Thanks, MmePerdu. I asked because a couple of people here seemed to suggest a north vs south difference, and I've heard that from other people too.

Jeff, I suspect people working in some kitchens the world over are only as careful as they think they need to be and some will miscalculate. I don't just mean hand-washing and general human hygiene, but also at what point do I throw away food items when they don't get used in a timely manner. That says to me also that those responsible for such decisions in the south may throw things out slightly before those in the north. But where profit is concerned, some will always push their luck. Meaning, take a chance on poisoning their customers. So I think it all evens out and, in any case, who knows who is being careful where. Eat veg, take expensive pills, or hope for the best everywhere.

MmePerdu ,

Thanks for the laugh, although I'm a bit frightened! Was hoping to hear it's safer in the south as I've already experienced a food born illness from the north which would have ruined a week of my trip had I not contracted it from the last meal I ate before flying home.

Do you think it is safe to eat exclusively vegetarian? I hate to miss out on the delicious foods, but I'm hesitant to eat chicken (which I suspect I got sick on last time) or mutton and wonder about the fish dishes which I was hoping to try in the south.

One often hears people say they'll eat only veg and maybe there's a good reason, other than religious reasons, for that in some parts of the world. But I always get distracted by the wonderful-sounding meat dishes and can never stick to it. Also, if you decide to include dairy along with your veg, it's another opportunity for dire consequences, as I mentioned earlier. To answer your question, I don't know if eating veg works 100% but so many do in India it might very well mean at least an improvement in the odds. If/when I go back I'm certainly going to try.

By the way, we can chuckle about it, but you should be frightened. I think the longer one stays, the better the chances for illness so that may be a good reason for a quick trip. But I just don't seem to be the quick trip type so may be doomed.

Regarding fish, on a trip to Israel, I had fish for dinner before going to the airport for my flight home. I was deathly sick most of the way home to CA, on an El Al flight with 1 toilet broken and lines for the rest. I just went to the front of the line, apologized and went in. No one gave me a hard time. I suppose just glad it wasn't them.

Eating exclusively vegetarian won't insure no illness, but some people believe it reduces the chances. Bacteria cling to vegetables as tenaciously as to meats. And as mentioned above, dairy can be problematic.

I figure the best one can do is to follow food and water precautions. I am "religious" about it when I first arrive in a new developing country, then may flex the rules when I know more about the place. For instance, I've been going to Bangkok since the mid-1980s, and have the sense that I know what is/is not safe to eat. So far, I've guessed pretty well, as I've never gotten sick in Bangkok (but then, I don't eat street food there). But I do eat fresh fruits and salads at places I know.

I did once get food poisoning from shrimp in Singapore... one of the cleanest places in the world! I was sick all the way home on the plane. I was flying in First and the flight attendants are all worried about me because I wasn't eating anything.

Sticking to a vegetarian diet was very easy in India because so much of the population eats that way, and the food is so delicious without meat, poultry or fish. Also spices are so ubiquitous that I would think it would be difficult to taste rancid mead or fish. Avoiding dairy is not as easy because ghee (clarified butter) is in most dishes.

But, as Kathie pointed out, what probably matters most is WHERE you eat. We stuck to finer hotels and more touristy restaurants than we usually do.

We travel to many developing countries and are rarely paranoid (we were very adventurous eaters in Thailand and visit Latin American countries several times a year without incident). But for us India was different. We know many people like Mme. Perdu (and Indian friends who live in the US) who relayed nightmare scenarios, that for us it was a no brainer to go with the very mild rifaximin. (And the expense was not really that outrageous compared to the rest of the trip.) Speak to your travel doc and go from there.

I honestly don't think there is any way to predict where one could be affected and by what foods. And, it could be poor luck of the draw. You could eat exactly the same thing as your traveling partner and get away completely scot free while s/he was unlucky enough to get the piece of food that had somehow been contaminated.

We have now taken three long trips to the area--6 weeks in the north, 3 weeks in the north combined with 3 weeks in Nepal, and this past year 6 week in the south. We have been lucky in that on each trip we have had nothing worse than travelers' diarrhea--maybe one bout each per trip, and the last trip my husband had no problems at all.

It used to be that our travel clinic advised waiting a bit to see if the diarrhea would resolve itself. No more; now they advise to start taking an antibiotic (prescribed for us to have on hand) as soon as symptoms develop.

