jumper22

Many of you are well-traveled, so I'm wondering what your opinion is on this. My main question is below, and here is the background:

I get sick when I go to Europe. Practically every time. So much so, that I now ask a Dr to prescribe an antibiotic every time I travel, just in case.

I get ill from what I eat and drink. Yes, I have followed ALL the rules (i.e. fruits with skins, bottled water - even when brushing teeth, piping hot foods, etc. I have researched & followed all advice to no avail. I still get sick). Not to mention it's no fun. My husband and I have shared meals before, and he'll be fine, while I'm vomiting & on the toilet for the first 2-3 days of our trip as a result, unable to leave the hotel room.

I've been sick in: France, Switzerland, Germany, Scotland, Jamaica, Mexico

I have not been sick in: Italy and Greece (yay!)


In a matter of days, we move to Dublin, Ireland for the entire summer. Of course, I am fearful of becoming immediately ill but this time I'll have my 7-month old son to care for too.

MY QUESTION:

How do you think immunity to the local "bacteria" will work? Should I just eat/drink like a normal person, likely be very ill, tough it out and then will my body gradually adjust to its new environment over time? Or I wonder if I would just be continually sick?

Taking an antibiotic for almost 3 months while we are there is not an option for me. I do have a 7-day supply, but wonder if taking that should I start showing signs of illness would make things better or worse ultimately.

I want to be able to function as I would anywhere, and not be confined to a limited (pathetic) variety of food/drink for almost 3 months.

Wondering if anyone knows what the best course of action would be for me? Just curious on hearing your input on how building local immunity works, etc.

Oh, and wish me luck!!

USNR

1. Do you normally run a fever when you travel?

2. Do you have similar symptoms when traveling within the U.S.?

3. What allergies do you believe you have?

4. How much sleep are you getting the week before you leave? The week upon your arrival?

5. Which antibiotics has your physician prescribed? Are you following his/her directions exactly?

6. Are you avoiding all alcoholic beverages at all times when you travel?

7. Have you had a colonoscopic examination in the past 12 months, either before or after a trip to Europe?

8. When was your last dental checkup?

9. When was your last full chest X-ray?

These may seem unrelated, but they may not be. You may suffer some low-grade chronic infection that rises to the surface when you are under the stress and circumstances of long-distance travel. A qualified internist is your best source of counsel and care.

Pegontheroad

USNR's points seem sensible to me. I also wonder about stress. I recall one year when I had one infection after another--all different kinds. I was puzzled, as I am normally extremely healthy. My doc thought it was probably that my immune system was weak because of job stress.

I think you should ask your doctor about this. How long has it been since you had a thorough physical exam?

Do you bring along things like Immodium and pepto-bismal to take care of the symptoms?

Christina

I work in public health, so have read and work on some of these issues, but I don't have a clinical background myself. So... I'd say you really need to go to a new doctor, unless there is more that you aren't telling us. It sounds like your doctor is very passive and to just give you antibiotics whenever you call up and ask for them -- when you are traveling to developed European countries -- is odd to me. Also, it sounds like he or she hasn't given you any instructions on how to take them or under what conditions or for how long, or you do not remember them or don't read them.

It isn't normal to experience what you are in developed countries with clean water. There shouldn't be all these bacteria in such situations that cause you such illnesses (Mexico and Jamaica, I can see it might happen). I'm not clear if you get diarrhea with this vomiting, which I think is an important sign, or not (maybe that's what you mean by being on the toilet, but I thought that could be due to the vomiting).

I'd see a travel medicine specialist or something, given the severity of what you describe -- which sounds very unusual to me. I don't think there should be any local bacteria om the water that causes these symptoms in W Europe (food poisoniong due to poor handling is another matter and can happen anywhere, but it doesn't seem like that's what you are doing). Sounds like salmonella or bacillus cereus or something, but I just can't believe you encounter that every time you travel to developed countries.

Just to play devil's advocate, if you follow all the rules (which shouldn't be necessary for developed countries) re eating and drinking, as you said (bottled water, etc.), and still get it, how do you know it is due to what you eat and drink? Do you have these symptoms under other conditions, such as various kinds of stress?

I'm sure real physicians don't want amateurs practicing medicine on here, but I just find this very unusual, and think you should get some other medical opinions from specialists, not whatever doctors are prescribing you Ab so randomly because you ask them to.

kerouac

A lot of people suffer from travel hypochondria. I spent last week at an office seminar in Cairo and, as usual, everybody who was afraid they would get sick did so, and the others did not, while we all ate just about exactly the same things (usually in a 5-star hotel). I confess that I break all of the rules and drink tap water in countries where you shouldn't, always eat salad and other raw items, and do not shrink away from mystery food items.

I was taught at the beginning of my travels to look at the condition of people selling or serving food (I am not talking about Europe -- I am talking about Cambodia, Cuba, Ethiopia, Indonesia and other such countries.). The general rule is that if THEY look healthy, there is nothing to fear, even if your body takes a day or two to adjust.

