysentery has been controversial because of concerns about
prolonging illness, but it is now considered safe when combined with an
antibiotic. A conservative approach would be to use loperamide for dysentery only if
combined with an antibiotic and if the traveler has a long trip or will have no
toilet access.
Oral rehydration solutions generally
are unnecessary in adults younger than 65 years. However, all travelers with diarrhea should be encouraged to drink plenty of
fluids and to replace lost electrolytes using foods such as salt crackers or
broth.
Traveler’s Diarrhea in Children and Pregnant Women
Traveler’s diarrhea is more common
in young children than in adults, and they have a higher risk of dehydration
and severe illness. Parents should seek immediate medical attention if their child shows signs of
moderate to severe dehydration, bloody diarrhea, a temperature higher than 39°C
(102°F), or persistent vomiting. Few data exist on the treatment of diarrhea in
children. The use of oral rehydration solutions is essential, and parents
should include prepackaged packets (to be mixed with safe water) in their
travel kits. These packets are available in camping stores in the United States
or in pharmacies in other countries.
Fluoroquinolones are not approved by
the U.S. Food and Drug Administration (FDA) for use in children, and rifaximin
is approved only for children 12 years and older. Therefore, azithromycin is
the drug of choice for most children with traveler’s diarrhea. Another option is nalidixic acid (Neggram) in a dosage of 55 mg per kg per day
divided into four doses, not to exceed 1 g in 24 hours. Loperamide is approved for children older than two years, but should not be
used in children with dysentery. Bismuth subsalicylate should be avoided for
prophylaxis in children because of the possible risk of Reye’s syndrome.
Pregnant women may be at higher risk
of traveler’s diarrhea than nonpregnant women because of lowered gastric
acidity and increased gastrointestinal transit time. Quinolones (FDA pregnancy category C) generally are not advised during
pregnancy, but azithromycin (FDA pregnancy category B) is safe. Oral rehydration
should be emphasized. Although rifaximin is not absorbed, the safety of this
medication in pregnant women has not been established. Loperamide (FDA
pregnancy category B) may be used, but bismuth subsalicylate (FDA pregnancy
category D) should be avoided. Being careful with food and water is
particularly important during pregnancy because infections such as listeriosis
can cause miscarriage, and hepatitis E can result in maternal mortality.
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