Travelling Without Montezuma’s Revenge – Dukoral
18 Feb 2007
Friends frequently ask me, "What antibiotics and other drugs are you taking with you for Montezuma’s Revenge when you travel to foreign countries?" They are surprised when I tell them I don’t carry any medication. I add that recently I visited Egypt and cruised up the Nile River to the Aswan dam without packing any medication. My son and I didn’t lose one minute from an attack of travellers’ diarrhea during the trip. Was this just luck, or did I have a secret weapon to counter this terror-inducing disorder?
On some other trips I’ve lifted my eyes to Heaven and prayed, "Dear Lord, above all other worldly benefits please quickly grant me the sight of a bathroom". I’m sure other travellers have raised this silent prayer on a bus when the next stop is miles away. Or when a plane is delayed before take-off and passengers are prohibited from using the facilities.
This uncivilized disability can strike with the speed of lightning and when it does, no one cares whether it’s called Montezuma’s Revenge, the Hong Kong Trots or the Casablanca Crud. Studies show that up to 50 percent of travelers to developing countries fall victim to this malady.
Traveller’s diarrhea is usually the result of an infection from a bacteria called E. coli or due to Vibrio cholerae. Both of these germs cause watery diarrhea, abdominal cramps and a cold perspiring brow.
Cholera, in particular, is one of the most infectious diseases known. Its severe diarrhea results in rapid dehydration and shock that may be life threatening in extreme cases.
It’s often been said that, "When in Rome do as the Romans do". That’s possibly OK in Rome, but not in many other nations were sanitation is questionable.
During trips to vulnerable countries I always follow basic rules of hygiene, an attempt to prevent the loss of several days sitting on the potty. But saying "no" to ice cubes in your drink, using bottled water, eating well-cooked food, avoiding street food vendors, eliminating fruits you don’t have to peel, and staying in clean hotels, never guarantees ultimate freedom from traveller’s diarrhea.
Tourists often forget that food handlers in the kitchen of five-star hotels don’t live in them. At days end they return to less desirable dwellings and may bring back E. coli the next day. The most common reason is the neglect of hand washing following a bowel movement.
This is why, before the trip to Egypt and another to Mexico, I decided to stop playing Russian roulette with intestinal infection. I decided to use, Dukoral, to vaccinate myself and my son against E. coli and Cholera.
Dukoral is an oral vaccine indicated for those two years of age and older. It’s prescribed in two doses one week apart prior to travelling and provides immunity for three months. The final dose should be taken at least one week before departure. If another trip is planned after three months a single booster dose is required to restore resistance to infections.
How effective is Dukoral? A study done in Bangladesh of 89,596 adults and children showed 67 to 85 percent protection against E. coli and 85 percent for Cholera.
And studies done in Bangladesh, Peru and Sweden show that Dukoral has no serious side effects.
In the past some physicians have recommended the use of antibiotics during trips to high risk areas. These can be effective, but there is always the risk that they too will cause diarrhea and other bowel complications.
Today travelling is too expensive to have a holiday ruined by Montezuma’s Revenge. Many of my patients have spent several thousand dollars to travel to a country they’ve been planning to visit for years. Unfortunately they return seeing more of the bathroom than the country.
One businessman I know travelled to China to give an important speech. But after travelling several thousand miles he was struck down by the "Ho Chi Minhs" a few hours prior to reaching the podium.
The cost of Dukoral is what you would pay for a good dinner. It’s a cheap insurance policy to avoid praying to the Almighty for the sight of a bathroom.