Jumper22, I assume that you are American. You should therefore learn that in Western Europe, the rules for processing and handling food are much stricter than in the U.S. Food poisoning statistics show 10 times more cases in the U.S. than in Europe. I'm sorry to say this, but it's all in your head.

PalenQ

Kerouac: i believe your above stats and then i guess all that meat and stuff hanging around in uncooled coolers is not all that dangerous. Seems controls in Europe are less than those strict ones in US so ironic that it's not in statistics.

kerouac

Since meat can be dried and eaten 6 months later, meat is rarely a problem as long as flies don't lay their eggs on it (yuck).

What gets me is that salmonella is such a big problem in the U.S. while France has enormous use of raw eggs, undercooked eggs, unpasteurized cheese, etc. -- and very few cases of salmonella.

Lawchick

You shouldn't get sick in Ireland - but if you do - and for your peace of mind I can recommend my old doctor - female - Dr. Keeling, in the Albany Clinic, Lower Fitzwilliam St. Dublin 2.

I haven't seen her in a few years but I was very happy with her when I lived in Dublin.

willit

Not wishing to start yet another transatlantic war, but there could be many reasons for the discrepancies in the food poisoning stats.

The two most obvious being the reporting rates (how do they count?) and local immunity.

I believe that the US and UK maay have a higher level of processed foods, and possibly fewer incidences of exposure to "dirt". It is possible that French and Italian children, with more food from markets might have stronger overall immunity.

Bazonia

When I stopped eating unpasteurized cheese (which I love) in Europe I stopped getting as sick as you describe - but for one day in my case, not two. Others on the trip ate the same cheeses and didn't get sick.

kenderina

I don't think this is a US vs Europe thing...the OP says that her husband (which I suppose is also American) doesn't have the problem. So something is wrong with her...maybe stress. Are you the one who does all the organization for the trip and at home while your husband gets to Europe relaxed ? You should visit an specialist, I don't think antibiotics are the solution.

parisnewbie

I don't know why an antiobiotic would necessarily help w/vomiting. What you describe sounds more like a type of food poisoning. If you always seem to get this, I'd also ask the doc for anti-naseua med (?compazine?). I actually have hypogammaglobulinemia which is very low immunity. I too am bring antiobiotics and I'm going to start mine right before I leave.

mercy

Just a thought but some of these things are sympthoms (?) of Irritable Bowel Syndrome and also of Celiac disease--intolerance to wheat flour, among other things. I noticed on a recent trip to Sicily that some bakeries and restaurants note that certain foods do not have wheat flour. Just suggesting this as I have friends/relatives with these types of problems and it took some time to discover what to do about them. Just my 2 cents worth!!Ciao!mhm

jumper22

Wow, I wasn't expecting so many varying responses. Let me provide more specifics then and answer your questions:

1. Do you normally run a fever when you travel? Nope, no fever.

2. Do you have similar symptoms when traveling within the U.S.? Now that you mention it, I suppose the answer would be yes. But not nearly the "violent" reaction. For instance, every time I go back to my college (northern Pennsylvania) I always end up with diarrhea, which was a huge issue when I attended. 2 weeks ago in Cincinnati I had severe diarrhea & stomach cramping, and I had drank about 3 huge glasses of water at dinner.

3. What allergies do you believe you have? There is nothing I was NOT allergic to at my first-ever allergy prick test in January, which does not test for foods. I have no food allergies that I am aware of, however.


4. How much sleep are you getting the week before you leave? The week upon your arrival? I sleep great, about 8 hours/night. Normally I nap for several hours in the afternoon after arriving in a new country because the jet lag gets to me.

5. Which antibiotics has your physician prescribed? Are you following his/her directions exactly? I can't remember what I took for our Swiss/German trip, but I took them as prescribed when the onset of sickness came on. That's the only trip I have taken an antibiotic on, as a result of my previous trip experiences.

6. Are you avoiding all alcoholic beverages at all times when you travel? No, I am a fan of red wine and do partake of a glass at dinner usually. No different than being back home though.

7. Have you had a colonoscopic examination in the past 12 months, either before or after a trip to Europe?

Yes. My last colonoscopy (my 3rd, due to my college diarrhea issues and a 2-year misdiagnosed kidney stone) was about 4 years ago. I have also had a stool test 2 years ago and all was fine.

8. When was your last dental checkup? Just last week, for a regular cleaning. Never any issues and my only 2 fillings are back from when I was 18 years old (I am 34).

9. When was your last full chest X-ray?
3 years ago (but that WAS due to stress of a divorce, all was fine).

Dukey

"So much so, that I now ask a Dr to prescribe an antibiotic every time I travel, just in case."

And, frankly, if you GOT them then your FIRST problem is with physicians..get a NEW one.

Taking those antibiotics can easily build up your resistance and make future courses less efffective than they otherwise might be,

You need a qualified internist who, in this case, is a really GOOD interviewer and it probably wouldn't hurt to have some public health/epidemiology skills as well.

