Traveller’s diarrhoea is the most common illness affecting people travelling abroad. While many cases are mild, some infections can become severe and require medical treatment.
One important bacterial cause of traveller’s diarrhoea is Shigella, a highly contagious bacterium that spreads through contaminated food, water, and poor hygiene. Recent cases involving British holidaymakers who died after contracting Shigella while visiting Cape Verde have highlighted the importance of understanding the risks of gastrointestinal infections when travelling internationally.
The Standards, quality and availability of medical care varies worldwide. Limited resources and lack of specialist expertise can lead to misdiagnosis and delays in appropriate treatment for gastrointestinal infections such as Shigella which could result in serious complications and even the risk of death.
Always travel with comprehensive travel medical insurance that covers pre-existing medical conditions, hospital treatment abroad and repatriation. This ensures that you have access to appropriate care abroad that is equipped to manage severe illness if required.
What Is Shigella?
Shigella is a bacteria that causes intestinal infection. It is a common cause of traveller’s diarrhoea. Symptoms include:
- Severe diarrhoea (sometimes bloody)
- Abdominal cramps
- Fever
- Nausea or vomiting
- Urgent need to pass stools
Symptoms usually develop 1–3 days after exposure, although they may appear up to a week later.
Why Travellers Are at Risk of Shigella Infection
Travellers are more likely to be exposed to Shigella when visiting regions with limited sanitation or unsafe water supplies. Higher-risk regions include South and Southeast Asia, Africa, Central and South America, however cases of Shigella infection occur worldwide, including in high-income countries.
Infection can occur through:
- Drinking untreated tap water
- Eating contaminated food
- Poor hand hygiene
- Contact with contaminated surfaces
- Person-to-person transmission, especially in crowded environments
Symptoms of Shigella Infection
Symptoms of Shigella infection can range from mild to severe. Common symptoms include:
- Sudden onset diarrhoea
- Stomach cramps
- Fever
- Nausea or vomiting
- Bloody or mucus-streaked stools
Most infections last 5–7 days, but some people may develop complications. Early recognition and treatment are important to prevent dehydration and reduce the risk of spreading infection.
When Traveller’s Diarrhoea Becomes Serious
Although many cases of traveller’s diarrhoea resolve without treatment, Shigella infection can sometimes lead to serious complications. Those at higher risk include children, older adults, pregnant women and people with weakened immune systems.
Possible complications include:
- Severe dehydration
- Persistent vomiting
- Bloody diarrhoea
- Seizures (especially in young children with high fever)
- Reactive arthritis
- Sepsis
Medical attention should be sought urgently if symptoms are severe or persistent.
How to Prevent Traveller’s Diarrhoea and Shigella Infection
Prevention is key when travelling to areas where food and water safety may be uncertain.
· Practice Good Hand Hygiene
- Wash hands frequently with soap and water
- Use alcohol-based hand sanitiser when handwashing is not possible
- Drink only bottled, boiled or purified water
- Avoid ice in drinks
- Eat freshly cooked hot food
- Avoid raw foods, salads and unpeeled fruits
These precautions can reduce the risk of Shigella as well as other causes of traveller’s diarrhoea such as Salmonella and E. coli.
Treatment for Traveller’s Diarrhoea
If diarrhoea develops while travelling, early self-care can help prevent complications.
- Maintain hydration: drink plenty of clean water (bottled)
- Use oral rehydration solutions (ORS) particularly when diarrhoea is frequent
- Anti-diarrhoeal medication such as Loperamide may help reduce symptoms, but should not be used if fever or bloody diarrhoea is present
- In situations where access to medical care may be limited, travellers may carry antibiotics such as Azithromycin to treat severe diarrhoea under medical advice before travel.
- Seek medical care and advice if symptoms last more than 48 hours, especially if you are at increased risk of complications including immunosuppression and long- term health conditions.
Wash contaminated clothing, bedding and clean the toilet, handles and surfaces regularly to kill bacteria and reduce the spread of infection.
Travel Health Preparation: What to Pack
Before travelling ensure you have a well-prepared travel medical kit that includes medicine for management of Traveller’s diarrhoea:
- Oral rehydration salts
- Anti-diarrhoeal medication such as loperamide
- Hand sanitiser
- Personal medications
Always have access to your travel medical insurance documentation. Knowing how to access medical care at your destination is also important in case treatment becomes necessary.
Travel Health Advice Before You Go
Traveller’s diarrhoea is common but often preventable. Understanding the risks, practicing good hygiene, and preparing a travel medical kit can significantly reduce the likelihood of illness disrupting your trip. If you are planning international travel, a pre-travel health consultation can provide personalised advice on:
- Preventing traveller’s diarrhoea
- Recommended travel medications
- Travel vaccines
- A suitable medical kit for your destination
To help ensure your trip is both safe and enjoyable and for further information and advice on your risk of Shigella, prevention and treatment options, medical kits and traveller’s diarrhoea kits, speak with one of our experienced travel health clinicians today.
