Some of us travel to see family, some to hang out with friends…but some of us get some unexpected guests when we go on vacation that make us sick. Hotel related illnesses result from any of a variety of exposures that can occur on vacation. Here’s your breakdown:
Most hotels do not wash the comforter. Headboards may also be unclean. Bedbugs may hide out, looking like dark spots on the sheet. Even though bedbugs should not cause disease from their initial bite, a secondary infection could take place and if one is not vaccinated could be at risk for tetanus.
Dust, smoke and allergens can pervade a room, if poor ventilation is in place. Those with asthma or lung disease could have an exacerbation due to allergies or poor air quality. A rise in complaints of marijuana stench have been noted as well.
Watch where you put your hands
Remote controls, light switches, glasses, ice containers, door handles, curtain wands do not get routinely cleaned and could harbor dangerous bacteria, viruses and fungi.
Watch where you eat
Buffets are a travel favorite with all-you-can-eat access to food. However buffet lines can be risky if patrons serve their own food. You may be handling spoons and serving utensils others (who didn’t wash their hands after going to the bathroom) touched. Moreover food may sit out for lengthy periods of time collecting bacteria.
Norovirus – notorious for making multiple cruise ships, the S.S. Stinky, norovirus outbreaks can occur in hotels or ships where close quarters expose many to contaminated food, water or surfaces. Symptoms occur within 12-48 hours of exposure, resulting in nausea, vomiting, diarrhea, abdominal cramps, low fever, and malaise. Severe symptoms may cause dehydration. Although symptoms last 1-3 days, those infected could shed the virus for weeks after exposure.
Most should be cleaned daily but use caution. Some hotels have reported Legionnaires’ disease outbreaks, where the bacteria may spray from the shower head. Legionella bacteria grow and flourish in water systems, therefore lurking in plumbing, air conditioning, and hot tubs.
Hotel Pools/Hot Tubs
These get cloudy and messy by the hour. Hundreds of guests with sun screen, sun tan lotion, body lotion inadvertently lose it when they bathe in the pool exposing others to the chemicals. Moreover when they drink they may not be inclined to jump out of the pool to go to the restroom.
The Water Quality & Health Council found one in four adults ADMIT to urinating in the pool, which can affect chlorine strength.
Many choose not to wait in line at public bathrooms or use the wet toilets at public water parks and find it easier to relieve themselves in the pool. For women worried about sitting on wet toilet seats I recommend using a large soda cup and in the stall standing and urinating into it. Pour it out into the toilet and flush. Clean, easy and environmentally sensitive. Men, there’s no excuse. Towel off and head to the potty.
Hot tub folliculitis caused by Pseudomonas aeruginosa can cause an uncomfortable rash around the hair follicles.
The CDC reports outbreaks associated with “treated recreational water” due to multiple organisms including Cryptosporidium, Pseudomonas, and Legionella.
Looking at the time period between 2000-2014, the CDC reports the following:
Investigations of the 363 outbreaks identified 24,453 cases; 21,766 (89%) were caused by Cryptosporidium, 920 (4%) by Pseudomonas, and 624 (3%) by Legionella. At least six of the eight reported deaths occurred in persons affected by outbreaks caused by Legionella. Hotels were the leading setting, associated with 157 (32%) of the 493 outbreaks
Hotel pools and hot tubs appear to be the biggest culprits.
Pseudomonas has been known to cause skin infections such as “hot-tub folliculitis” and ear infections, otitis externa, known as “swimmer’s ear.” Legionella is known for causing Legionnaires’ disease, a severe pneumonia as well as a milder illness known as Pontiac Fever.
The largest number of cases, however, were caused by Cryptosporidium. Known as “Crypto”, this parasite can cause severe gastrointestinal illnesses. Here’s the breakdown:
What is Crypto?
Crytosporidium is a parasite protected by an outer shell.
This shell allows it to live outside the body on surfaces. The shell also allows it to be chlorine resistant which explains why it can live in swimming pools.
How common is Crypto?
According to the CDC, Cryptosporidium is a leading cause of waterborne disease among humans in the United States. Its found in every region of the US and the world.
The CDC reports close to 750,000 cases of cryptosporidiosis occur every year in the US.
How is it spread?
Its spread in drinking water and recreational water, such as swimming pools. Since it lives in the intestines of humans and animals it becomes spread after one passes stool, or poops. People coming into contact with an infected individual’s poop could become infected with Crypto.
It is not passed through respiratory transmission or blood. However if feces comes into contact with one’s mouth, or wound, it can transmit Crypto.
Coming into contact with feces contaminated soil, surfaces, water, food therefore put one at risk.
What are the symptoms?
The parasite can cause any of the following:
Abdominal Pain and Cramping
Lack of appetite
and sometimes no symptoms at all.
When do symptoms show and how long do they last?
After one becomes exposed to Cryptosporidium, symptoms could show within 48 hours to 10 days. Symptoms can last 1-2 weeks.
What is the treatment for Crypto?
The infection many times is self-limiting. Hydration is imperative and initial treatment is making sure one does not become dehyrated. Young children, pregnant women, elderly, those with weakened immune systems, AIDS, cancer and immunosuppressed transplant patients are at higher risk of serious infection.
Some medical providers may use Nitazoxanide. According to the National Foundation for Infections Diseases:
Nitazoxanide (Alinia ®) may be used to treat Crypto in both adults and children 12 months of age and over. Nitazoxanide is available as a tablet for adults and as a liquid suspension. A three-day treatment regimen is recommended.
How do we prevent Crypto?
Always wash your hands with soap and water
Avoid eating off of non clean surfaces
Avoid swimming pools that may have just been soiled
Avoid ingesting water while swimming
Avoid feces of those individuals infected
Avoid sexual contact where oral – anal contact can occur
Change baby’s diapers away from the pool in case it blows into the water
Do not allow any family members with diarrhea to enter the pool
Inform your medical provider if you have any of the above symptoms so he/she can test the stool.
Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.
She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada