Unwelcome Guests

It is common knowledge that as a traveller, you can pick up something that will give you a tummy upset. Usually these things are caused by unfamiliar bacteria in the water or on fruits or vegetables. Thankfully the problem usually runs its course in 2-3 days and though unpleasant, it is not a big problem for most people.

But, there are also a variety of “bugs” – bacteria, viruses, amoebas, worms, and other parasites that one can encounter, and the results can be more serious than an ordinary travellers bug. All of these things are far more likely in developing countries and/or tropical countries so if you tend to stray off the beaten path, it is good to be aware of precautions and treatments. And, sometimes even with precautions, something can sneak in so thankfully there are medications that can help if necessary.

Disclaimer – I am not a professional anything and I am not responsible for your health. I am only sharing some things I have learned along the way. Consult a health care professional if you have further questions or if you are sick. 

What precautions?

  • Hand washing is always advised. Our hands are on everything so if you can keep them from carrying something to your face and body, this is the first line of defense against this and all germs. The alcohol based gels, liquids, and wipes on the market are also very effective.
  • Watch out for the water. If there is a concern that it might cause problems, drink bottled or boiled water. This includes ice cubes, water for brushing teeth, and any other water that will go in your mouth, and resist that smoothy from the street vendor (learned that one the hard way!)
  • Choose fruits and vegetables that can be washed and peeled. If they can’t be peeled wash them carefully and disinfect. The advice I have read and been told is to wash with (drinkable) water and vinegar, lemon, or salt, and rinse. You can spray it on smooth things, or soak other produce. Vinegar seems to be the most widely recommended. If you want to be even more sure, you can wash with a bleach solution. It kills everything. You will want to rinse carefully afterwards though. Recently I also saw a recommendation for cleaning with hydrogen peroxide, then vinegar, then washing with water. There are also washing solutions that you can buy but everything I have read says they are no more effective than careful washing with one of the above methods.
  • Wash hands, countertops, knives, cutting boards, and any other food prep utensils before and after preparing food.
  • Keep hot food hot and cold food cold. Avoid those middle temperatures that “bugs” like so they won’t multiply.
  • Avoid antacids if you can. Your stomach acid can kill most of the “bugs” that may get past your precautions.

What if you get sick?

  • Drink fluids! Diarrhea can quickly cause dehydration. Mineral waters or sodas are especially helpful because the sugars and salts are more effective than plain water. There may be commercially available rehydration drinks like Gatorade and other sports drinks where you are. You can also make your own with a liter of water, 6 teaspoons of sugar and 1/2 teaspoon of salt.
  • Rest and allow your body to heal itself. Minimizing other stressors on your mind and body will allow you to recover more quickly.
  • Avoid anti-diarrhea medications of you can. Your body is trying to flush out the toxins.
  • If you are very dehydrated, run a fever, have blood in the stools, don’t get better in a week, or have any other symptoms that worry you, find a doctor. There are antibiotics and medications that can help.

Of course children, the elderly, people with immune system problems, or other health concerns needs to be especially careful. It would be good to consult a doctor beforehand on how to manage any potential problems.

Do I have a personal reason for writing all this?

Umm.. yes. I know a number of people and I, myself have also been affected by the ordinary travelers tummy upset. As predicted, it tends to run its course in a few days with no lasting effects. For travelers in Panama, Bocas del Toro is notorious for this. Even with careful precautions, a couple of people in our party got sick the last time we went.

My trip to Nicaragua was a bit more of a problem though. I knew I had a problem a couple of days before we left, and I thought it would run its course like everything else. It didn’t though. Of course I didn’t take my own advice and seek treatment after a week. Two weeks went by, then three – tummy upset, little appetite, queasy, feeling run down and tired all the time, it was a real drag. I tried a few days of Panamanian remedies recommended to me and finally got fed up. I asked a friend for the name of her meds, went to the pharmacy for a consult, and got the recommended medication. I took it on Friday afternoon and on Sunday I woke up feeling like myself again.

I believe I had amoebas, or amoebiasis. My research said it is one of the more common causes of problems in Nicaragua, and my symptoms fit the description. I took Amoebriz and it seems to have done the trick. I am SO thankful that we have these medications available! The only good things about being sick is how wonderful you feel when you are better again, and I lost enough weight that my friends are noticing. From now on though I plan to be more vigilant about precautions, and I’d rather manage my weight with healthy eating and exercise.

OK, enough about sickness. The next post is also from Nicaragua, from my friend who is helping people affected by the disaster. If you helped and want to see how your money was spent and what effect it had, you need to read this.


About Kris Cunningham

We live in David, Chiriqui Provence, Republic of Panama! This blog is about some of our experiences in our new country.
This entry was posted in medical care, Miscellaneous and tagged , , , . Bookmark the permalink.

21 Responses to Unwelcome Guests

  1. 4sarge says:

    When younger, I was a Mexican regular and Never had a problem in 15+ years. Took the wife for a vacation and Bam, I either got some bad ice or the lime in the Margarita and I was Sick (Note the capital S) for 2 weeks plus till it finally ran its course. I was still Young and Fearless because IF I had gone to the Dr. I probably would have been well much Quicker.


