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Food safety in exotic places


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Obviously when traveling to places known for both wonderful food/culture but uneven water quality--like Morocco for one example, one is safest sticking to bottled drinking water. We know to peel the fruit, etc. But if the fruit, or vegetables, etc. needs to be washed before eating, does one need to sterilize tap water before washing and if so, what's the best method for a traveler to do so?

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I'm curious about this as well. Bourdain eats just about anything in No Reservations with no ill effects for the most part. Is it just a matter of diving in, getting Montezuma's Revenge once, then having a primed system that can handle the local cuisine?

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I'm curious about this as well. Bourdain eats just about anything in No Reservations with no ill effects for the most part. Is it just a matter of diving in, getting Montezuma's Revenge once, then having a primed system that can handle the local cuisine?

I spent most of my growing up years in Thailand, and after a few first bouts with Dehli Belly (what we called it), never suffered any other ill effects. Interesting thing (although a bit personal) is that to this day, I have an iron clast intestinal system, am very regular and never have gas (a fact which my kids brag about). I can eat or drink anything with no ill effects. I must have developed the right kind of karma or bacteria or something in my system.

Susan Fahning aka "snowangel"
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Well, the trick is to be careful----but one of my favorite tips for traveling is taking acidophilus. Most likely your stomach problems will be purely due to unfamiliar bacteria as opposed to anything truly unclean. My DH has an extremely sensitive stomach and many things in the U.S. will put his bowels into turmoil. However, when we went to Mexico and China we took acidophilus daily, ate all sorts of street food, and he didn't have one incident.

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Obviously when traveling to places known for both wonderful food/culture but uneven water quality--like Morocco for one example, one  is safest sticking to bottled drinking water. We know to peel the fruit, etc. But if the fruit, or vegetables, etc. needs to be washed before eating, does one need to sterilize tap water before washing and if so, what's the best method for a traveler to do so?

Some people go so far as to use bottled water to wash

veggies, brush teeth, etc. I guess they also shower with

their mouths and noses tightly closed....

Milagai

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I'm curious about this as well. Bourdain eats just about anything in No Reservations with no ill effects for the most part. Is it just a matter of diving in, getting Montezuma's Revenge once, then having a primed system that can handle the local cuisine?

My understanding is that the best way is to attempt to adapt slowly to the local bugs by being "cautiously adventurous" with the food at first. Picking obviously risky things like warm food sitting out at ambient temperatue is asking for trouble, but apparently also is attempting to be super-cautious eg only eating in "good" hotels (where the assumption that food hygiene standards behind the scenes may not be correct anyway) - because this way your system does not get chance to adapt, so when the inevitable happens and you do inadvertently eat something - Delhi Belly or Montezuma's revenge strikes you.

I've always eaten street food - but been reasonably sensible about the choices especially initially, and never (touch lots of wood here!) had any problems.

There are various tricks of the trade too about local water - sanitising tablets, drops of iodine, drops of bleach etc, but as most enteric bacteria responsible for DB and MR cannot abide a sugary environment (because the sugar is all gone from your food before the residue reaches their natural environment, which is the bowel) - you can make a passably safe drink by adding sugar or cordial to about normal soft-drink strength, and keeping it at room temperature.

Happy Feasting

Janet (a.k.a The Old Foodie)

My Blog "The Old Foodie" gives you a short food history story each weekday day, always with a historic recipe, and sometimes a historic menu.

My email address is: theoldfoodie@fastmail.fm

Anything is bearable if you can make a story out of it. N. Scott Momaday

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I'm born and brought up in London and my parents are from India. They moved here 40 years ago. We are lucky enough to go back to India (Calcutta, now Kolkata) once a year at least.

India has dodgy water. When we first used to go, everyone would boil and then filter water for drinking. I still got ill for the first few times I remember clearly (from about 9 yrs old til about 14 yrs old). Then there was a new UV filter system released, so now I can drink that water and I'm fine. BUT...whenever we're invited to an outside catered event, I would more often than not forget to pack a water bottle. So I would take little sips of water here and there. Now I can manage tap water more or less. Altho I still drink filtered or mineral water if I have a choice. I'm now 28.

The same goes with the food. I hardly ate raw veg/salads, and still dont. Most of my eating was at home (washing would have been done in unfiltered tap water, as would have the dishes) or at restaurants, where dishes were also liked washed in regular tap water. But as I grew up and started going out on my own without my parents, I ended up eating more and more street food. Now, I dont get "travellers diarrhoea" ever when I go to India and I can handle more or less any street food. Iron Belly!

But, from a medical point of view, this immunity (or colonisation of the GI tract with local bacterial flora) takes a long time to develop, and doesnt happen after one episode of "Delhi Belly". So beware of that.

