How do I avoid getting ill on holiday abroad?

Travellers' diarrhoea is common, usually short-lived and almost entirely preventable by a small number of habits. It is worth taking seriously not because it is dangerous in itself for most healthy adults, but because it can ruin a week and because the dehydration that comes with it in a hot country is a genuine risk, particularly for children and older travellers.

Safety

What you'll need

• Oral rehydration sachets
• Hand sanitiser
• Bottled or treated water where tap water is not safe (optional)
• Basic medicines from a pharmacist (optional)

Step by step

1. Check the destination's health advice before you go.TravelHealthPro and the NHS travel pages list the recommended vaccinations, malaria advice and food and water precautions for each country. Some vaccinations need weeks of lead time, so check early.
2. Find out whether the tap water is safe there.Not universally, and not always consistent within a country. Where it is not, that includes ice, salad washed in it, and brushing your teeth — the last is the one people forget.
3. Use sealed bottled or properly treated water where needed.Check the seal is intact. A filter bottle or purification tablets are cheaper, produce less plastic and work where bottled water is hard to trust.
4. Wash or sanitise hands before every meal.Soap and water where possible, sanitiser otherwise. This is the single highest-value habit and the one most often skipped when eating with hands at a street stall.
5. Prefer food that is freshly cooked and served hot.Busy places with high turnover are safer than quiet ones, because the food has not been sitting. Buffets left warm, reheated rice, and anything lukewarm are the classic risks.
6. Be careful with raw produce and unpasteurised dairy.Fruit you peel yourself is fine. Salad and unpeeled fruit washed in unsafe water is not. Unpasteurised milk, cheese and ice cream from an unreliable source are worth avoiding where water safety is a concern.
7. Take rehydration sachets with you.They are small, light and the actual treatment for the thing most likely to happen. Buying them abroad while ill, in a language you do not speak, is much harder than packing four sachets.
8. Ask a pharmacist what else to take.Anti-diarrhoeal medicine has a place for a long journey and is not always the right thing otherwise. A pharmacist will put together a sensible small kit for your destination and your family.
9. Treat it properly if it happens.Fluids first and constantly, small and often. Plain food when you can face it. Rest. Most cases settle within a couple of days without anything else.
10. Know when to get medical help.High fever, blood, severe or persistent vomiting, inability to keep fluids down, signs of dehydration, or illness in a baby, young child, older person or anyone immunocompromised. Ring the insurer's emergency line — they can direct you to a facility they deal with directly.

Tips

• Heat and sun cause as many spoiled holidays as food does. Shade in the middle of the day, water constantly, and sun protection reapplied properly.
• Take a small supply of your usual over-the-counter medicines. Familiar brands are not available everywhere and reading a foreign packet while ill is not ideal.
• Insect bites are the other common holiday problem and the preventable one — repellent, covering up at dawn and dusk, and checking whether the destination needs specific precautions.

Common mistakes

• Drinking bottled water but using tap water for teeth and ice — It is the same water. Where the tap water is not safe, that covers ice, washed salad and toothbrushing too.
• Not packing rehydration sachets — They weigh nothing, they treat the most likely problem, and they are much harder to find while ill in an unfamiliar place.

Questions people ask