Food and water safety while traveling: how to mitigate your risks of becoming ill.

Food borne illness is a sure way to ruin a vacation. Travelers to developing countries are especially at risk for traveler’s diarrhea, but with the right precautions you can avoid this snag, and enjoy a great trip.

Safe Foods: Hot food is usually safe. Cooking food at high heat kills the germs that can cause travelers diarrhea. Beware of food that has been cooked, but allowed to sit at warm or room temperature on a buffet where it could become re-contaminated.

Dry or packaged foods like bread or potato chips are usually safe because most germs require moisture to grow. Foods from factory sealed containers like tuna or canned vegetables are safe as long as it was not opened and handled by another person.

Risky Foods: Raw foods should generally be avoided. Raw fruits and vegetables are typically safe if you can peel them yourself or wash them in bottled or disinfected water. Avoid platters of cut up fruits or vegetables since you can’t be certain they were prepared with clean hands, or washed in safe water.

Salads should be avoided because they have multiple surface areas for germs to grow, and the vegetables are often washed in unsafe water. Avoid fresh salsas or other foods made from raw fruits or vegetables. Raw meat or seafood should also be avoided. Don’t be tricked and eat ceviche or other seafood that has been “cooked” by marinating in citrus juice or vinegar, but not brought to a high temperature.

Eat food from street vendors with caution. Street vendors in developing countries are not held to the same hygiene standards as restaurants (which may be low to begin with). If you choose to eat street food apply the same rules as to other food. For example, if you see something come right off the grill steaming hot it is more likely to be safe.

Bushmeat refers to wild meat that is generally not eaten in the United States, such as bats, monkeys, or rodents. These meats can be a source of animal origin disease such as Ebola or SARS, and should be avoided.

Safe Drinks: Bottled or canned drinks from factory sealed containers are safe. Beware that some dishonest vendors may sell tap water in bottles that are “sealed” with a drop of glue. Carbonated drinks like soda or sparkling water are safest since the bubbles will let you know that the container was not tampered with. If you drink directly from a can be sure to wipe the lip of the can before you drink.

Hot drinks such as coffee or tea are considered safe if served steaming hot. It’s ok to let it cool before you drink, but avoid coffee or tea served lukewarm. Be careful about adding things like cream or lemon to your drink that may be contaminated.

Milk that is pasteurized and comes from a sealed bottle should be safe, but avoid milk served from open containers that have been sitting at room temperature. Be careful about cream that you add to coffee or tea that has been sitting at room temperature. Pregnant women or people with weakened immune systems should avoid unpasteurized milk or other dairy products such as cheese or yogurt.

Liquor is generally safe to drink since the alcohol content will kill most germs. Be careful about adding unsafe mixers to drinks, and avoid ice in your drink. The alcohol content of beer or wine is not enough to kill most germs, but these beverages should be safe if they came from a sealed bottle or can.

Risky Drinks: Tap water in most developing countries should not be consumed, even in cities. Remember to avoid swallowing tap water in the shower or when brushing your teeth. Tap water can be disinfected by boiling, filtering, or chemically treating.

Fountain drinks are made by carbonating water and mixing it with flavored syrup. Since the water most likely came from a tap, fountain drinks should be avoided. This includes juice from a fountain, which is most likely a concentrate that is mixed with tap water.

Avoid ice in developing countries, which is typically made from tap water.

Freshly squeezed juices should be avoided unless you washed the fruit in safe water and squeezed it yourself. Avoid ice pops or other treats made from freshly squeezed juice.

Reference: Centers for Disease Control and Prevention (2013) Food and Water Safety retrieved from https://wwwnc.cdc.gov/travel/page/food-water- safety