Safe Eating While Traveling Abroad

[Malawry]

FWIW, Chris the Infamous Sanitation Instructor taught my class that taking acid reducer medications on an ongoing basis will lead to a decreased ability for your stomach to kill bugs before they can get to work on you. Apparently, stomach acids kill quite a percentage of the nasties before they get to your small intestine and can enter your bloodstream. This doesn't mean you can't take acid reducers, but it means that if you rely on them you need to be that much more careful about what you eat and drink at home and while on the road.

This is also true of pregnant women, the elderly, the very young, and those with compromised immune systems, yadda yadda.

[Jaymes]

JAYMES -- So  feel free to tell me to go piss up a rope for my inexactitude.

Golly - can you do that?

I'll admit, I would like to see it.

[Tonyfinch]

Actually the idea that some countries are "cleaner" than others food wise may be a myth.

In the UK, for example,despite ever more stringent hygeine and food safety regulations,we have had more food related illness outbreaks in the last decade than in any I can remember-listeria, botulism, mad cow disease, as well as lots of less serious illnesses and complaints.

Widerspread refrigeration encourages the long term storage of food way beyond any time it would be stored in a hot country without universal refrigeration. Similarly with freezing. Many problems are caused by incomplete thawing after lengthy freezing. Food does deteriorate,albeit slowly,in the freezer but many are under the impression that they can freeze foods for ages.

Total and thorough handwashing after the toilet is LESS likely to be universal in countries where everyone uses toilet paper. When I was in rural Pakistan and using the old left hand to clean myself, handwashing was amazingly rigourous and thorough amongst everyone,including children.Eating with the hands, considered "rude" by many in the West, is, in fact,less likely to cause you problems than knives and forks which might have been slopped around in dirty water and may contain residual food or bleaches used in the washing process.

In the supposedly hygeinic West we eat far more foods which contain potentially harmful products than they do in poorer countries-artificial additives,preservatives,colourings,"flavour enhancers" etc etc.

We also eat a lot more uncooked or partially cooked food. I like my beef and lamb "rare" but potential problems from undercooked meat are far more likely than from a piece which might have had flies on it at the market stall but which is served up totally and thoroughly cooked. Cheese riddled with bacteria is considered delectable in the West but has reportedly been the source of many outbreaks of food related illnesses. Many Eastern countries find cheese repulsive.

So I'm not sure we can make assumptions that just because a place doesn't appear to be as "clean" as the sanitised West,we are more likely to get ill from the food.

[mamster]

Tonyfinch, as Bourdain said, I'm a huge proponent of eating meals on the street. I can go on at interminable length about the great meals (especially breakfasts) I've had on the streets of Bangkok, about how I would stop on the way to lunch in the rain to get papaya salad from my favorite vendor.

The nuance you're missing, however, is that one place can have far more food poisoning than another, but food poisoning will still be relatively rare in both places; you just don't get poisoned at every meal even in a real hellhole. Thailand (this is just the example I know best, and it's no hellhole) faces serious problems with food-borne illness, way beyond the occasional E. coli outbreak we get in the US or UK. Perhaps you've seen the billboards in northeast Thailand that say (in Thai), "Isaan doesn't eat raw fish!" (wishful thinking, that) because so many people get liver fluke from eating the delicious homemade fish paste pla raa.

I don't want it to sound like I'm being a party-pooper here, and I agree completely that you are no more likely to catch something on the street than in a restaurant. I got mildly sick the first time we went to Thailand, but since I was eating constantly, I don't know what got me--maybe just the benign local flora.

For me, the choice is easy: when I travel, I eat whatever looks good and whatever the locals are eating because that's where the flavor and the fun is. I'm absorbing some level of risk this way, but I'm young and healthy and my immune system kicks ass. If I were immune compromised for one reason or another, I would probably tread with greater care. Then again, other than sticking to overcooked American fast food, I don't know what you can do other than use your vaunted common sense: eat cooked food at places with high turnover and a long line of locals waiting to get in. (I've heard that raw papaya sitting out on a cart all day is a magnet for pathogens, but I'm choosing to ignore this rumor.)

[Beachfan]

Actually the idea that some countries are "cleaner" than others food wise may be a myth.

Infant mortality rates would say otherwise. Having seen people bath in the same stream their livestock defecate in, I'd say there are problems far beyond out of date frozen food.

[Beachfan]

I have been told that the practice of taking a Pepto Bismol daily, or something similar, as a prophylactic can mess up your digestive tract so that you are worse off than had you not.

I've done it for several trips. It has some effect, but mostly color. It wasn't much of a problem.

