Prevention of gastrointestinal infections in India

Sama · Sep 30th, 2008, 20:49

Quote:

Originally Posted by wonderwomanusa

I wouldn't automatically start taking Cipro for a bad tummy, but if you do take it, be sure to take a full course of it

I would absolutely take Cipro with me.....again.

I had Cipro with me on my first two trips....on my third trip I didn't have it with me thinking "bah! I never get sick in India."

toward the end of my third trip I had -- as was diagnosed when I got home, i.e., barely got home - salmonella food poisoning. while I was in India I knew it was more than a case of simple runs, my doctor here said that I was lucky to have gotten the IV when I did in India or else....

anyway, when I got back home (still sick tho not as much) I went to the doctor and she gave me Cipro and it knocked the salmonella right out of me.

I won't travel to India without it again.

Drews60 · Sep 30th, 2008, 21:14

Thanks to IM, I'll be starting my probiotic program 3 months before departure.

My Steri-pen will arrive this Friday. Talk about convenient, a portable, battery operated UV water purification device. The model I purchased comes with a water bottle and filter kit.

I should be able to fill the bottle up from any tap in India and use the steri-pen to convert otherwise "bad" water into "safe" water within 90 seconds or so. Amazing.

Feedback from other users, please.

camelgirl · Sep 30th, 2008, 22:20

Quote:

Originally Posted by Drews60

My Steri-pen will arrive this Friday. Talk about convenient, a portable, battery operated UV water purification device. The model I purchased comes with a water bottle and filter kit.

I should be able to fill the bottle up from any tap in India and use the steri-pen to convert otherwise "bad" water into "safe" water within 90 seconds or so. Amazing.

Feedback from other users, please.

See my post #263 in this thread for more feedback on steri-pens.

Nick-H · Sep 30th, 2008, 23:04

Cipro is available here, no need to bring it with you.

Maybe have two or three, to get you through the first day, by which time you might feel better about going our to buy some more.

Swat Kat · Sep 30th, 2008, 23:46

Or, drink a sip of local water for immunity, something like taking flu shots

Nick-H · Oct 1st, 2008, 00:26

Kill or cure principle, eh?

saritat · Oct 8th, 2008, 02:38

i swear on grapefruit extract!better as more as concetrate possible! just few drops in water, limonade or else fluids and everything is ok. few drops if u getting first complains from ur stomach and over (for me at least).

altmtl · Oct 8th, 2008, 02:43

Quote:

Originally Posted by altmtl

I'm a big fan of probiotics, I usually bring the "heat stable" type with me...
Viomax Profidus or PB8 - I sometimes bring Activated Vegetal Charcoal and GSE Liquid Concentrate (citrus extract)

Can I get similar products in India, I don't want to bring a 3 month supply... my med kit already takes up too much space.

I hate to repeat myself, but can I get these products or similar ones at any chemist shop in India?

Nick-H · Oct 8th, 2008, 02:52

Quote:

Originally Posted by saritat

...few drops if u getting first complains from ur stomach and over (for me at least).

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drzog · Oct 14th, 2008, 10:31

This summary just came through on my e-alerts

Self-treatment the key to managing travellers’ diarrhoea

Hill, D. Ryan, E. 2008, ‘Management of travellers’ diarrhoea.’ British Medical Journal published online.

10 Oct 2008

Although sensible hygiene can help reduce the risk of travellers’ diarrhoea, patients should be counselled about the benefits of early self-treatment when they run into trouble, a recent review has stated.

The inconvenient and sometimes debilitating condition affects somewhere between 20% and 60% of people travelling to low income countries, and the median time to onset is six or seven days after arrival.

Identifying the pathogen among the myriad of possibilities is often difficult and rarely helpful in uncomplicated cases, with the causes varying with the destination, setting and season. Several types of E. coli as well as Campylobacter, Salmonella and Shigella species are the most common bacteria involved. Norovirus is often responsible for outbreaks in holiday resorts and on cruise ships, with rotavirus being the next most common viral cause.

