Contaminated food and water are the main cause of travellers’ diarrhoea and several other travel infections, so safe food and water habits are among the most useful things you can do abroad. The idea is captured by a well-known rule: “boil it, cook it, peel it — or forget it.” Careful habits reduce the risk substantially, though they do not remove it entirely, so it also helps to know the diarrhoea red flags.
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In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.
If illness does strike, blood or mucus in the stool, a high fever, severe or persistent symptoms, or signs of dehydration need medical care — and symptoms that persist after returning home should be checked.
How illness is caught
Food- and water-borne illness comes from swallowing food or water contaminated with bacteria, viruses, parasites or, sometimes, chemicals — and contaminated water can look perfectly clean. Typical routes are tap water and ice made from it, food washed or prepared with unsafe water, raw or undercooked meat and seafood, unpasteurised dairy, raw vegetables and salads, unpeeled or already-peeled fruit handled with dirty hands, food left at room temperature, and food from vendors or premises with poor hygiene.
Safe water and drinks
Drink only water you know is safe: factory-sealed bottled water with an intact seal, water brought to a rolling boil, or water that has been appropriately filtered or chemically treated. Canned or bottled carbonated drinks and hot tea or coffee are generally safe. Avoid tap water where quality is uncertain — including for brushing teeth — and avoid ice, which is often made from tap water and is not made safe by freezing.
Safe food
Prefer food that is freshly and thoroughly cooked and served piping hot, and note that dry and packaged foods are generally safe. Peel fruit yourself after washing it in clean water, and avoid raw vegetables and salads, food served at room temperature or reheated, raw or undercooked meat and seafood, unpasteurised dairy, and food from street vendors or premises with poor hygiene. If you do eat street food, choose busy stalls that cook to order and serve it piping hot, and avoid anything raw or lukewarm.
Hand hygiene
Wash your hands with soap and water regularly, especially before handling or eating food and after using the toilet. When soap and water are not available, use an alcohol-based hand sanitiser containing at least 60% alcohol. Simple hand hygiene, combined with safe water and thoroughly cooked food, prevents a great deal of food- and water-borne illness — though, again, not all of it.
Red flags if you do get sick
The warning signs are the same as for travellers’ diarrhoea: blood or mucus in the stool, a high fever, severe or persistent diarrhoea or vomiting, or signs of dehydration. Take extra care with infants and young children, the elderly, pregnant women and immunocompromised travellers, who should be seen early, and get any symptoms that persist after returning to Singapore reviewed by a doctor, as they can occasionally be due to a parasite needing a stool test. Severe dehydration or collapse is a 995 emergency.
Planning ahead and if you get sick
A pre-travel consultation with a GP or travel clinic is the best prevention step: tailored food and water advice, oral rehydration salts to pack, and any destination-relevant vaccinations such as hepatitis A or typhoid. If illness develops, oral rehydration is the mainstay — oral rehydration salts with clean water — while loperamide is only for mild adult watery diarrhoea and not with bloody diarrhoea or high fever, and antibiotics are used only on medical advice. Safe food and water practices and hand hygiene remain the core of prevention.
Extra care for higher-risk travellers
Some travellers should be especially careful with food and water. Infants and young children, pregnant women, older travellers and anyone with a weakened immune system or a chronic illness are more likely to become seriously unwell from food- or water-borne infection, so it is worth being stricter about safe water, thoroughly cooked food and hand hygiene, and seeking care earlier if illness develops. If you are travelling with a baby, prepare formula only with water that has been boiled and cooled, and continue breastfeeding where possible, which is both safe and protective. People with reduced stomach acid (for example those on certain acid-reducing medicines) may be more susceptible to some gut infections and should take particular care. Remember, too, that safe food and water habits work alongside — not instead of — relevant travel vaccines such as those against hepatitis A and typhoid, so discuss these at a pre-travel consultation. When in doubt about a food or drink, it is safer to skip it than to risk an illness that can spoil a trip, and packing oral rehydration salts before you go means you are ready if something does slip through.
When to see a doctor
See a doctor for any red flag, for illness in a higher-risk traveller, for symptoms lasting more than a few days, or for diarrhoea continuing after returning home — and call 995 for severe dehydration or collapse.
Related travel-health topics
- Pre-travel health advice
- Travel vaccinations
- Travellers’ diarrhoea
- Altitude sickness
- Motion sickness
- Travel-related DVT
- Rabies
- Japanese encephalitis
- Insect bite prevention
- Travelling with medication
- Malaria prevention
- Travel clinics in Singapore
Sources
- HealthHub (Singapore) — Protect yourself from travellers’ diarrhoea: healthhub.sg
- Communicable Diseases Agency (CDA) Singapore — Health advice for travellers: cda.gov.sg
- CDC Travelers’ Health — Food and Drink Considerations: cdc.gov
- NaTHNaC / TravelHealthPro — Travellers’ diarrhoea: travelhealthpro.org.uk
