Traveler’s diarrhea

I see a lot of pre travel patients in our Vancouver Travel Clinic and this article advice is very good. I add a hydration handout for patients if required, especially for parents travelling with young kids. I mention that Pepto Bismol contains aspirin and bismuth. We have handouts for use of azithomycin, now preferred due to quinolone resistant Campylobacter (SE Asia) and I check that there are no concerns about raised QT or arrhythmias or drug interactions in these patients. They should also be instructed on use of antibiotic, that it can be stopped if the diarrhea resolves, and the other causes of diarrhea such as Norwalk (common on cruise ships) ,and toxins such as E Coli 0157 for whom antibiotic use is contraindicated. For the latter, and any ongoing bloody diarrhea with/without fever urgent medical care may be needed.
The use of one time use of plastic bottles is contributing to plastic waste. I urge travellers to travel with a litre bottle, filter system and water disinfectant tablets so they can prepare clean water themselves, and to consider boiling water when possible in their accommodation.