My tuppence worth!

Cheers

Raj

PS also beware of ice cubes if you dont know what water has been used to make them, and remember my comments about dishes and glassware and crockery - you never know what water, and indeed what soap, has been used to wash them.

having said all of that, bourdain certainly has the right idea. if it doesnt kill u, it only makes u stronger. and hopefully u got to enjoy the food in the first place! risk vs benefit scenario, seems to me.

Also, in response to your question, water purification tablets are available. In the UK, you can get them at pharmacists or camping stores. I dont know how well these work, otherwise, boil and filter as appropriate. The UV filters are not portable, so I dont think they would be any good but maybe someone knows where they can be purchased. They are called AQUAGUARD in India.

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Obviously when traveling to places known for both wonderful food/culture but uneven water quality--like Morocco for one example, one  is safest sticking to bottled drinking water. We know to peel the fruit, etc. But if the fruit, or vegetables, etc. needs to be washed before eating, does one need to sterilize tap water before washing and if so, what's the best method for a traveler to do so?

Some people go so far as to use bottled water to wash

veggies, brush teeth, etc.[...]

Bottled or boiled water. It's safest, if you're somewhere where the tap or well water isn't safe to drink without boiling. When I was living in rural Malaysia in the 70s, I wasn't so careful about using only boiled water for washing raw vegetables or brushing my teeth, and I got a large whipworm infestation. Ironically, I was seemingly asymptomatic for years and was checked only 4 years later, when I had a serious illness that wasn't caused by the parasites but couldn't have been helped by them. So be careful out there, folks!

Michael aka "Pan"

 

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Recently when working in a restaurant kitchen in Oaxaca, we washed all veggies and herbs in water with iodine drops in it.

If you're getting big vats of potable water delivered, you can also wash all your fruits and veggies in that.

I've never peeled anything in all my years of travelling. I eat street food - but cautiously - and do eat in markets regularly.

I've been sick sure, but I've also been sick where I live in Canada. It's a crap shoot. Hey, that's a pun!

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Some people go so far as to use bottled water to wash

veggies, brush teeth, etc.  I guess they also shower with

their mouths and noses tightly closed....

A colleague with a Ph.D. in microbiology is convinced that his bout with traveler's diarrhea was caused by not closing his mouth tightly enough when showering. This was in St. Petersburg, Russia, which has notoriously dodgy drinking water. We took reasonable precautions on our two trips to Russia, ate wonderful food from a wide variety of sources, and had no problems.

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I lived in China and the Philippines (also Japan, but this isn't a problem there, obviously), ate street food all the time, ate in dodgy-looking places, and never got sick. In China, we boiled all our water for drinking and brushing teeth, and didn't eat raw vegetables and fruits that couldn't be peeled. We applied the same strategies in other developing nations we travelled to. However, I understand this had changed and it is now safe to eat lettuces and what-not in China. It wasn't then. With a little bit of caution and a lot of adventursome spirit, you should be fine.

Interestingly, the only time I ever got food poisoning - a bad, BAD case of food poisioning ultimately resulting in an IV to get fluids in me - was from Domino's pizza. After all the street food I'd been eating for years in numerous developing countries, the one time I got sick was from an American chain. Go figure.

-Sounds awfully rich!

-It is! That's why I serve it with ice cream to cut the sweetness!

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I'm curious about this as well. Bourdain eats just about anything in No Reservations with no ill effects for the most part. Is it just a matter of diving in, getting Montezuma's Revenge once, then having a primed system that can handle the local cuisine?

We're not sure if Bourdain takes any precautions in the way of antibiotics or antiparasitic meds before traveling. It is well known that the more careful we are in protecting ourselves from germs to weaker our immune systems can become.

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This is an interesting topic. I am traveling soon to Thailand and Vietnam and have been very curious about this whole subject. One of the things I am most excited about is indulging in the street food and local food markets, however I have never traveled in this part of the world and am curious how I will fare. I do not have a sensitive stomach, but again, it has never experienced that corner of the globe and may not know what the hell hit it. Something like Pho, in Vietnam seems like it would be fairly harmless given that it is all cooked, however, I wonder about adding the fresh herbs that accompany it (and are so good)

I seem to recall one instance in Bourdain's original show where he did suffer from some ill effects while in Asia, not certain where, he may have also mentioned it in his book.

