It has been estimated that more than 15 million people experience traveller's diarrhoea each year, it most often occurs during the first week of travel.

About a third of those affected are unable to continue planned activities for between half to an entire day and further costs and time may be used if a health professional needs to be consulted.

There may be risk factors such as low stomach acidity and genetic causes of increased risk.

Prevention advice is not straightforward, but hand-washing and avoiding high risk food and drink is sensible, but does not guarantee protection and hygiene standards in food preparation may be outside traveller's control.

Use of antibiotics may occasionally have a role in some  travel circumstances. There are concerns regarding antibiotic resistance and cost.

 Probiotics are being investigated, but there is no current consensus due to variability across destinations and populations of travellers in studies.  There is also concern regarding commercially available products and whether they are equivalent to those used in trials. The most commonly used probiotics for protection are lactobacillus species and Saccharomyces boulardii.

Dukoral ( cholera vaccine) has a small protective effect , it is thought to be because of the similarity between the cholera toxin and the enterotoxic E Coli , which is a common cause of traveller's diarrhoea. It is not licensed for this indication in Australia, but it is in a number of other countries.

The Centers for Disease Control and Prevention in the US has developed the app, Can I Eat This, providing a scroll down list of the countries of the world. You then can chose the type of product you are planning to consume, whether you are pregnant  and answers are given as to whether it is okay, eat at your own risk or don't eat.   The app does not require internet connection once downloaded.

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