[Jaymes]

I have been told that the practice of taking a Pepto Bismol daily, or something similar, as a prophylactic can mess up your digestive tract so that you are worse off than had you not.

I've done it for several trips. It has some effect, but mostly color. It wasn't much of a problem.

Golly - Do you mean you poop pink?

[Kim WB]

In 2000, I went with 32 other people on a trip to China, to adopt my beautiful neice. We were in the southern provinces of Nanning and Guanzhou...about 45 miles from the Thai border. Talk about lack of adventure...most of these future parents were crazed about staying healthy in order to care for their new daughters. And without generalizing...but I am..most of the group were the kind of folks who thought the Olive Garden and REd Lobster were high end dining. Smart, caring, loving and able....but diners, they were not. There was only one another couple, from the Portland area, who were as equally interested as I in soaking up the culture and the food...but as a group, we were a conservative bunch, to say the least.

Everyone use bottled water...for drinking, teeth brushing, etc. 75% of the group never opted for a food choice outside the hotel DR...there wre no Hiltons and Hyatts..just Chinese owned luxury palces. There were two sts of parents that, after going out on the streets to a mandatory adoption meeting with their new daughters. would return to the hotel and shower off their stroller with bottled water...not joking. Out of this most conservative group ( which included my highlyt allergic to seafood sister-in-law) at least half suffered from dysentary, nausea and assorted complaints. Personally, I think they went expecting to get it, and did. These were the same set of parents that brought a pharmacy with them when they travelled..and nothing helped.

Now, granted, as only an aunt, with a single parent sister in law determined to be supermom, I knew my role would be limited..so I was more adventurous. Now, after all this info, I can share the true secret of feeling fine in a foreign land: Find the local beer. Drink two when you get there. Drink two before, two during every meal. I think I pickled my food...but seriously, I ate amazing dishes, seafood, meats and poultry, breakfast lunch and dinner. On the second day, I was a little "loose"...hello, with this group, either yours or the baby's BM was a MAJOR subject of conversation...but plowed through and had a great trip..and a great, once in a lifetime culinary adventure.

[Tonyfinch]

Conepts of hygiene are as culturally biased as other cultural concepts.

For example a dog's mouth is one of the most permanently filthy bacteria ridden places on the planet. Yet millions in the West allow their dogs to slobber and snuffle around their kitchens,in and out of their plates and utensils and around their dining rooms. Many feed their dogs dirctly from the table.

The same people go oh how filthy when they see a couple of flies on a piece of meat at a butcher's stall.

[Blue Heron]

For example a dog's mouth is one of the most permanently filthy bacteria ridden places on the planet. Yet millions  in the West allow their dogs to slobber and snuffle around their kitchens,in and out of their plates and utensils and around their dining rooms. Many feed their dogs dirctly from the table.

I thought scientists were still in disagreement about which is cleaner... a dog's mouth or a human's mouth?

My own scientific experiment conducted in Jr. High (or High...I forget which) School biology showed that dogs had less bacteria in their mouths than humans.

[Tonyfinch]

You may well be right but my point is that it is quite common in the West to have dogs around in kitchens and even in restaurants but in large parts of the supposedly "less hygienic" world they would not be allowed within 50 feet of a kitchen.

So which culture is the "cleaner"?

[Scottf]

Yet millions  in the West allow their dogs to slobber and snuffle around their kitchens,in and out of their plates and utensils and around their dining rooms. Many feed their dogs dirctly from the table.

The same people go oh how filthy when they see a couple of flies on a piece of meat at a butcher's stall.

That sums Sam up too a T

[StephenT]

That sums Sam up too a T

Scott, I assume your avatar is representative of your and Sam's relationship?

[Scottf]

Scott, I assume your avatar is representative of your and Sam's relationship? 

Not at all Stephen

[Ellen Shapiro]

Everyone is different in what they can tolerate both at home and away. I have never gotten sick--not in Egypt (I drank the water in Cairo), not in Nepal after countless visits (I've had the water there too on many occasions), not in Africa. I have an iron gut so I know I can get away with whatever I want to eat. So while I'm not "afraid" to eat anything, I'm what I call a "recovering vegetarian." I was a veg. for 12 years and though I now eat meat with abandon I get a little squeamish in developing countries when I see meat lying about on the street and on the ground, etc. I'm a hypocrite as it pertains to meat eating--I can eat it if it's put in front of me but when confronted with the reality of the actual animal and its parts, I find it difficult to consume. For me, abstinence from meat in these countries is not a scientifically based safety precaution but I've still got to wonder: This guy carried this meat in a basket from Tibet to Nepal and now its lying on the ground--who amongst you thinks your gut could withstand this? All the power to you.

