Saba and Sint Eustatius
Travellers' Diarrhea

Saba and Sint Eustatius: General Health Risks

Travellers' Diarrhea


The term Travellers' Diarrhea is used to describe gastrointestinal infections affecting travellers caused by ingesting bacteria, viruses, and protozoa. These microorganisms are found worldwide and are typically transmitted from person to person via the fecal-oral route – an infected person who does not practice proper hand or body hygiene passes on the infection to another person when handling food and water. Travellers' Diarrhea is one of the most common illness among travellers.


Travellers' Diarrhea can happen when:

  • Eating raw, under cooked, unwashed, or improperly handled meat, poultry products, dairy products, fruits, vegetables, shellfish, and seafood.
  • Drinking contaminated water or beverages.
  • Inadvertently ingesting fecal matter, protozoa eggs, or viruses by touching the mouth with dirty or improperly washed hands.
  • Eating in restaurants, from buffets, or from street vendors where food handling and hygienic practices are not followed properly.

The golden rule to prevent gastrointestinal infections is: Boil it, Cook it, Peel it, or Forget it! However, it’s not just about what you eat, it’s also important to consider where you eat. It’s not always easy to know if a restaurant or food vendor follows proper food handling and hygienic practices (such as separating raw from cooked ingredients, properly cleaning cutting boards and utensils, washing their hands, and correctly refrigerating food). Avoid restaurants and food vendors that appear unclean or that don’t have many customers. Be cautious of food that has been stored uncovered, has been improperly refrigerated, or has been standing out for a long time such as buffets.

If you are unsure about the tap water quality, bring the water to a rolling boil. Boiling water destroys pathogens that can cause Travellers’ Diarrhea and other gastrointestinal infections. If you cannot boil your water, opt for treated or bottled water instead.

The risk of Travellers’ Diarrhea can also be minimized by following good hygiene practices. Make sure to wash your hands for at least 20 seconds with warm water and soap, especially before preparing or eating food and after using the bathroom. If water and soap are unavailable, use an alcohol-based hand sanitizer that contains at least 60% alcohol.

Managing Travellers’ Diarrhea

At the first sign of diarrhea, drink an oral rehydration solution (ORS), a mixture of salt and sugar designed to replenish electrolytes and treat dehydration. Antimotility agents like loperamide can also be used to reduce symptoms, but they do not treat the gastrointestinal infection. Traveller’s diarrhea is usually a self-limiting infection (it resolves itself), but if it persists and becomes worse after 2 or 3 days, you may want to consider taking an antibiotic for treatment.

If you are on high blood pressure medication watch for signs of dehydration since it can become an emergency very quickly.

Before you go, consult your doctor for the best diarrhea treatment options. Travellers who have pre-existing health conditions and are more susceptible to gastrointestinal infections may consider taking preventive medication.

For more information on preventing Travellers' Diarrhea, check out these resources from IAMAT:

Information last updated: February 23, 2021. 

  • Velarde JJ, Levine MM, Nataro JP,Escherichia coli Diarrhea. In: McGill, A; Ryan, E; Hill, D; Solomon, T, eds. Hunter's Tropical Medicine and Emerging Infectious Diseases. 9th ed. New York: Saunders Elsevier; 2013: 442-447.
  • Wolfe MS. Traveler’s Diarrhea. In: Jong, E; Stevens, D, eds. Netter’s Infectious Diseases. New York: Saunders Elsevier; 2012: 390-393.
  • Virk A. Amebiasis, Giardiasis, and Other Intestinal Protozoan Infections. In: Jong, E; Sanford, C. eds. The Travel and Tropical Medicine Manual, 4th ed. Waltham, Elsevier; 2008: 448-466. 
  • Centers for Disease Control and Prevention: Yellow Book, Traveler’s Diarrhea
  • Committee to Advice on Tropical Medicine and Travel, PHAC: Statement on Travellers' Diarrhea