What some of you are describing sounds more like food poisoning to me. Several years ago my husband had a bad raw oyster in Mexico; he was really sick for about two days. When we visited Vietnam I somehow contracted campylobacter from something, while he didn't get sick at all.

My advice is don't be completely paranoid about the food, but don't take foolish risks either. Part of the joy of traveling is having the opportunity to try to local dishes you can't get at home. And, obviously use bottled or purified water even for teeth brushing. Speaking of water, for our last two trips (12 weeks in total) we never purchased bottled water. Instead, we used our camelbak UV purifier and purified the water right from the tap.

"My advice is don't be completely paranoid about the food, but don't take foolish risks either."

Again, while this advice sounds utterly logical, one can take no risks, eat only in upscale places and still get sick. I think there simply is no other answer except, if you want to avoid food-borne illness and not starve, avoid developing countries. And I, despite my stories, am leaving for Mexico shortly.

Eating in "upscale" places is certainly no guarantee. On my last trip to India - six weeks in the south - I got sick in the most expensive hotel of the entire trip. And I ate in a couple of decidedly dodgy looking places without getting sick. But, I ate veg in the dodgy places and chicken in the posh one. YMMV.

I'm joining in a little late here but, here's my two cents...

- Vegetarian is better. The meats served may not be the animal advertised (ie: pigeon for chicken) and the care taken to keep it refrigerated is sketchy.
- Avoid dairy and milk based sweets.
- Avoid salads and cold items. Fruit is best if you can wash it and peel it yourself.
- Bottled water is fine, but check that the seal appears from the factory. There is an underground booming business of refilling water bottles and selling them.
- Bring food with you if you'll be out for several hours and not sure of where you will be able to eat. Ask your hotel about making a lunch for you to take with you of foods that will do well at room temperature.
- Avoid food from the street vendors - delicious as it may look and smell. The locals eat there, but they too risk food borne illness and fevers.
- The more expensive/upscale restaurants are more likely to have trained their kitchen personnel in proper food handling and storage.

'Trying to avoid getting sick in India from food is, in my experience, a futile exercise.'

I think eating veggie is worse - at least meat is cooked, ususally well cooked, whilst vegetable are not always.
MmePerdu nailed it !

Stats on being sick :
I only go to India for work.
Been there 3 times, never been sick - I break the record of my colleagues... Usually all of them are sick 1 out of 3 times on average.
Been eating in a canteen, same food as locals (yes, live like a local !), on an aluminium plate, with no fork or knife.
I saw how they washed the tray when I left - I'm still dumbfunded as to how I didn't get sick as hell.

Will go in coming months, all odds are against me !

Um, pariswat, do you use a spoon in India, chopsticks or use your fingers to push food onto a roti bread? Here in T'land locals use only fingers when eating sticky rice. The make a ball, dip the ball into a sauce and pop it into the mouth. Works well.

My advice, for what it's worth, since I grew up in India but have lived in the US for the last 16 years is -

- Drink bottled water.
- Don't limit yourself to vegetarian food. There are delicious meat based curries, kebabs and dishes, both in the North and the South, so if you enjoy Indian food, you don't have to miss it.
- Don't limit yourself to eating in expensive restaurants or hotels. This does not guarantee you will not fall sick. Recommended small restaurants or shacks even, with a high turnover of local patrons, usually means that the food is very good and fresh.
- Most Westerners don't enjoy Indian sweets because they're, well, too sweet. However, if you do, I think it's safe to have them as well, if bought from a well known shop. If you're in Rajasthan, definitely try fresh hot jalebis. If you're in the South, Chennai has some great options.
- If you're in the South, drink lots of fresh coconut water.
- Lastly, it's important that you don't get food poisoning or severe diarrhea. But, having a mild case of the runs is fine, IMO, and something easily taken care of by an Imodium or two. Our stomachs need some time to get used to the food. We go back to India every year to visit family, and our stomachs take a day or two to settle down, even though we eat quite a bit of Indian food here in the US.

My advice is very simple

1. Eat only if you see the food cooked in front of you and is steaming hot.

2. If the place is busy that's a good sign, these vendors need to feed their family and if are getting people sick they go out of business very simple.

3. Do not drink water from the tap make sure it is bottled water and the seal is not broken.

4. No ice at all lots of Indian homes have filters but not in the shops etc.

5. Try the food the people who go to India and do not try the food are missing out.

6. Don't be put off by people saying you are going to get sick.

7. Most important is have fun I loved India and going back in Nov.

Hi Jobin
I used fingers at the plant, like everybody :-)