ascorbic's comments on avoiding food poisoning at home are
excellent, but do remember that
hygiene is always a
relative
concept. No matter how
fanatical you are about food
preparation, the dishes you cook yourself are still liberally
sprinkled with millions of airborne
bacteria. Due to this
constant
exposure, odds are very high that you're already
immune to them; you're far more likely to run into problems
in places where the
bacteriological fauna are new to you.
I hereby present:
Avoiding Food Poisoning on the Road
There's an old
adage for eating in the
Third World:
"Boil it, cook it, peel it, or forget it."
This seems simple, but in practice it's a tough road to follow,
the problem being not so much the risk of
accident as
the risk of
temptation. For example, the following items
are highly likely to cause problems:
Test: It's another sweltering hot day in
Bangkok and that
tom yam soup you just ate is still scorching your throat,
so how about
a nice
strawberry shake to cool you down? If you said "Sure!",
you just passed an
intestinal death sentence on yourself: that shake contains
every single one of the four banned items. The ice that
makes it cold has either been made from tap water or, worse yet,
comes from the factory in huge blocks that are often literally
dragged down the street. Milk spoils very quickly in the tropics,
and those yummy leafy veggies and unpeeled fruits have been
washed in that same parasite-laden tap water -- if at all.
Having read this, your instinctive reaction will be to panic
and to head for the nearest expensive, air-conditioned,
friendly tourist restaurant where the kitchen is hidden from
view. Bad move. They're still using the same
ingredients, stored with the same levels of hygiene or lack
thereof, but because it's a tourist restaurant their business
model relies on catching a couple of farangs a day,
instead of feeding a crowd of locals. This, in turn, means
that those same ingredients have, more probably than not,
been sitting around a long time waiting for you.
What to do then? It's a numbers game, but here are a few
guidelines to improve your odds of escaping unscathed:
- Choose a popular restaurant (or street stall).
Many people (especially locals!) means that the food isn't
left sitting around, and more likely than not, it also means
the chow is good and the price is right.
- Choose cooked dishes that are made on demand. Things like
fried rice and fried noodles are popular in the tropics for a reason.
Buffet-style meals, on the other hand, may appear cheap but
(unless extremely popular) are very risky indeed.
- Dishes that are kept boiling hot -- in
practice this means hot drinks and soup -- are also a pretty
good option. Fiery curries and the like are not quite as
good, but they're usually OK largely thanks to the
disinfectant properties of most spices.
- Avoid meat, fish and shellfish; go visit the market
to find out why. Eating ground meat (meatballs etc) or
anything not well-done is especially risky, not only due to food
poisoning but because of the risk of things like trichinosis.
Additionally, things like barbecues and
roast chicken have to be prepared in advance, and who knows
how long they have been sitting there?
- Drink only beverages from untampered bottles
and cans, and check the seals first! Don't let waiters pour
stuff in the kitchen, because you won't be getting what you
expect. Reputable restaurants will open their drinks in
front of you for this very reason.
The good news is that in a couple of days you'll start to
acclimatize to the local bacteria and your odds of getting
sick will start to decrease. The bad news is that it only takes
one
fly in the wrong place at the wrong time to foil all
your precautions, and that if you stick around for a while a
run-in with
Delhi Belly,
Montezuma's Revenge or whatever
the local equivalent is more or less unavoidable.
Treating Food Poisoning
So one day your luck runs out, and you find yourself feeling
distinctly queasy. Runny bowels or simple
diarrhea
don't really qualify for food poisoning in my book, and
dysentery is in a league of its own, but if
you...
- feel sick and dizzy
- get a fever
- start to feel like you need to throw up
...then, well,
congratulations. The first thing to do is
to get the
acute phase over with: head for the toilet, kneel
in front of the bowl (I pity those of you who have to
deal with this with a
squat toilet!) and let go. You won't
start to feel better until you start throwing up, and you won't
get this over with until your stomach is empty, so just do it.
Do not attempt to eat anything, and do not drink anything other
than water yet. When there's nothing left, wash your mouth,
brush your teeth and go to bed. You'll feel more alive in the
morning. If, however...
- the acute symptoms persist for more than two days, or
- there is blood or pus in your feces, or
- you are getting chills as well as fever
...you may have something worse and should see a
doctor.
Do not, repeat, do not take any antidiarrheal or antiemetic
drugs. These will just block up the nasty stuff in your system
and you'll risk turning (relatively) harmless food poisoning into
something much worse. A doctor may prescribe antibiotics in
severe cases, but this is usually overkill.
For the next few days, you will find that your appetite has
all but disappeared. Don't force yourself to eat, but do be
sure to rehydrate yourself: water, weak tea, flat soda,
diluted fruit juice are all good. If you feel like eating
something, stick to bland, stomach-friendly foods like rice,
porridge, crackers, bread. Do not, under any
circumstances, consume alcohol.
Data Points
To the best of my knowledge, I've gotten food poisoning three
times in my life:
- Nepal. Culprit unknown, could be almost anything. I was
all of 6 years old at the time, so I don't remember much.
- Jordan. Probably attributable to breakfast in a
Bedouin tent, although there weren't any red flag foods
and nobody else at the table got sick; the yogurt may have
been responsible, although usually fermented milk products
are pretty safe. My immune system was already weakened by
flu and the resulting double punch was distinctly unenjoyable.
- Japan. I ate at a too-cheap ¥800 Chinese buffet
in Kobe and proceeded to regret it before the Porcelain God
all night. This, incidentally, is the only time I've ever
gotten sick in Japan, despite eating immense amounts
of raw (and just plain weird)
food; usually Japanese hygiene is excellent, but evidently
something at that buffet had been sitting there for a bit too long.
Suspicious places where I have managed to avoid the dread disease include
but are not limited to
Egypt,
Tunisia,
Turkey,
Russia,
India,
Indonesia,
Thailand and
Malaysia, so despite the slips above my usual
level of paranoia seems to have paid off. Do note that, generally,
speaking, I have a pretty tough stomach and I e.g. make a habit of
drinking tap water whenever locals do so (
Cairo,
Tunis,
Kuala Lumpur), even when most tourists steer clear.