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heading out of canada? here's how to avoid some common travel illnesses (that aren't covid)

hookworm and diarrhea are just two common travel-related illnesses that can take the magic out of any trip.

by robin roberts

published dec 07, 2022

6 minute read

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6 minute read

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it's worth mentioning again: hand sanitizer

"well on your way" is a booklet from the canadian government that covers how to handle a health emergency while abroad. getty

most canadians stayed hunkered by the home fires during the pandemic, but now, as travel restrictions have eased, so too have worries about globe-trotting. health agencies, however, advise packing some preventative measures along with that sunscreen and bug spray to avoid returning home with a nasty souvenir. the canadian government created a booklet, called well on your way, which covers health risks, precautions, and dealing with a health emergency abroad to carry along with your guidebooks. here are some potential maladies to avoid.

traveller’s diarrhea

the most common condition affecting international travellers is gastrointestinal illness, caused by bacteria (including e. coli and salmonella), viruses (norovirus and rotavirus), or parasites (such as giardia and cyclospora) found in contaminated food or water.

high risk destinations include central and south america, mexico, africa, the middle east and asia. “in canada, if you get diarrhea, there’s a 90 per cent chance it’s caused by a virus, so you wouldn’t be prescribed antibiotics,” says dr. ashleigh mccullagh-cheung, assistant clinical professor, department of family medicine at mcmaster university. “in lower and middle income countries with warmer weather and maybe poor hygiene standards, there’s a 90 per cent chance it’s bacteria. so it’s often a good idea to bring a course of antibiotics or imodium.”

in addition to diarrhea, symptoms can include fever, nausea, vomiting, bloating, and cramping. since you can lose a lot of fluids through diarrhea, it’s important to replace them by drinking bottled water. symptoms usually only last a few days, but if they do persist, or if you have blood in your stool, it’s best to see a health care professional.

you can minimize your risk by being vigilant about the food and water you consume (or brush your teeth with), washing your hands frequently and using hand sanitizer.

illnesses from insects

although zika virus is on the decline, malaria, dengue fever, and tick-borne encephalitis (tbe), transmitted by infected insects such as mosquitoes, ticks, fleas or flies, are still a concern.

according to health canada, malaria is a serious and sometimes fatal disease caused by an infected mosquito, mostly found in parts of africa, south asia, central and south america, the caribbean and the middle east. symptoms begin 10 days to four weeks after infection but can take up to a year, and can mimic the flu (although it’s not contagious), with fever, headache, muscle aches, fatigue, chills, nausea, vomiting, and diarrhea. untreated, it can lead to kidney failure, coma and death.

there is no vaccine for malaria, but there are antimalarial drugs. check with your doctor to determine the type and dose.

dengue fever is a viral disease spread by infected mosquitoes and, like malaria, can cause severe flu-like symptoms. outbreaks are increasingly common in tropical and subtropical regions, and there is currently no vaccine or treatment. it can also be life-threatening if untreated, but will typically last two to seven days.

according to the world health organization, tbe is a viral infection of the central nervous system found in many parts of europe, northern china, mongolia and russia. caused by an infected tick or from consuming unpasteurized dairy products from infected animals, there is a vaccine available if you’re spending extended periods in endemic areas. most people have no symptoms, others have fever, aches, loss of appetite, headache, nausea and vomiting. some develop swelling of the brain, which can be deadly.

use bug spray on skin, clothes and camping gear, wear long-sleeved shirts and long pants, know where the ticks hang out and avoid them. if you find one, remove it carefully and promptly.

chikungunya virus is also spread by an infected mosquito, and its symptoms are also similar to the flu. outbreaks have been recorded in some african and asian countries, as well as the americas, europe, and the caribbean. there is no vaccine, so it’s essential to use bug spray and cover up.

yellow fever is a virus spread by mosquitoes in parts of south america and africa that usually has no or mild symptoms of fever, chills, headache, muscle aches, but some people can develop serious illness, including jaundice, organ failure and death. fortunately, there is a vaccine.

food and water-borne illness

norovirus, salmonella, e. coli, giardia, listeria, campylobacter and hepatitis a are all examples of illnesses transmitted through contaminated food and water. found in some countries in africa, southeast asia and the eastern mediterranean, these illnesses are caused by using unsafe water for cleaning and processing food, or by tiny particles of feces or vomit that find their way into food or water.

norovirus is highly contagious, with symptoms that include vomiting and diarrhea that starts suddenly. there’s no treatment so you have to ride it out for the few days it lasts, and drink plenty of fluids.

salmonella has similar symptoms, and is transmitted through foods contaminated with animal feces. it can last up to a week and may need no treatment, unless it’s severe, in which case antibiotics are typically prescribed.

e. coli are bacteria found in the environment, foods and intestines of people and animals. most are harmless, some can cause diarrhea, urinary tract infections and pneumonia. one particularly bad strain can lead to acute kidney failure in children and older adults. infections are transmitted through undercooked meat, unpasteurized milk, fruit juices, as well as yogurt and cheese made from raw milk, and through fruits and vegetables contaminated by tainted water.

giardia is caused by a parasite transmitted through the feces of infected people or animals, through unsafe food and water, and from contaminated surfaces. diarrhea and nausea symptoms usually last from two to six weeks, and anti-parasitic medications can help.

hepatitis a is a virus that lurks in the stool and blood of infected people and is very contagious. it’s spread through contaminated food and water and causes fatigue, nausea, stomach pain, and jaundice for a few weeks to several months. it can also cause inflammation of the liver, which can be serious for older people and those with other health issues. avoid contamination and get vaccinated.

foot infections

strolling barefoot on a tropical beach is the stuff of dreams, but in some areas, parasitic hookworms can be a nightmare. “when you walk in the sand where a stray animal that has not been dewormed has pooped, you can get nasty rashes on the feet,” says mccullagh-cheung, who also runs the clinic travel health md in hamilton, ont.

according to the cdc, hookworm larva can penetrate your skin causing severe itchiness and raised red lines.

because humans aren’t the normal hosts for these hookworms, the parasites usually don’t live more than six weeks and symptoms will go away on their own.

another infection caused by parasitic worms is schistosomiasis, also known as bilharzia. mccullagh-cheung says canadians wouldn’t necessarily be at risk, as the parasites that cause schistosomiasis live in certain types of freshwater snails in parts of africa, south america, the caribbean, asia and the middle east.

what if you need medical help when you are away?

if you do find yourself in need of medical attention while in a foreign country, go to the nearest hospital, or contact the nearest canadian government office which can provide a list of local physicians, clinics and hospitals.

you can also check with a major tourist hotel, since they almost always have an in-house doctor who can treat you or arrange appointments with local physicians.

mccullagh-cheung also posts resources on her site, and recommends a podcast called polaris travel health, which highlights regions around the world and their potential health risks.

the canadian government recommends following the three r’s of international travel: research the health risks, safety and security of your destination; register with canadians abroad to be contacted in case of emergency; and reach the nearest embassy or consulate for help.

robin roberts is a vancouver-based writer.

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robin roberts

heading out of canada? here's how to avoid some common travel illnesses (that aren't covid)