Category: Traveler’s Guide

Travelers’ diarrhea (TD) is a clinical syndrome resulting from microbial contamination of ingested food and water; it occurs during or shortly after travel, most commonly affecting persons traveling from an area of more highly developed hygiene and sanitation infrastructure to a less developed one. Thus, TD is defined more by circumstances of acquisition than by a specific microbial agent. In fact, there is considerable diversity in etiologic agents, which include bacteria, parasites, or viruses. A similar but less common syndrome is toxic gastroenteritis, caused by ingestion of pre-formed toxins. In this syndrome, vomiting may predominate, and symptoms usually resolve within 12-18 hours.

Travelers’ diarrhea occurs equally in males and females and is more common in young adults than in older people. In short-term travelers, bouts of TD do not appear to protect against future attacks, and more than one episode of TD may occur during a single trip.

For travelers to high-risk areas, several approaches may be recommended, which can minimize but never completely eliminate the risk of TD. These include

1. instruction regarding food and beverage selection,
2. use of agents other than antimicrobial drugs for prophylaxis, and
3. use of prophylactic antibiotics.

Antibiotics are the principal element in the treatment of TD. Adjunctive agents used for symptomatic control may also be recommended.

As bacterial causes of TD far outnumber other microbial etiologies, empiric treatment with an antibiotic directed at enteric bacterial pathogens remains the best therapy for TD.

Fluid and electrolytes are lost in cases of TD, and replenishment is important, especially in young children or adults with chronic medical illness. In adult travelers who are otherwise healthy, severe dehydration resulting from TD is unusual unless vomiting is present. Nonetheless, replacement of fluid losses remains an important adjunct to other therapy. Travelers should remember to use only beverages that are sealed or carbonated. For more severe fluid loss, replacement is best accomplished with oral rehydration solutions.

Here are some of the services offered through our Traveler’s Guide Program:

• Providing you with a list of physicians and contact information to schedule an appointment
• Obtaining cost estimates on hospital fees, physician fees, and procedures you will be receiving
• Financial arrangements, such as opening an account with a local bank, wire transfers, contacting your insurance company or employer to determine authorization requirements needed prior to your visit, and other transactions
• Travel arrangements, confirming airline reservations, air and ground ambulance, transportation to and from the airport/airstrip and accommodations
• Assistance with making accommodations at local hotels for relatives overnight stay
• Assistance with any emergency situations that may develop while a patient has been admitted to Belize Medical Associates Hospital
• Advice on leisure activities

To eliminate financial hardship, confusion and delays should you or a family member require medical care while on your visit, check with your payer (insurance company, employer, etc.) prior to leaving to ensure that you have written approvals and that you understand exactly how much of he charges they will cover and how much will be your responsibility.  (Some restrictions apply)

It is best to have your return trip with an open date to avoid extra charges which may be imposed in the event of changes in your travel schedule, due to unforeseen circumstances such as delays in travel due to extended treatment and/or hospitalization.

At the hospital, wear casual clothing and comfortable shoes.  A light sweater is recommended all year round since hospital room temperatures are generally very cool.

Telephone calls can be made with telephone cards (available at the pharmacy), collect calling or charges placed on patient bill.

• Cash
• Wire transfers
• Visa/Mastercard/Travelers Cheques/American Express/Discover Insurance (a letter of authorization outlining benefits from the insurance company will be required before you receive treatment).  Some restrictions apply.

Review these items for your convenience and preparation prior to your departure:

• Passport or other form of photo identification
• Copies of medical records, diagnostic films (CT scans, x-rays, etc.)
• Original authorization letter from insurance company
• Name, address and telephone number of your referring physician(s)
• A list of your current medications and dosages
• A book, magazines or any other items to keep you occupied between appointments
• Money for payment of services, travel and subsistence