If the turista is especially frequent in tropical or subtropical countries with bad hygiene, the south of Europe is not spared either.
Also called traveler’s diarrhea, “Kabulite”, “Djerbienne” and a thousand other small names with colorful connotations, the turista (or tourist) affects more than 60% of travelers. She is still of infectious origin. It is named after the fact that vacationers from countries where drinking water is easily accessible are the most affected: indeed, their body is not used to meeting germs in proportions much greater than its daily.
Often benign, the turista can sometimes lead to severe dehydration, even death, in the most fragile people: infants, the elderly, and people with chronic illness. A good reason to anticipate it and when it is present, do not neglect it.
What are the causes of the turista?
The turista is the result of contamination by germs, a drink or food that is ingested. The most common infectious agents involved are bacteria (Escherichia coli, Shigella, Salmonella, and Campylobacter), sometimes viruses (rotavirus) or parasites (amoebae). Insufficient hygiene (especially the use of unsafe water) promotes this transmission. The countries regularly concerned are Egypt, India, Thailand, Pakistan, Morocco, Kenya, Tunisia, the Caribbean, Turkey, Mexico, etc. And in Europe, Malta, Greece, Spain and Portugal are also at the origin of some cases, but to a much lesser extent.
How does the turista manifest itself?
Bellyache and diarrhea are the main symptoms, but sometimes nausea, vomiting, even fever and / or blood (and in this case, medical advice is required). The most risky period is within 3 to 5 days after arrival at the holiday location. The majority of turistas heal spontaneously in three to five days during which one must be particularly wary of the risk of dehydration (main complication).
How to prevent turista?
Given that 98% of travelers who declare a turista did not respect the precautionary rules regarding water, that 71% ate raw vegetables or salads and that 53% put ice cubes in their drink, the most important advice is to follow all precautions without neglecting any!
- To limit the risk of contamination, it is recommended to follow the rule with respect to a solid or liquid food: “boil it, cook it, peel it or forget it“. On the other hand, one must drink only bottled water decapsulated under his eyes (or another drink in bottle and decapsulated in front of him). If there is not (bush), you can fall back on boiled water for at least 15 minutes (tea, coffee). Similarly, we must consume hot dishes (no crudités or cold dishes).
All that is raw should be avoided: unpasteurized dairy products and butters, as well as minced meat, sauces such as mayonnaise (uncooked egg based), shellfish, seafood and raw fish are strongly discouraged.
- Ice cubes, ice creams and milks reconstituted from powder should not be used as it is impossible to know which water has been used. For the same reasons, whether you eat in a large restaurant or a typical bar, tropical disease specialists advise to avoid cold dishes, especially if they are served on a crushed ice.
- If you want fruit, you must consume only those bought by the unit: indeed, some unscrupulous sellers inject water (whose origin is not known) in their fruit sold by weight to make them heavier. Then you have to peel them yourself, after washing and soaping your hands.
- To clean your teeth, you must use tap water that has been previously purified by tablets sold in pharmacies or in some sports shops (such as Hydrochlonazone, Micropur, Aquatabs, etc.) or use water purification systems. Water (type Katadyn purifier, etc.). Finally, avoid swallowing water while showering.
How to treat a turista when the prevention was not enough?
In case of diarrhea, the most important measure to take is to rehydrate with uncontaminated water. To bring minerals, essential, it is necessary to resort to oral rehydration solutes or ORS (to be provided automatically before the departure and to put in its emergency kit). Otherwise, 6 teaspoons of powdered sugar can be mixed with a teaspoon of salt in one liter of drinking water. The interest of cola remains controversial, but if it is the only drink available which one is sure (bottle encapsulated), it is better to take than to drink nothing!
- While waiting for the transit to be regularized, a diet based on rice, pasta, semolina, carrots well cooked, is essential. On the other hand, intestinal antiseptics have not proved their effectiveness. And antidiarrheals are not recommended, except in special situations (like a very complicated access to the toilet for example): they are even contraindicated in case of fever and blood in the stool because this severe diarrhea may require antibiotic treatment.
When to consult in case of turista?
A medical consultation is recommended automatically for children under the age of two, pregnant women, the elderly or those suffering from a chronic illness.
- Similarly, medical advice is required at any age of life, in moderate or severe forms, with fever and bloody stool.
- It is also advisable to consult in the absence of improvement within 48 hours or in case of aggravation. Indeed, one cannot put all digestive disorders on the back of traveler’s diarrhea. If symptoms worsen, if there are more than 20 stools a day or if new signs appear as jaundice, discolored stools with brown urine, severe abdominal pain or fever at 40 ° C, it may be something else: indeed, nothing is more like a turista than a cholera or viral hepatitis in their infancy. As for late diarrhea (often returning from a trip to the tropics), with abdominal pain or blood in the urine, they require a medical consultation. They may for example come from bilharzia due to the presence of a parasite in the intestines or in the urinary tract, contracted during a swim in infested water: a single treatment is sufficient to overcome it, but it is still necessary to know how to reach. It can also be related to amoebiasis.