STORY BYDr. Charles Ericsson has some advice for college students who are taking the party to Mexico for Spring Break.
Pack an anti-diarrheal. If binge drinking is on the travel itinerary, and you are a college-age man, chances are you're going to need it.
A recent study of U.S. college students who were visiting Mexico revealed that men who drank heavily were far more likely than their female counterparts to suffer diarrhea, says Ericsson, an infectious disease and travel medicine expert at The University of Texas Medical School at Houston.
Of men ages 18-21, 90 percent who drank more than five beers or cocktails a day developed diarrhea.
The alcohol itself is probably not the cause of travelers' diarrhea. Researchers believe the cocktails may serve as a catalyst for unwise food choices that make vacationers sick.
Vacationers often already have a relaxed mindset, Ericsson says. Pour a several stiff drinks into the mix, and it's easy to forget that food in developing countries is not always safe to eat.
"These young kids are throwing caution to the wind," Ericsson says. "We suspect that alcohol is impairing their judgment, and they are making risky food choices. They go out drinking, and suddenly they think it's a good idea to eat a taco from a street vendor or snack on salsa that's been sitting out all day."
Ericsson and colleagues studied the relationship between alcohol consumption and travelers' diarrhea in 171 U.S. students who attended summer educational sessions in 2001 and 2002 in Guadalajara.
He presented the research last month at the African-European Conference on Travel Medicine in Cape Town, South Africa.
Overall, almost 80 percent of the men who consumed more than five alcoholic beverages daily suffered "Montezuma's Revenge," compared to 46 percent of women.
"It needs to be studied further, but we think behavior changes may be the reason more men get travelers' diarrhea after they drink heavily," Ericsson says. "They may be more likely to grab a snack after they leave the disco, whereas women may just call it a night and go home."
The study also revealed some sobering news. Men and women who drank no alcohol at all during their trip to Mexico also had a high incidence of travelers' diarrhea, Ericsson says. Almost 70 percent of them got sick.
Ericsson believes non-drinkers may be more prone to stomach upset because of their diet. If they are trying to maintain a healthy lifestyle by drinking water and eating raw fruits and vegetables, they are more likely to consume infectious contaminants, such as E. coli, that will make them sick.
So is there a happy medium? "You need to be smart about what you eat when you are in a developing country," Ericsson says. "Enjoy yourself. If you want a drink, have a drink, but I would advise that you do it in moderation so you have the ability to make smart, safe decisions about what you eat."
Regardless of alcoholic intake, travelers' diarrhea may be unavoidable. It is the most common illness affecting international travelers, with an estimated 10 million people each year developing a bout.
There are ways to minimize the risk, though. Ericsson says travelers should avoid raw fruits and vegetables, including salads and lettuce garnishes. Stay away from raw or undercooked meat and foods or beverages sold from street vendors or establishments where the cleanliness is questionable.
If handled properly, well-cooked and packaged foods are usually safe, as are bottled beverages and water that has been boiled or appropriately treated with iodine or chlorine.
Steer clear of tap water, unpasteurized milk and dairy products.
And if you are going to have a drink, Ericsson's advice is: don't order it on the rocks. The ice, like the water, may be contaminated. Contrary to what travelers may think, freezing the bacteria doesn't kill it. It preserves it.
UPDATED: 3-04-2004
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Dr. Charles D. Ericsson is professor and clinical director of infectious diseases at the UT Medical School.
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