BY: Terence Lee

Two Singaporeans fell mysteriously ill about three months after returning from a trip to Saudi Arabia in December.

The probable cause: drinking brucella-laced camel's milk, fresh from the camel itself. Brucella is a type of bacteria.
"Just because a food is fresh doesn't mean it's safe," said Dr Lim Poh Lian, senior consultant of the department of infectious diseases at Tan Tock Seng Hospital.

This is especially true for those who travel to countries where standards of hygiene may be lower than their home countries. They could risk contracting illnesses from bacteria, parasites and viruses which may be hidden in food there.

According to the United States Centers for Disease Control and Prevention website, some of the possible illnesses contractable include traveller's diarrhoea - which can be caused by a wide variety of bacteria and parasites - and hepatitis A. Other less common illnesses include typhoid fever, cholera and stomach flu.

While traveller's diarrhoea is widespread, it is non-lethal and self-limiting. However, illnesses like cholera and hepatitis A are potentially deadly.

Dr Lim advised travellers to avoid raw and poorly cooked cuisine, especially street food. Unpasteurised dairy products and half-boiled eggs must also be avoided.

Avoid having ice in your drinks too because the water might have come from a standpipe which spouted faecally contaminated water. However, you could still get diarrhoea even if you ate only well-cooked food. This includes food that has been left standing for a long time, like at a buffet.

"It's okay to try street food if you're a 30-something single travelling alone on vacation. But if you have a 71-year-old mother with diabetes and weak health, reconsider," she added.

Dr Manik Imsiroviv, a general practitioner from Mel & Partners, offered a guideline for eating overseas: "Cook it, boil it, peel it or chuck it."

That is, trust only yourself or your fellow travellers when it comes to opening a bottle of water or peeling your own fruits. And wash your hands, not with tap water but a sanitiser.

In the event that diarrhoea does occur, the best thing to do is to just let it pass. Also, drink more fluids to avoid dehydration and eat only if you are hungry.

According to Dr Imsiroviv, most traveller's diarrhoea cases will pass within two to three days without medication. Antibiotics are needed only in more serious cases like bloody diarrhoea caused by the salmonella and shigella bacteria.

Dr Lin Kai Wei, a family physician from International Medical Clinic, advised travellers to take an additional measure: vaccinate themselves before they go on a trip.

He recommended the hepatitis A vaccine as a minimum, but a typhoid shot is also good for added assurance.

However, while these vaccines may prevent the onset of certain illnesses, it is still no substitute for being careful while travelling.

This article was first published in Mind Your Body, The Straits Times on July 2, 2008.