[Jinmyo]

Ellen, another great photograph. I wish you would post more of them.

[Jaymes]

This guy carried this meat in a basket from Tibet to Nepal and now its lying on the ground--who amongst you thinks your gut could withstand this? All the power to you.

You're right, Ellen. I'd be far more interested in the textiles behind him.

[Blue Heron]

You may well be right but my point is that it is quite common in the West to have dogs around in kitchens and  even in restaurants but in large parts of the supposedly "less hygienic" world they would not be allowed within 50 feet of a kitchen.

So which culture is the "cleaner"?

That reminds me, not only is our dog in & out of the kitchen, but the cat likes to jump up on the kitchen counter.

Considering all the germs I've been exposed to all these years, it is surprising that I do get sick when traveling to some foreign countries.

Ellen, I also love your pics.

[Tonyfinch]

:

Considering all the germs I've been exposed to all these years, it is surprising that I do get sick when traveling to some foreign countries. 

Which probably confirms the theory that getting ill abroad has nothing to do with hygiene or cleanliness and everything to do with the change in the type and nature of germs and bacteria that you are exposed to.

[stellabella]

Those occasional lonely moments praying for relief on a dirty bathroom floor make the good ones all the more magical.

so many different sets of advice--who's right? those of us who have traveled beyond the mucky-muck have had pretty disparate experiences, and the botton line is that, at least half the time, you can never REALLY know what got you.

when i travel in a developing country i pack a round of cipro and a round of flagyl, pepto-bismol and antacid tablets, advil, anti-bacterial wipes, anti-itch cream and essential oils of peppermint and lavender. i put peppermint oil in a glass of water for upset stomach--save the drugs for anything more serious which fortunately is rare. in ecuador a couple years ago an otavalan woman offered the members of our group hot oregano tea--half the kids had upset stomachs--we all drank the tea and it eased the upset better than any prescription med. so another tactic is to ask the locals what they do for an upset stomach. etc.

my husband found out in may that his fever and chill spells, which had been growing more frequent and intense over the previous 14 months, were brought on by an onslought of active malarial parasites. we always take antimalarials when we go into the amazon--i always take doxycycline--bourdain is right--there is virutally no foolproof prophylactic against all strains of malaria--BUT doxycycline does reduce the risk for contracting more serious [lethal] strains. larium and mefloquine can cause hallucinations and psychosis, so anyone with a history of depression should steer clear. but in my opinion, it's foolish not to take doxycycline, even if only to REDUCE the risk. that said, you can get over malaria, but you can never donate blood again

[bourdain]

I strongly recommend against Larium. The side effects are truly disturbing. Hunter Thompson's musings on a near lethal combo of ether/bad mescaline/cocaine and booze come to mind: Something about "looking down and seeing your dead grandmother crawling up your leg with a knife in her teeth" Typical Larium dream. People on the crew travelling with me had even more unpleasant reactions. One claims to have lost all sense of taste and smell for months following the course of the drug. I stopped taking them in Cambodia--as I was quickly becoming too terrified to sleep--knowing the kind of physically affecting dreams I was likely to have. Malaria is indeed serious, lifelong business--and it is probably a good idea to take a prophylactic if travelling in areas where malaria is not uncommon. But no kidding about the psychotic behavior. If you've been following news accounts of the rash of Special Forces related murders at a US base--you'll see that a Larium connection was one of the first things investigated as a possible cause. (Though since discounted). If you've ever had a sudden urge to shave your head, climb a tower and start shooting strangers--or have been hearing voices lately--or think CarrotTop is funny--then Larium is definitely not for you. Stick with the thorazine.

[Ellen Shapiro]

knowing the kind of physically affecting dreams I was likely to have.

Hey! Carrot Top IS funny! I've taken Larium before and never had "Larium" dreams. I'm off to India in a couple of weeks and have my scrip for Larium (filled). Now I'm starting to wonder. It's two weeks in India and then off to Nepal where I don't need to continue to worry about malaria but will have to continue the medication for four weeks--my entire stay in Nepal. I suppose I could always quit the meds if they're making me ill.

Have any of you actually had "Larium dreams" or just your travel companions? The Larium lore is incredible.

[Jason Perlow]

I was having a pretty shitty day until I read Tony's last post. That was classic.

I'll avoid Larium and stick with the IMODIUM.

The guy who invented Imodium should get a Nobel prize.

[Fat Guy]

Bourdain v. Carrot Top in Celebrity Death Match.

[Jason Perlow]

I would actually pay to see that.