Dr Marc Shaw provides a guide for safe eating when travelling overseas.
The case of 23-year-old New Zealander Sarah Carter dying, apparently from food poisoning after a night out with a couple of friends in Thailand, highlights the importance of consuming good food and water when travelling overseas.
Eating local food at a restaurant is one of the reasons people travel, yet no one expects the experience to end in a hospital admission.
Without looking at the specifics surrounding Carter's death, there are certain rules that can guide all travellers.
Objectively, poor sanitation, unhygienic food handling and the heat and humidity of tropical climates all contribute to the growth of bacteria which contaminate food. High temperatures during cooking may help to eradicate bacteria or parasites.
Here are 10 tips for food safety while travelling:
1. Keep to your usual diet for a few days on arriving, then gradually adjust to the local food.
2. Try any spices and "extreme local foods" in a controlled situation (such as a hotel) first.
3. Ensure that all food is well cooked and never reheated.
4. Buy fresh, clean meat or poultry. Do not use the same utensils for raw and cooked meats.
5. Serve and eat food as hot as possible.
6. Eat fruit and vegetables that you have personally washed and peeled.
7. Raw vegetables should always be washed in purified water before preparation for eating.
8. Decline foods such as:
* Leftovers, especially reheated ones
* Unpasteurised dairy products
* Raw seaweed, shellfish and sushi
* Cold cuts of meats
* Peeled fruit
9. Nuts may be eaten, but with caution, as they often contain aflotoxins from fungi, which produce gastro upsets. If eaten in large amounts these can damage the liver. Avoid nuts with mould or sprouts, or which are shrunken or misshapen.
10. Remember the adage: "Cook it, peel it, boil it or avoid it." Let that guide your eating habits.
When it comes to thirst, the standard advice in developing countries is "avoid the local water".
Here are 10 tips for water care while travelling:
1. Avoid tap water
2. Consider buying a reliable water filter, thus reducing the need for bottled water and waste plastic.
3. Drink only commercially bottled water (after checking that the top and the bottom of the bottle have not been interfered with) and carbonated drinks.
4. Use purified water for making iceblocks and brushing teeth.
5. Use only pasteurised milk products.
6. Check the contents of drinks on the package before consumption as they may have different concentrations of additives than those with a similar, familiar name.
7. Commercial wines and beers are usually reliable, in moderation.
8. Purified water is obtained in one of three ways:
- Boiling for a minute will destroy most gut pathogens
- Using filters that remove micro-organisms and chemicals
- Using halogen chemicals: 10 per cent povidone-iodine for clear water, 8 drops per litre, and leave for an hour; for cloudy water 16 drops per litre and leave for an hour; or 2 drops of 5 per cent bleach per litre of water per hour; or 1 chlorine tablet per litre, leave for 10 minutes
9. Oral rehydration sachets should be included in any medical kit, especially for children.
10. Remember the adage: "Purify it, pasteurise it or pitch it."
* Dr Marc Shaw is medical director of Worldwise Travellers Health Centres in New Zealand and Worldwise Online Travellers Health Informatics worldwise.co.nz.