What Makes Travelers Sick

 American water.

Travelers worry that our fierce advocacy of the free market includes opposition to government meddling in the water supply. I regularly assure them that all American tap water is drinkable.

American food.

No one believes that Taco Bell or McDonald’s sell healthy food, but foreigners worry that these exotic, colorful substances are toxic. We Americans are warned about eating in nations with poor sanitation; about one in three American tourists in these areas get sick. If we’re careful, our sickness rate drops to… Actually, it doesn’t drop. No one knows how to prevent traveler’s diarrhea. The Swiss get sick when they come to the US.

Air conditioning

Americans accept air conditioning with even more enthusiasm than personal firearms, but most of the world has never caught on. They tolerate it as an odd American custom but believe that air from a machine is unhealthy whether it’s automobile exhaust or a box in a window. When someone gets sick, they turn it off. I wear a suit, so caring for foreign tourists during the summer is a painful experience.

Air Travel

Travelers blame the airline for any illness that occurs within a week of flying. This is not so for aches and pains and unlikely for an upset stomach but true for respiratory infections.

Stress

Vacations are stressful, particularly if children are involved. They miss their friends; they hate the food; they prefer watching TV to sight-seeing; they refuse to adjust their sleeping hours.  It turns out that stress makes everything worse, but it doesn’t cause anything, so there’s no reason for the parents to get sick. When they do, it’s a respiratory infection, usually the children’s fault.

I Just Got Back From Mexico...

One third of visitors to poor countries from rich countries get sick. Experts warn tourists to avoid uncooked food, street vendors, ice, and tap water. By obeying, they lower the risk of getting sick to… one third. The truth is that no one knows how to prevent traveler’s diarrhea. Poor sanitation seems essential, but travel itself must play a role. The Swiss get sick when they visit the US.

Tourists visiting the tropics worry unnecessarily about parasites. Germs and protozoa like malaria remain a problem, but larger creatures reproduce slowly. Victims must stay long enough and undergo repeated exposure before they accumulate enough to realize something is wrong. If you harbor a few dozen schistosomes, flukes, or hookworms, you won’t notice.

Having said this, I visited one horrified guest who had seen what looked like an earthworm swimming in the toilet after a bowel movement. Unfortunately for my education, he had flushed it down. This was undoubtedly an ascarid, a parasite that affects a billion people worldwide and an unknown number in the US. Unlike parasites such as hookworms which bite into the intestine and eat your blood, ascarids swim freely and eat what you eat. You can support a dozen without difficulty. Victims get into trouble when huge numbers cause an obstruction or when a single worm crawls into a duct and gets stuck. If you return from vacation with a small infestation, you have little to worry about. The females will mate, but their eggs only hatch outside the body in warm earth, so they disappear down the sewer, and the average ascarid dies after a year or two.