How to tell a ‘dodgy belly’ from a parasite on holiday – how long it will last and the 4 signs you need emergency help

THE holiday you’ve been planning for months is right around the corner and between the excitement for sun and sea, you’ve probably not been too concerned about virus outbreaks abroad. While getting a dodgy tummy on holiday is common and usually not serious, parasite infections can wreak havoc on your gut long-term and should get medical treatment. While getting a dodgy tummy on holiday is common and usually not serious, parasite infections can wreak havoc Credit: Getty A few simple steps can help you stay healthy and avoid dealing with an upset stomach on your flight home Credit: Getty With a parasite causing explosive diarrhoea spreading like wildfire across the US, you may want to know where the hotspots for the bug are before you head off. Cases of cyclosporiasis are surging in the US, with more than 11,000 suspected or confirmed cases. Generally, international travel is thought to be a major risk factor for developing gastrointestinal illnesses, linked to lower hygeine standards and sanitation. But you’re not always safe at a luxury hotel, either. There have been many outbreaks of bugs in countries like Turkey, Mexico and Spain. Here’s how to tell when a tummy bug might be something more, and a few simple steps that can help you stay healthy. FOOD, DUBIOUS FOOD Bacterial infections like E. coli or salmonella lurk in contaminated food Credit: Getty THE top reason your stomach hurts on holiday is a change in your diet. This could simply be that the cuisine is richer, sweeter or spicier than you are used to, and your gut doesn’t want to play ball. Letting loose on the sangria probably won’t help either, as alcohol can cause upset. And allergies or intolerances might strike when you try something new or struggle to keep track of ingredients on foreign menus. Sometimes the food is dodgy – it’s not been cooked properly, or is contaminated with a bug. Bacterial infections like E.coli or salmonella lurk in contaminated food and water when it has been stored at unsafe temperatures or prepared by an infected person. “Stomach bugs are the most common cause of an upset whilst travelling,” says Kenny Chan, of Numark online pharmacy. Bugs like norovirus can also spread via the same routes and are very contagious. Believe it or not, tummy bugs can also be spread through sex. A recent study by the University of Cambridge found that sexually transmitted shigella – the bacteria behind dysentery – is becoming a “distinct public health threat” with outbreaks becoming more common in England. PARASITE THREAT The parasite cryptosporidium caused mayhem among British tourists in Spain in 2023 Credit: Getty IN some unfortunate cases, however, holiday-wrecking symptoms may be caused by a parasite infection. Parasites are tiny organisms most commonly contracted from water, either outdoors or in tap water in some countries, contaminated food, or insect bites. Best known human parasites include tapeworms and threadworms, malaria, head lice and giardiasis. Kenny says: “Parasites can be found in contaminated water such as streams, lakes and poorly treated tap water. “They can also be found with raw vegetables that have been washed in contaminated water.” Raw or undercooked meat or fish can be risky too, he adds. While bacterial or viral infections can clear up on their own, parasitic illnesses should get medical treatment. They can cause tummy upset that lasts for weeks or months if left untreated. PARA-SIGNS: HOW TO SPOT A BUG A parasitic infection takes longer to appear, says Kelly Fisher, a health and wellbeing nurse at Benenden Health Credit: Getty IF you fall ill on holiday, away from your usual supermarket, pharmacy and GP, working out what you’ve got can be anxiety-inducing. There are some telltale signs you can use to work out if you’ve picked up run-of-the-mill food poisoning or a parasite. Kenny Chan says: “Signs you’ve got a parasitic infection can include diarrhoea that becomes persistent or recurrent, often lasting weeks, foul-smelling stools that could float, cramps and abdominal pains and unintentional weight loss.” Kelly Fisher, a health and wellbeing nurse at Benenden Health, adds that typical tummy bug symptoms strike within 12 to 48 hours of you eating or drinking it. “But a parasitic infection takes longer to appear,” she says. “It can take one to three weeks before you start to feel unwell. “The symptoms can also last for much longer – weeks or months in the worst cases, if medical treatment isn’t sought.” This can mean you don’t really start to feel ill until you get home, and also that it can be difficult to work out where you got sick. An outbreak of the cyclospora parasite has sickened thousands of people across 30 states in the US since May. Health authorities believe it could be linked to fresh produce like lettuce but haven’t managed to pin down the source. PROTECT YOURSELF Try to avoid lettuce and salads that might have been washed in tap water Credit: Getty The simplest way to protect yourself from parasites is to be wary of water, whether you’re drinking it, swimming in it or washing your hands or food. Kelly Fisher says: “Parasite eggs or larvae can be ingested when drinking unclean water or from eating food that hasn’t been adequately prepared. “If you are unsure about the tap water, always drink bottled water and avoid ice, as this may have been prepared with the contaminated water. “Avoid swallowing water from swimming pools, lakes and other bodies of water.” Try to avoid lettuce and salads that might have been washed in tap water.Eating fruit that must be peeled can add an extra layer of protection, but peel it yourself. To be super careful you can also brush your teeth with bottled water. Kenny adds: “Travellers should wash their hands regularly with soap and clean water, especially before eating and after using the toilet.” Soap and water is the best way to kill germs, but when it’s not available, “alcohol-based hand sanitiser is a good alternative”, says Kenny. WHAT TO DO IF YOU GET SICK If you get sick, make sure to stay hydrated and stick to plain foods Credit: Getty SOMETIMES even the most careful of us end up ill, and if you develop diarrhoea while abroad, then staying hydrated should be your top priority. Kenny says: “Drink plenty of fluids such as water or diluted fruit juice, and use oral rehydration salts, which are available over the counter.” Stick to plain foods like rice, pasta, toast, crackers, bananas, potatoes, chicken or eggs. staying away from rich, greasy or spicy delicacies. Kenny adds: “You should contact a doctor if your diarrhoea lasts for more than two days without showing signs of improvement. “For children, seek medical advice if symptoms don’t improve after one day.” WHEN TO GET URGENT HELP Dizziness, dark urine, or little to no urination can signal dehydration Intense abdominal or rectal pain, or a high fever Passing blood, pus or black stools Vomiting so much you can’t keep fluids down. The emergency phone number across most of Europe is 112.