Josser

Dukey, you took the words out of my mouth.
If American doctors are handing out antibiotics like sweeties "just in case", no wonder we have super-bugs.

logos999

>I've been sick in: France, Switzerland, Germany, Scotland
Do you drink milk and have you been tested for lactose intolerance?

janisj

unless you know what you have HOW ON EARTH will you or the doctor know if an antibiotic is appropriate??

Either there is more to the story (which is a definite possibility) - or your GP just gives you a prescription to get you out of the office/out of his hair.

From my TOTALLY non-clinical but totally personal experience perspective: My brother got sick just before or on the first day of <b>every single</b> family vacation we had for over 20 years. Didn't matter if it was to a 4 star hotel or tent cabins in Yosemite. Vomiting/stomach cramps/diarrhea - the whole gamut.

The excitement and anticipation just was too much for him and the stress made him sick. Eventually a low dose tranquilizer for just the few days right before/after the trip solved things.

Not that that is your problem - but from here it does look like it could be more mental rather than physical.

jumper22

**CONTINUED FROM MY PREVIOUS REPLY, IT DIDN'T POST THE WHOLE THING

First country I visited was Mexico. It was the ice cubes, I was a fool. Montezuma's Revenge for sure.

I visited Italy and was never sick. I ate salads, drank wine, etc. No problems.

Next trip was Scotland. I had spaghetti carbonara (which I now know could have raw egg in it?) and within an hour I had SEVERE stomach cramping and SEVERE vomiting. I pretty much lived in the hotel room for the next 2 days. After that I ate sparingly, drinking only bottled cokes and eating extra-safe things until we left.

I chalked it up to the spaghetti. Next trip was France. On the train from Paris to Brest, my husband and I split a sandwich and a bottled coke. The sandwich may have had lettuce on it? I cannot recall. Within an hour, a repeat of the above. I spent 30 minutes at the train station (about to die because we had no change to get in the door and I thought I would go in my pants!! it wasn't funny at the time LOL). For the next 2 days I stayed in the hotel room, eventually leeping on the floor by the WC. SEVERE stomach cramping and SEVERE vomiting. Same deal, for the rest of the trip I drank bottled coke &amp; ate only extra-safe foods.

At this point, I feel it's more than a coincidence that 2 trips in a row have been halfway ruined due to my diarrhea/vomiting. So for our next Swiss/German trip, I ask the doc to prescribe an antiobiotic since I our trip would be 2 weeks. He did, and the second morning in Zurich I woke up with that dreaded I'm-gonna-be-sick-soon feeling. We had a long train ride from Zurich to Wengen scheduled, so I took the antibiotics and ~6 hours later was 50% better. No diarrhea or vomiting ever (thankfully since we were on the train) and a great rest of the trip as I took the antibiotic daily.

Next trip Jamaica. Did great the first 5 days there and then had one bad day of stomach being bad and some light diarrhea. Didn't take anything though, and by the next day I was fine again.

Last trip Greece 2 weeks ago. Ate salads, drank wine, cheese, etc. No problems at all. So I still have the 7-day supply of Leviquin (sp?) that was prescribed for me should I get ill on that trip.

--------

RE: whether it's a physical or mental issue with me. Of course I'm sure anyone would say this, but it's NOT mental. Believe me, the last way I want to spend int'l travel is in a hotel bathroom. I am not a stressful person - very few things in my life have caused me anxiety, I do very well with stress. I pack a carry-on only for even long Europe trips, I am organized to a &quot;t&quot;, I have a wonderful family and a healthy life. I am a very lucky person.

To further corroborate that: this past trip to Greece was my first trip away from my then-6-month old son. Now that WAS stressful and I know the difference between physical ailments brought on by stress. I was freaking out on the plane(s) and literally breaking into a sweat, thinking of &quot;what if something happened to me &amp; my husband, my son would be parentless&quot; etc. (I know it's ridiculous but what can I say, I'm a new mom). If there were ever a time when travel-related stress should have caused diarrhea or something, that would have been the time. Yes, I was stressed but I tried to be logical and control it, and as I mentioned, had no problems whatsoever in Greece.

Perhaps the above info will help in figuring out what my issue is in Europe.

And of note: Yes, I am in the U.S. Other than 2 kidney stones and a c-section this past Fall, I have been sick ONCE in 10 years (knock on wood) with strep throat that was 2 years ago. I had to take an antibiotic for the first time in years (I'm on no medications and am not a fan of medications in general if it can be avoided) and wouldn't you know as a result I ended up with &quot;c. diff&quot; (clostridium difficile, look it up if you want to know more but I highly recommend probiotics when taking antibiotics). So now, I take a probiotic once a day when traveling as my Dr has suggested it will help to &quot;boost&quot; any colon issues that may occur from travel.

None of your replies have answered my question - I know this all seems odd, I agree. But I just wonder if I &quot;tough it out&quot; should I get sick, whether I'll eventually be fine within, say, a week or say of building up &quot;immunity&quot; to the &quot;local bacteria&quot;, which is the best hypothesis I can come up with in regards to my health vs. travel.

logos999

Read this, it's VERY common for travellers (We have great milk products over here)
http://digestive.niddk.nih.gov/ddise...seintolerance/