A Fate Worse Than Banditos?
By David Eidell (Revised 06/08)
Mexico is overly famous for the threat of banditos and Moctezuma's revenge. The latter is a stereotypical buzzword used to describe any stomach or intestinal ailment experienced while on Mexican soil. The fact is that most tourists never contract diarrhea or nausea diseases while touring Mexico, but often experience an upset stomach from over dosing on too many greasy tacos, especially when followed by a couple dozen cervezas (beers).
The best way to avoid stomach problems in Mexico, is to take it easy for the first week, and indulge in fits of gluttony on a gradual scale. It's really hard to resist those totopos (chips) and salsa, sitting on the table, while waiting for your lunch to arrive. Go ahead and indulge yourself, but don't eat half a dozen bowlfulls of salsa and not expect gastrointestinal ramifications later in the day.
Fruits and vegetables should be washed in sterilized water (refer to the article on water elsewhere in the mini-series) so that a weak chlorine bleach solution kills offensive bacteria. Chicken should be treated like it is radioactive, until cooked (just as true in the U.S.). Wash your hands after handling untreated, raw food, and frequently when preparing food. I like to carry a small package of moistened "towelettes" when foraging through markets, and wash my hands every hour or so. Typical restaurants may have restrooms with cold running water, but no soap and no paper towels. I'll use a handy towellette instead.
Even if all of my careful precautions should fail, and I get sick anyway, I know that I am not helpless. Many well-meaning articles have suggested "toughing-it-out" with intestinal ailments, and "letting nature take her course". I think this isn't being realistic, especially if I happen to be in the middle of travelling to a different area. Instead, I checked with my doctor before I left home, and obtained a prescription for "Bacrtrim F" tablets (also available in Mexico without a prescription). Bactrim effectively annihilates offensive bacteria within twelve hours after dosing. To control watery stool, I also take Lomotil. I know instinctively, that letting things clear up on their own, is the "natural way". But while proponents are still doing the four-yard-dash inside their rigs, I'm buckled up and heading down the road. Occasionally an unfortunate forager will come into contact with food poisoning. The symptoms are usually quite pronounced and "miserable". Happily, the most common variety of food poisoning in Mexico (infrequently encountered however) lasts only 12 hours. The only cure for food poisoning is time. Sipping sugary soft drinks is a good way to maintain energy (At this point if you're clutching your stomach and muttering "no way!" then you've lost track of reality).
Update Note: A wide spectrum antibiotic Ciprofloxacin, has proven to be extremely effective in rapidly treating hostile bacteria in the intestines. This medicine is also available generically in Mexico. Many US doctors will prescribe Ciprofloxacin as a prophylactic medicine if you tell them you are headed for Latin America.
Lomotil update: Several years ago the formula of Lomotil was changed and now it is safe to use.
I've gone on long trips to Mexico, time after time, without so much as a sniffle, then the odds catch up, and I'm unpleasantly reminded to always talk about the subject accurately and subjectively. The truth is, that I've had the very same symtoms as Moctezuma's Revenge while residing in the United States (probably 100 times as often). The chances are about fifty to one, that you'll come into contact with the affliction named after the famous aztec emperor, on a two-month vacation. Rather than gnash your teeth over the subject, remember that Mexico has an excellent health care system, and that someone else is going to take your parking spot on that lovely beach if you are scared away by a tiny bacteria. As for myself, I worry more about avoiding a bad hangover, or missing out on a nearby fiesta, than I do about Moctezuma's Revenge.
Update: Amoeba And Protozoa
Illnesses caused by single-cell organisms are not common but I have added this addendum just in case. Flagyl is the most prescribed medicine for this form of infestation. It is mostly successful but if it isn't alternative medications may be useful. Because these medicines are powerful I would rather direct someone who needs them to a doctor in Mexico. If Flagyl proves to be not effective, take the medicine in with you and clearly explain that it is not working. If you are prescribed a medicine that sounds like "Diidoquin" follow the doctor's instructions exactly---this medicine has caused damage to the optic nerve. Stop using the medicine just as soon as you can. Iodine based medicines are incredibly effective in eradicating infestations in the G.I. tract, but they come with a risk. I would be very cautious about using this medicine in people that had other eye problems such as glaucoma or macular degeneration. Once again I would have to recommend that travelers consult their personal medical professional for guidance before they depart on a trip.