The United Kingdom’s Health Protection Agency (HPA) Tuesday revealed the top five countries where travelers from England, Wales and Northern Ireland are most likely to acquire gastrointestinal infection following their visit: Egypt, India, Thailand, Pakistan, and Morocco.
According to the report, half of the 24,322 laboratory confirmed cases of gastrointestinal infection reported in those who had recently traveled abroad between 2004 and 2008 were caused by Salmonella. The report also tracked reports of Campylobacter and Shigella and organisms such as Giardia and Cryptosporidium.

In the agency’s release, HPA travel expert Dr. Jane Jones noted that travelers can take precautions to help avoid illness while traveling.

“There are measures people can take to protect themselves while they are away and it is also important that travel health specialists and the travel industry work together to increase awareness of travelers’ diarrhea and to actively promote prevention strategies in high risk destinations,” said Jones.
“We know from studies that travelers may not follow health advice consistently while abroad,” added Jones. “Personal hygiene and precautionary measures against food and water borne illness are important at all times anywhere, but particularly when traveling to countries with less robust sanitary infrastructure than the UK. Taking sensible precautions such as avoiding tap water and ensuring food is properly cooked will help to keep a holiday at any time of the year both enjoyable and healthy.”
HPA outlined a number of factors than can affect a person’s risk of acquiring traveler’s diarrhea while abroad:
— Destination of visit. Although gastrointestinal infections occur worldwide, some are more common in countries or areas where there is a lack of sanitation and access to clean water. The world can be divided into three different risk zones for risk of travelers diarrhea. HPA lists Western Europe, USA, Canada, Japan, Australia and New Zealand as “low risk” countries. Southern Europe, Israel, South Africa, some Caribbean islands and the Pacific are considered “medium risk.” Africa, Latin America, the Middle East and most parts of Asia are considered “high risk.”

– Hygiene standards at accommodation (including swimming pools)

– Hygiene standards at eating establishments

– The personal hygiene of the traveler and the individual’s health or susceptibility to infection – underlying ill health or certain illnesses may increase the risk of infection and make illness more severe

HPA also offered some advice for travelers to help avoid traveler’s diarrhea:

– Wash your hands after using the toilet and before eating or preparing food; if soap and water is not available, carry alcohol hand gel with you.

– Investigate the destination before you go; is the tap water safe to drink? If it is not, then do not drink it or use it for cleaning your teeth.  Avoid ice in drinks.

– Make sure any food you eat has been recently prepared, is properly cooked and piping hot. Avoid raw fruit and vegetables unless you know they have been washed in clean water or peeled yourself.  More information about food and water hygiene is available from the National Travel Health Network and Center.