    • I know, sometimes you just have some bad luck and of course being young and fearless (ha!) I also thought I could beat it without help too. Hopefully nothing like that happens again to either one of us.


  2. oldsalt1942 says:

    When I was visiting the Rio Dulce in Guatemala on my sailboat I met a young, American doctor who gave me and a friend a few pointers on things we should avoid putting in our mouths. One big no-no was “street food,” with one exception. Tamales! They have been steamed in being cooked so they are completely safe to eat.


    • Oh thank you, I read about street food and completely forgot to include that in my post. Unfortunately I think street food is so interesting and part of the culture that I want to try everything I see, so I’ll probably regret that sometime. That’s good news about the tamales though!


  3. tombseekers says:

    David brought home every parasite known to man from India. Three different treatments, each increasing in length, finally got things under control. Not pleasant, Glad you are doing better evicting your guests.


  4. Jolene says:

    We are planning to visit Panama next month — the WHO and CDC puts out a list of recommended vaccines for travelers. We provided our itinerary and were given immunizations for Hep A, Tdap and oral doses of typhoid vaccine. Since we plan to visit Bocas del Toro we were also provided with malaria pills to begin the day before our trip & ending 30 days after our return to the USA.


    • Bocas is known for the tummy upset so take precautions. I know many people who have gotten sick there, myself included (that smoothie on the street). I haven’t heard about anyone getting malaria or other nasty diseases outside of the Darien or other wilderness areas. It seems like the main concern within the country is dengue fever. They have been doing all they can to control mosquitoes and educate the public about standing water, etc.
      I hope you have a wonderful, and healthy time while you are in Panama! Thanks for taking the time to comment 🙂


  5. John & Susan says:

    Great info!
    Susan and I eat non fat Greek Yogurt every morning. I use to occasionally have stomach issues, but not anymore.
    Susan has a great recipe for making home made Greek Yogurt…although a bit time consuming but if you can not buy it in Panama it may be worth it. Perhaps Price Smart has it?
    Keep those bugs at bay, eat some yogurt every day!


    • I don’t generally eat yogurt because for me, it’s like ice cream – addictive and I’ll eat it all immediately. I believe there is Greek yogurt in the supermarkets here though. I’ll have to check the next time we go.


  6. We traveled from Panama City to David to Boquete and only had one problem. I think it was under cooked fish in a pasta sauce.It was our first trip to Panama and we sampled many new foods in the main restraunts on the road. We took some probiotics pills, drank ginge ale and ate bland foods.Acouple of days later we were back to normal. I can’t wait to come back and stay longer. We hope to move there in the near future.

    Thank you for the information. Also, I love your blog as you write abot daily life.


    • Thank you so much, glad you enjoy the blog. I’m also glad your illness passed quickly. I have had no problems anywhere in Panama (except Bocas) but I guess these things can happen anywhere. I think this is a great place to live, so I hope it works our for you too 🙂


    • oldsalt1942 says:

      Of course you ate bland foods. What did you expect to find in a country whose national dish is chicken soup (sancocho)? Did you ever notice in the States that almost every city of any size has at least one Mexican restaurant with salsa picante but you NEVER see a Panamanian restaurant anywhere? Why is that?


  7. Pathway To Portugal says:

    I’m glad you’re feeling better as it sure isn’t fun being sick. I had food poisoning when I was 20 from a Red Lobster. I went to the hospital but I was sure miserable. I can’t eat clams to this day. I know not quite the same as having unwelcome guests but I sure have empathy.


    • Ugh, that sounds awful. My daughter used to work at Dead … aaa … Red Lobster, actually met her husband there. She is quite picky about restaurant practices so I think in general they are good but I suppose bad things can happen anywhere. Hopefully that will never happen to you again!


      • Pathway To Portugal says:

        Haha Dead Lobster. Very funny! It was back in the 80’s and I don’t blame the restaurant. How could they have known since it didn’t even taste funny. But a lot of other people got sick too and it was even on the news. I’ve eaten there since. Glad there was a quick fix for you 🙂


  8. hrosson says:

    thanks for the valuable information. as someone who will be living in costa rica next year, and visa running to Nicaragua, I need all the help I can get!


  9. lifesgoodpanama says:

    Kris We have always taken Zyntel every 6 months to be sure. Just in case we have picked anything up it is killed. It is worth doing as a preventative since you cannot avoid all the opportunities for “bugs” that might present themselves and you are best off by catching them early. It is only a one day dose and no side effects. I am laughing a little about the CDC atc since if you look up Florida there you will read many of the same warnings. I cannot believe that they warn against Malaria in Bocas. I wonder when the last case was? The Darien possibly but Bocas?


    • Thanks for the recommendation. I know others who do the same thing, just in case.
      I know what you mean about the CDC. I was about to tell someone they were going overboard, but I looked up the recommendations before I ran my mouth and sure enough, that is what it says about malaria. And typhoid? Really? I have never heard of any typhoid here. But I am not going to contradict the CDC or anyone who feels better protecting themselves.


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