Strict precautions over food and water, as well as careful personal hygiene, should decrease the risk, but there has been little decline in the incidence of the complaint despite the travelling public becoming better informed over the years. The main determinant of risk is probably the sanitation level at the destination.

Antibiotic prophylaxis generally has little to offer, because the benefits are unlikely to outweigh the personal and community risks.

When diarrhoea strikes, adequate hydration is the key. For healthy adolescents and adults, normal potable fluids are sufficient, but the young, old and frail might benefit from the addition of electrolytes, sugar and a buffer.

Bismuth or an antimotility agent – usually loperamide – are the mainstays of symptomatic relief. Antibiotics taken as a single dose or for up to three days usually improve symptoms within 20 to 36 hours, and shorten the duration of diarrhoea by one or two days. Fluoroquinolones (cipro) are effective in most parts of the world. Combining an antibiotic with loperamide should be considered for people with classic travellers’ diarrhoea who need rapid relief.

My opinion: Typically mainstream medical lacking positive preventative strategies and disappointing they didn't mention probiotics, in the summary anyway.

AlanJ · Oct 14th, 2008, 11:35

Certainly not much to argue about in that report... however, all it really tells us is what to do AFTER something strikes, which, of course, was not the point of this thread at all(surely this discussion is about what, if anything, you can do before you leave home so that all these dreaded organisms with the funny names won't strike in the first place?)

The article quoted dismisses all talk of preventive measures in the first half-sentence ("Although sensible hygiene can help reduce the risk of travellers’ diarrhoea..."), which would seem to indicate that the author doesn't think much of any of them; "sensible hygiene" is, I guess, BASIC hygiene, such as washing one's hands. As you say, he doesn't get into the subject of probiotics or any kind of dietary/medical preventive measures at all. But this doesn't mean that such things don't exist! What it DOES perhaps mean is that it's very difficult to prove or disprove their effectiveness scientifically. Since there are so many other factors in play, the "treatment" can't be isolated, which makes accurate measurement, and the compilation of statistical data, next-to-impossible.

But this thread, I think, is VERY valuable because, in the absence of being able to measure things, it is providing a wealth of anecdotal information... which, eventually (if we get enough "sample stories"), should at least show up a TREND, shouldn't it?

Nick-H · Oct 14th, 2008, 11:44

No, I don't think so, due to the anecdotal nature of each report, and due to the lowish sample size (there I go using technical terms; actually I don't have any knowledge of statistics at all).

One thing that often happens is that people get fixated on what they think caused their illness. It may sometimes be obvious; very often it is not. A particular meal may be blamed, when the culprit microbe might have entered our mouth via a hand. A particular part of a particular meal may be blamed; sometimes even putting us off eating that thing again. It can all be wrong!

The only occasion on which I am almost a 100% sure that a particular thing could be blamed, it was the ice cream that was the only thing my wife ate that I did not in a 24 hour period. But hey, we had the same food, but maybe her plate was dirty!

Equally, we have our own theories about why we didn't get ill, whereas the only thing that can truly be said for sure is ...we didn't get ill.

But I still agree that this thread is very valuable

Even though participants have sometimes strongly disagreed about what constitutes down-to-earth good advice, there is a lot of it in the thread!

trustindia · Oct 14th, 2008, 11:51

Just to note, are we talking about ciproflaxin here???
If so, go easy on it, it's one of the last line of defences for really serious health issues, anyone heard of MRSAs

trustindia · Oct 14th, 2008, 12:57

Quote:

As you say, he doesn't get into the subject of probiotics or any kind of dietary/medical preventive measures at all. But this doesn't mean that such things don't exist! What it DOES perhaps mean is that it's very difficult to prove or disprove their effectiveness scientifically. Since there are so many other factors in play, the "treatment" can't be isolated, which makes accurate measurement, and the compilation of statistical data, next-to-impossible.