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This is an interesting topic.  I am traveling soon to Thailand and Vietnam and have been very curious about this whole subject.  One of the things I am most excited about is indulging in the street food and local food markets, however I have never traveled in this part of the world and am curious how I will fare.  I do not have a sensitive stomach, but again, it has never experienced that corner of the globe and may not know what the hell hit it.  Something like Pho, in Vietnam seems like it would be fairly harmless given that it is all cooked, however, I wonder about adding the fresh herbs that accompany it (and are so good)

I seem to recall one instance in Bourdain's original show where he did suffer from some ill effects while in Asia, not certain where, he may have also mentioned it in his book.

i get the feeling from some of these posts that the more "nervous nelly" you are about things, the more likely something WILL go wrong. sort of a psychosomatic situation. these days, you should be fine traveling in thailand and vietnam. everyone's body is different and you know your body best, so use common sense and don't eat something just to be adventurous...if it looks bad or smells bad DON'T EAT IT. Better to eat things that are heated through, etc.

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About 15 years ago I got very sick while travelling - sick enough that it left me with various issues that I will always have to live with.

If I'm travelling to a location where I have any concerns, I'll stick to bottled water only - even for brushing my teeth. I won't eat vegetables or fruit that don't have a hard peel unless they're cooked and I'm very cautious about what I eat altogether. I'd rather be more carefree about the issues, and not be a nervous nelly, but with the experience I've had, I just won't risk it.

And don't forget that Immodium is a traveller's friend.

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Something like Pho, in Vietnam seems like it would be fairly harmless given that it is all cooked, however, I wonder about adding the fresh herbs that accompany it (and are so good)

I've found that as long as the soup's on the boil, it's usually all right. I find Vietnam to be very clean, and eat raw vegetables washed in tap water all the time here, with no ill effect. But I've travelled all over Asia, and my gullet, for lack of a better word, is pretty iron-clad. I never used to drink tap water in Korea, for example, not because of the water quality, but because of the pipes - it used to come out of the tap red! The sickest I ever got was in India, but I think that was from the water, not from the food, and I'd been in the country for a month, eating and brushing my teeth with the water. Then my last week, something got me, and I was laid low for four days (In Goa! All I could do was drink bottled water and eat dry toast! Aggh!) Like Shelora said above, it's a bit of a crap shoot. You never know when something will find you. Don't let worrying about that too much keep you from trying delicious things. Exercise common sense, and pack some wet-wipes just in case. If you know what I mean.

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Count me in with the exposure (with some common sense) group.

When growing up in India I guess my mother indoctrinated

(or inoculated?) us: mom and kids used to regularly sneak out of the

house and gorge on chaat and other yummy street food, while my

father stayed at home prophesying gloom and doom.

Nothing bad happened to us GI-wise.

Now, on annual India trips I head to the bazaars for good

street food as soon as I get over jet lag. I'm looking fwd

to getting my kids onto this routine, they are 9 and 4,

The 9 YO is starting to show some appreciation for

good junk food, but her 4 YO brother is still firmly a mac and cheese

boy, alas.

We do drink treated water at home and buy bottled if out.

But my germ-sense got a jolt when my 9 yo was a baby

and we were carefully boiling all her water and utensils

and stuff, and then found her sitting in the garden ecstatically

drinking rainwater from a puddle on the ground.

Her now 14 yo cousin (when a baby) was similarly caught sharing

the dog's water bowl (same location).

They all survived and thrived, so hopefully we can go on

to build further GI immunity (thanks for the budding medical

endorsement from Raj Banerjee) :biggrin:

Milagai

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There's travelers belly and then theres amoebic dysentery. That latter one can kill ya. If you are going to take the precautions of eating only hot food or peeled fruits/veggies, then go all the way and used boiled or othewise sanitized water for the washing. Why not be consistent?

Ive seen it recommended that when partaking in street food etc, bring your own plate (or use disposables like paper napkins), drink sanitized water and watch out for icecubes. A family friend got amoebic dysentry from the ice in his scotch in Egypt. He was hospitalized for several weeks when he returned to the US and was several months to "full" recovery (some lingering issues). I, on the other hand, drank the dirty grey freshly pressed cane juice in a village in rural Venezuela to no ill effect. Them amoebas are a gamble.

I've wondered if simultaneous alcohol imbibing reduces the risk of travelers belly?

"You dont know everything in the world! You just know how to read!" -an ah-hah! moment for 6-yr old Miss O.

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I've wondered if simultaneous alcohol imbibing reduces the risk of travelers belly?

I dont believe theres any evidence to suggest that imbibing alcohol in some way diminishes the possibility of contracting travellers diarrhoea - in case you were thinking the alcohol would somehow "kill" the bacteria/viruses/parasites/fungi that may cause your stomach upset.

However, it may well be the case that, under the effect of alcohol, one makes some dubious food choices when you just gotta have some scooby snacks! Explains my 3am Doner (gyro to you folks in USA!) from the Turkish round the corner anyways!!!

In all seriousness, its not a good idea.

