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Outbreak of Acute Watery Diarrhoea in Ethiopia

28 Jul 2017

Up to 54 people have been hospitalized in an outbreak of acute watery diarrhoea (AWD) in Mekelle city, 783 km (about 486 miles) north of Addis Ababa. Local health officials say the outbreak is linked to poor food and personal hygiene practices.

Advice to Travellers

There are some general rules of food and water precautions. While it may not be practical to follow all of these rules, all of the time, applying them where possible will reduce the risk of Traveller's Diarrhoea.

Personal hygiene when eating and drinking is very important. Where possible, wash hands prior to handling food, eating and always after using the toilet. Handwashing facilities may be poor or not available when travelling, therefore it is advisable to carry sanitising gel or hand wipes at all times.

Ensure that clean dishes, cups and utensils are used; use alcohol wipes to clean them if necessary.

If using street vendors, where possible, choose food that is freshly cooked to a high temperature and served immediately while still hot.

Food Precautions

Freshly prepared, thoroughly cooked food, served piping hot, including meat and vegetables, is generally safe. Avoid leftovers or food that may have been exposed to the air for any length of time.

Be cautious with:

  • Cheese and ice cream
    • Often made from unpasteurised milk and when in doubt, these should only be bought from larger, well established retailers where quality can usually be assured.
  • Fish and shellfish
    • Can be hazardous at certain times of the year, even if well cooked. Take local advice about seafood but when in doubt it is best to avoid.
  • Salads and fresh herbs (including in drinks)
    • Should be avoided as these are easily contaminated by soil or flies and are difficult to clean.
  • Fruit (including tomatoes). Should be peeled as the skin can be contaminated by flies and insects.
    • Berries, in particular raspberries, maybe a source of Cyclospora infection.  They are difficult to wash and are best avoided.

Water and Liquid Precautions

Boiled and bottled water (with intact seal) is usually safe, as are hot tea and coffee, beer and wine.

  • Water should only be drunk when you are sure of its purity.

Do not drink unsafe water without boiling, chemical purification or using a reliable filter.

  • This applies to water used for making ice cubes and cleaning the teeth.
  • Milk should be boiled unless you are sure that it has been pasteurised.

Note: Chemical purification/filtration may not remove all viruses or parasites. The manufacturers leaflet accompanying these products should be checked.