Some studies have apparently shown a strong placebo effect as well.
Belief is a powerful thing.
As to personal hygiene, it's cost very little time to wash you hands so why not.

theyyamdancer · Oct 14th, 2008, 15:41

I just re-read most of this thread. One thing stood out for me - DON'T drink Bisleri "Mineral Water" as it has been found in tests to be unclean. Wish I had remembered that when struck down by debilitating illness earlier this year in Varanasi after buying mineral water. It looked OK, but the results a few hours later were dramatic - fever, vomiting, diarroeh. I ruled out food as the culprit since my travelling companion and I did not eat the same foods. Only other possibility was the glasses we drank out of, maybe not properly washed, or properly handled. I was very pleased to have some Cipro in my luggage, although not enough. Mr. T. recovered within a week but I needed a second dose of 5 days of Cipro prescribed by the doctor on returning home. As for the probiotics - the time for taking them is before travelling and after recovery from illness. As soon as you finish the course of medicine it's helpful to up your intake of curd, lassi, yoghurt, probiotics in pill form.

Sep 30th, 2008, 23:04	#274
Nick-H Loud-mouthed, Noisy Bird Join Date: Oct 2004 Location: Chennai, India Posts: 27,692	Cipro is available here, no need to bring it with you. Maybe have two or three, to get you through the first day, by which time you might feel better about going our to buy some more. __________________ . Just one member of the IndiaMike Mod Team

Oct 8th, 2008, 02:38	#277
saritat Member Join Date: Sep 2007 Location: greece, europe Posts: 16	grapefruit extract i swear on grapefruit extract!better as more as concetrate possible! just few drops in water, limonade or else fluids and everything is ok. few drops if u getting first complains from ur stomach and over (for me at least).

Oct 14th, 2008, 10:31	#280
drzog Based On A True Story Join Date: Nov 2004 Location: Melbourne, Australia Posts: 101	‘Management of travellers’ diarrhoea.’ 2008. This summary just came through on my e-alerts Self-treatment the key to managing travellers’ diarrhoea Hill, D. Ryan, E. 2008, ‘Management of travellers’ diarrhoea.’ British Medical Journal published online. 10 Oct 2008 Although sensible hygiene can help reduce the risk of travellers’ diarrhoea, patients should be counselled about the benefits of early self-treatment when they run into trouble, a recent review has stated. The inconvenient and sometimes debilitating condition affects somewhere between 20% and 60% of people travelling to low income countries, and the median time to onset is six or seven days after arrival. Identifying the pathogen among the myriad of possibilities is often difficult and rarely helpful in uncomplicated cases, with the causes varying with the destination, setting and season. Several types of E. coli as well as Campylobacter, Salmonella and Shigella species are the most common bacteria involved. Norovirus is often responsible for outbreaks in holiday resorts and on cruise ships, with rotavirus being the next most common viral cause. Strict precautions over food and water, as well as careful personal hygiene, should decrease the risk, but there has been little decline in the incidence of the complaint despite the travelling public becoming better informed over the years. The main determinant of risk is probably the sanitation level at the destination. Antibiotic prophylaxis generally has little to offer, because the benefits are unlikely to outweigh the personal and community risks. When diarrhoea strikes, adequate hydration is the key. For healthy adolescents and adults, normal potable fluids are sufficient, but the young, old and frail might benefit from the addition of electrolytes, sugar and a buffer. Bismuth or an antimotility agent – usually loperamide – are the mainstays of symptomatic relief. Antibiotics taken as a single dose or for up to three days usually improve symptoms within 20 to 36 hours, and shorten the duration of diarrhoea by one or two days. Fluoroquinolones (cipro) are effective in most parts of the world. Combining an antibiotic with loperamide should be considered for people with classic travellers’ diarrhoea who need rapid relief. My opinion: Typically mainstream medical lacking positive preventative strategies and disappointing they didn't mention probiotics, in the summary anyway. __________________ yours in health http://drzog.blogspot.com

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Sep 30th, 2008, 21:14	#272
Drews60 Senior Member Join Date: Aug 2007 Location: Norman Oklahoma USA Posts: 159	Thanks to IM, I'll be starting my probiotic program 3 months before departure. My Steri-pen will arrive this Friday. Talk about convenient, a portable, battery operated UV water purification device. The model I purchased comes with a water bottle and filter kit. I should be able to fill the bottle up from any tap in India and use the steri-pen to convert otherwise "bad" water into "safe" water within 90 seconds or so. Amazing. Feedback from other users, please.