However, going back to the original question, there are also plenty of "local" remedies which you may or may not want to consider, which can have a good prophylactic and remedial effect. Again, I only really know about India, but my parents and brother (who can't handle the food like I can any more!) always rely on a combination of an Ayurvedic medicine called Pudhi Nara (which is mint based, and really "cools" the stomach) and another one called Aqua Ptychotis. I am ashamed to say that even tho I am a medical person, I have no idea how this works, although I am sure a quick web search would reveal it...unfortunately, exams next week, so I dont have the time! I am sure there are plenty of other such local fixes available, which may work better than the Pepto Bismol etc. Although I do love Pepto Bismol!

The CDC info seems very sensible. As is all the advice to remember that you're on vacation, and that you should be enjoying yourself and you're more than capable of making sensible decisions based on the information in front of you at the time ie food looks and smells delicious etc and from what info you pick up here etc.

Have fun!

Raj

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Ive seen it recommended that when partaking in street food etc, bring your own plate (or use disposables like paper napkins), 

I think bringing your own plate is incredibly ridiculous. And most street vendors have disposable everything these days, including plates.

Use your eyes first and your instincts when eating street food.

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Oh, how very timely! We leave for Belize this weekend, and I'm not at all worried about malaria, dengue, or feeling ill from eating something weird. MIL has instructed us all to get vaccinations, take malaria meds, never walk or swim barefoot, use hand sanitizer often, and not eat anything not packaged or bottled. And, of course, to look both ways before we cross the street.

We've done no such preparation for this trip, or any of the 20-odd trips we've taken to "red and yellow" areas (based on that map). As a matter of fact, my kids generally don't get sick, and other family members seem to be sick from stomach viruses, colds, etc., since they were little. Maybe it's because we eat out a lot? I dunno. But why travel, if not to sample the local foods? If I get sick, big deal. I'll get well again.

And yeah, I ate from street vendors in Mexico. I went into it thinking it would be my own personal blowfish experience, and wound up with a heck of a tamale.

"Oh, tuna. Tuna, tuna, tuna." -Andy Bernard, The Office
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In the thick of the paranoia we must remember that people get sick in our own countries from the food - it is not just a problem in "foreign" places. People can die from the hemorrhagic form of E.coli - dodgy hamburgers for example; botulism kills only a few, but it kills, hepatitis B is not nice either; salmonella and campylobacter occur everywhere.

Common-sense, use of eyes, sense of smell, graduated exposure if you can.

By far the commonest serious health hazard while travelling is motor-vehicle accidents, and the second most likely is one of the things that would get you at home anyway such as heart problems.

In any case, as another poster has said - if you get sick, you get well again. Most of "us" - i.e travellers financially well enough off to be able to travel are by definition well-nourished and basically healthy to start with, so more able to withstand illness. And have travel insurance or sufficient wherewithall to pay for decent medical care if it is available.

Travelling with extreme caution and paranoia is hardly worthwhile I would think - surely some sense of adventure is what it is about? otherwise why not stay home?

Happy Feasting

Janet (a.k.a The Old Foodie)

My Blog "The Old Foodie" gives you a short food history story each weekday day, always with a historic recipe, and sometimes a historic menu.

My email address is: theoldfoodie@fastmail.fm

Anything is bearable if you can make a story out of it. N. Scott Momaday

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........ never walk or swim barefoot, use hand sanitizer often, and not eat anything not packaged or bottled. 

And yeah, I ate from street vendors in Mexico. I went into it thinking it would be my own personal blowfish experience, and wound up with a heck of a tamale.

I've never heard of don't swim barefoot. I'd say moist towelettes over hand-sanitzer anyday.

"my own personal blowfish". That's excellent.

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I do eat things from street vendors while traveling, and I surely don't regret having done that in Malaysia. But malaria is nothing to fool around with. I have no idea whether any part of Belize is endemic for malaria, but if you are planning on traveling anywhere where malaria is endemic (which is often not just a particular country put a particular part of that country), for God's sake, take some preventative medicine! You _DON'T_ want to have a severe and possibly life-threatening illness on vacation, when you could have prevented it.

Michael aka "Pan"

 

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I never liked the idea of schlepping a plate/bowl whatever around, and so never bothered, but I do see the logic, since street-vendor dishwater is scary stuff in more than one way. Again, depends on whether its a bout of the runs or a nastier bug one is avoiding. I'm conservative anyway. I stick to the hot, peeled, etc. I dont like being chained to the loo. Damn. Now I can smell the roast yams in November in Beijing and its way too hot here to roast yams.

Re malaria, Pan pegs it. Much better to prevent than to cure, IMO.

"You dont know everything in the world! You just know how to read!" -an ah-hah! moment for 6-yr old Miss O.

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