Sepsis and Travel

There are many illnesses that affect people no matter where they are, like influenza or pneumonia. But there are also diseases and infections found only in certain parts of the world. These are endemic diseases. Some can make a traveler very sick and could cause sepsis. Most people in the United States wouldn’t contract these infections unless they travel to locations where they are endemic. 

Like all infections, some endemic diseases could cause sepsis. Sepsis is a life-threatening emergency that happens when your body’s response to an infection damages vital organs and, often, causes death. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.

There are other diseases and infections that you can pick up as you travel around the world. Infection prevention strategies, such as watching where you get your food and drink, hand washing, vaccinations, bug bite prevention, and avoiding intimacy with people whose medical history you don’t know, can go a long way to keeping you safe. 

Suggested Citation:
Sepsis Alliance. Sepsis and Travel. 2024. https://www.sepsis.org/sepsisand/travel/

Updated June 18, 2024.

 

More About Endemic Diseases

Dengue Fever

Dengue fever is a viral infection spread mostly by mosquitoes. According to the World Health Organization (WHO), it is the leading cause of serious illness and death in some countries in Asia and Latin America, mostly in tropical and subtropical climates. There have been some outbreaks in the United States and its territories. The CDC reports that most cases occurring in the U.S. affected travelers who contracted the infection somewhere else. Although not common, severe dengue fever can cause sepsis. 

Symptoms 

Not everyone who gets dengue fever becomes sick. Symptoms can be mild, but they also can be very severe and the infection can be life-threatening within hours. 

Symptoms include: 

  • Nausea
  • Vomiting
  • Skin rash
  • Achy muscles, joints, or bones
  • Pain behind the eye

Prevention

Protecting yourself from dengue fever means preventing mosquito bites. There is a vaccine, but unlike most vaccines that must be given before you are exposed to an infection, this one is only for people who already had the infection – and it’s only for children from age nine through 16 years. Children who already had dengue fever are at high risk of becoming seriously ill if they get it again. 

The CDC recommends using Environmental Protection Agency (EPA)-registered insect repellants. This search page helps you find the right repellant for your situation. The CDC also offers several tips on how to prevent bites when you travel. 

Malaria

Malaria is a parasitic infection, also spread by mosquitos. It is most frequently found in sub-Saharan Africa, Asia, Latin America, and the Middle East, although it can affect people in Europe. 

There was no vaccine for malaria until recently. In October 2021, the WHO recommended that a ground-breaking vaccine be given to children in sub-Saharan Africa and a few other regions that had high levels of malaria infection. It is not, however, available to adults who will travel to affected regions. 

To learn more about malaria, including symptoms, visit Sepsis and Malaria. 

As with dengue fever, the best way to prevent malaria is to take precautions against mosquito bites. There are also some medications you can take starting four to six weeks before traveling. Speak to your doctor or pharmacist about if these are an option for you. 

The medications reduce the risk a lot, but not 100% so the CDC recommends you combine the medication with bite prevention strategies. 

Traveler's Diarrhea

Researchers say traveler’s diarrhea is the most common travel-associated condition. It is often caused by bacteria but can also be viral or parasitic. The infection is usually the result of consuming water or foods that have bacteria, viruses, or parasites. It most often affects travelers who visit sub-Saharan Africa, followed by Latin America, the Middle East, and South Asia. 

It is possible to contract traveler’s diarrhea anywhere, but the highest risk is in areas where food and service hygiene may not be regulated or the infrastructure makes it hard to keep cold food cold and hot food hot. 

Symptoms 

The most obvious sign of traveler’s diarrhea is loose, watery stool – at least three within 24 hours. Other symptoms may include: 

  • Bloating and abdominal cramps
  • Nausea
  • Blood in the stool
  • Urgency to move your bowels
  • Fatigue
  • Fever

It is rare, but traveler’s diarrhea that does not go away can become so severe as to cause complications, including sepsis. 

Prevention 

You can lower your risk of contracting traveler’s diarrhea by following some simple rules: 

  • Drink fluids from sealed containers only. You should open them yourself whenever possible. Avoid tap water or drinks from unsealed bottles.
  • Avoid ice cubes because you don’t know where the water came from to make them.
  • Brush your teeth with water from a sealed bottle.
  • Avoid touching your face, particularly your mouth.
  • Wash your hands well with soap and water often, or use sanitizer if no soap is available.
  • Eat only hot, cooked food that has been kept at hot temperatures, not at a buffet.
  • If you eat raw fruit, wash it with clean water or peel it.
  • Don’t eat raw or undercooked meat.
  • Food preparation utensils and surfaces must be cleaned with boiled or chemically disinfected water.
  • Many experts also recommend avoiding food sold by street vendors.

There are some medications, taken a few weeks before travel, that can also decrease your risk. Speak with your pharmacist before your trip to find out if this might work for you. 

There’s no doubt that traveler’s diarrhea can be very unpleasant, but it is rarely serious enough to be life-threatening. That being said, people with the infection should be careful and take care of themselves to keep from becoming seriously ill. 

Treatment 

There is no cure for traveler’s diarrhea. Over-the-counter (OTC) anti-diarrhea medications can help ease how often you need to go to the bathroom but not everyone should take them. People who are pregnant, children, and those who have blood in their stool and are not taking antibiotics shouldn’t take these OTC drugs. Some other tips for treatment include:  

  • Stay hydrated. This means drinking between eight to 10 glasses of clear fluids, preferably drink rehydration solutions. If none are available, you can mix rehydration salts into safe water. Rehydration salts are generally available in camping stores.
  • Children can drink Pedialyte® or suck on Pedialyte popsicles, or other rehydration drinks meant for children.
  • Eat several small meals a day, rather than three large ones.

Watch for signs of dehydration, especially with children or older people.  Dehydration can lead to organ damage. Dehydrated people will urinate less frequently or not at all. With babies, watch how often and how much they wet their diapers. Lack of tears when crying is also a sign of dehydration. 

If you see signs of dehydration, the diarrhea doesn’t go away or gets worse, or you start to see blood in your stool, see a doctor as soon as possible. Diarrhea caused by bacteria may need antibiotics. If you are severely dehydrated, you may need intravenous (IV) fluids for rehydration. 

Hepatitis A

Hepatitis is a vaccine-preventable viral liver disease. Travelers can be exposed to hepatitis A, particularly if they visit rural areas or places with poor food and service hygiene. However, you can get hepatitis A at higher-end resorts and tourist spots because it only takes one person who has the disease to pass it on to someone else. 

You can contract hepatitis through: 

  • Consuming food or drink contaminated with the virus
  • Having close personal or intimate contact with someone who has the virus
  • Touching an object or surface that has the virus on it and then touching your mouth

Symptoms 

Unlike traveler’s diarrhea, you won’t know right away if you have hepatitis A. You will only begin to experience symptoms two to seven weeks after infection. 

Symptoms include: 

  • Jaundice, yellowish tint to the skin, yellow in the whites of the eye
  • Loss of appetite
  • Nausea and vomiting
  • Abdominal pain
  • Dark or brown urine
  • Light color bowel movements
  • Fatigue
  • Joint pain

Prevention 

Hepatitis A is vaccine-preventable. Some forms of the vaccine also offer protection against hepatitis B. It takes three injections over six months to have full immunity. 

Also, continue to practice good infection prevention practices with frequent hand washing, particularly after using the bathroom and changing a diaper, and before touching food. 

There is no cure for hepatitis A. The virus generally clears on its own. After about six months, your liver should have healed any damage the virus caused. 

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