Water and food precautions for travelers

• Bottled or canned beverages that have been sealed before use.
  • Ideally travelers open beverages themselves or observe them being opened.
  • For carbonated beverages, travelers should listen for a hiss and look for bubbles at opening.
• Disinfected water – When safe drinking water is not available, water can be disinfected in the following ways^[1]:
  • Boiling at a rolling boil for at least a minute (three minutes at altitude ≥2000 meters [6500 feet]); this approach inactivates all waterborne pathogens.
  • Halogenation (addition of chlorine or iodine)^*¶:
    • Chlorine dioxide tablets are effective against waterborne pathogens, including some efficacy against Cryptosporidium oocysts.
    • Liquid bleach (which contains sodium hypochlorite) may be used to disinfect tap water by adding 2 drops per liter of water (if the water is cloudy, add double the amount) and waiting 30 minutes. Bleach is effective against bacteria and viruses but not against Cryptosporidium oocysts.
    • Iodine (tablets or tincture) is effective against bacteria and viruses but not readily effective against Cryptosporidium oocysts.
  • Filtering – Most filters readily remove bacteria, Cryptosporidium and Giardia, but many do not remove viruses reliably.
• Ice cubes should be used only if they are known to be made from safe drinking water.
• Dairy products – Only pasteurized or cooked dairy products should be consumed.

• Food that is piping hot.
• Food that is thoroughly cooked.
• Food that is processed or packaged.
• Fresh produce that has been washed with safe drinking water and peeled by the traveler.

Food items to avoid include:

• Salads or other fresh produce that may have been improperly washed or washed with unclean water.
• Table condiments.
• Hot food buffets; bacteria in food can multiply at ambient temperatures if left between 40°F and 100°F (4°C to 38°C).
• Food from street vendors.