Sep 30th, 2008, 23:46	#275
Swat Kat Exploring India Join Date: Sep 2008 Location: Central Pennsylvania Posts: 16	Or, drink a sip of local water for immunity, something like taking flu shots

Oct 1st, 2008, 00:26	#276
Nick-H Loud-mouthed, Noisy Bird Join Date: Oct 2004 Location: Chennai, India Posts: 27,692	Kill or cure principle, eh?

Oct 14th, 2008, 11:35	#281
AlanJ Member Join Date: Dec 2007 Location: Australia Posts: 95	Certainly not much to argue about in that report... however, all it really tells us is what to do AFTER something strikes, which, of course, was not the point of this thread at all(surely this discussion is about what, if anything, you can do before you leave home so that all these dreaded organisms with the funny names won't strike in the first place?) The article quoted dismisses all talk of preventive measures in the first half-sentence ("Although sensible hygiene can help reduce the risk of travellers’ diarrhoea..."), which would seem to indicate that the author doesn't think much of any of them; "sensible hygiene" is, I guess, BASIC hygiene, such as washing one's hands. As you say, he doesn't get into the subject of probiotics or any kind of dietary/medical preventive measures at all. But this doesn't mean that such things don't exist! What it DOES perhaps mean is that it's very difficult to prove or disprove their effectiveness scientifically. Since there are so many other factors in play, the "treatment" can't be isolated, which makes accurate measurement, and the compilation of statistical data, next-to-impossible. But this thread, I think, is VERY valuable because, in the absence of being able to measure things, it is providing a wealth of anecdotal information... which, eventually (if we get enough "sample stories"), should at least show up a TREND, shouldn't it?

Oct 14th, 2008, 11:44	#282
Nick-H Loud-mouthed, Noisy Bird Join Date: Oct 2004 Location: Chennai, India Posts: 27,692	No, I don't think so, due to the anecdotal nature of each report, and due to the lowish sample size (there I go using technical terms; actually I don't have any knowledge of statistics at all). One thing that often happens is that people get fixated on what they think caused their illness. It may sometimes be obvious; very often it is not. A particular meal may be blamed, when the culprit microbe might have entered our mouth via a hand. A particular part of a particular meal may be blamed; sometimes even putting us off eating that thing again. It can all be wrong! The only occasion on which I am almost a 100% sure that a particular thing could be blamed, it was the ice cream that was the only thing my wife ate that I did not in a 24 hour period. But hey, we had the same food, but maybe her plate was dirty! Equally, we have our own theories about why we didn't get ill, whereas the only thing that can truly be said for sure is ...we didn't get ill. But I still agree that this thread is very valuable Even though participants have sometimes strongly disagreed about what constitutes down-to-earth good advice, there is a lot of it in the thread!

Oct 14th, 2008, 11:51	#283
trustindia Senior Member Join Date: Sep 2008 Location: Gt Britain Posts: 301	Just to note, are we talking about ciproflaxin here??? If so, go easy on it, it's one of the last line of defences for really serious health issues, anyone heard of MRSAs

Oct 14th, 2008, 15:41	#285
theyyamdancer Maha Guru Member Join Date: Dec 2005 Location: Crete Posts: 2,094	I just re-read most of this thread. One thing stood out for me - DON'T drink *Bisleri* "Mineral Water" as it has been found in tests to be unclean. Wish I had remembered that when struck down by debilitating illness earlier this year in Varanasi after buying mineral water. It looked OK, but the results a few hours later were dramatic - fever, vomiting, diarroeh. I ruled out food as the culprit since my travelling companion and I did not eat the same foods. Only other possibility was the glasses we drank out of, maybe not properly washed, or properly handled. I was very pleased to have some Cipro in my luggage, although not enough. Mr. T. recovered within a week but I needed a second dose of 5 days of Cipro prescribed by the doctor on returning home. As for the probiotics - the time for taking them is before travelling and after recovery from illness. As soon as you finish the course of medicine it's helpful to up your intake of curd, lassi, yoghurt, probiotics in pill form.

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