I realize that this is probably a stupid question, but I just got back from being vaccinated in preparation for a 6-month trip to India, and my doc has me nice and paranoid about all of the various scary-sounding diseases that I have a chance of catching while in-country.
Since I’ve never been to India before, I was hoping to ask experienced travelers or residents: assuming I’m careful to eat clean, hot food and don’t drink the local water, how likely am I to get sick during my trip?
I’ve traveled through Asia and while you won’t get sick, you probably will have an upset stomach and a bit of “loose bowels” for awhile. It isn’t likely to be illness, but your body has to adjust to bacteria in the food.
It shouldn’t be too bad if you are careful, but when I moved to China, it took me 2-3 months for my stomach to completely adjust. I felt fine, though. Just a bit of stomach pain and loose bowels.
Ooh, thanks for the reply! I usually assume that a few upset stomachs and bouts with traveler’s diarrhea are par for course… the hypochondriac in me was just terrified that flying to India was an instant ticket for dengue fever, malaria, TB, and oodles of other stuff. ^^
When they say “don’t drink the water” it doesn’t just mean taking a drink from the tap. A cold drink with ice cubes is just a bad. Same goes for brushing your teeth. That one got me in the Philippines.
It just makes sense to carry Imodium D with you wherever you go. India hell, I keep it in the first aid kit in my car. When you need it, it’s too late to look for a pharmacy.
And don’t let anyone serve you bottled water with the seal broken (it’s been refilled with tap water). Send it back.
I got sick in India from hot tea - served in cups that had been rinsed in the tap, left with a little bit of water in the bottom of each one.
I’ve been to India - sick both times, but just the unpleasantness noted above. I did get up to date on all shots and took malaria pills (which gave me horrible vivid dreams). I also took prescription strength anti-diarrhea medicine with me (or, now that I think about it, not sure if it was prescription strength, I got it from my doctor though) and it was a LIFESAVER.
Don’t forget to keep your mouth closed in the shower and buy some little rolls of TP to carry with you!
Enjoy your trip - India was one of the most wonderful adventures of my life.
The two things you want to take special care of are unsafe water and mosquitoes (depending on where you travel). And by take care of, I mean destroy.
Water: Do not drink from any tap. When in hotels or restaurants, ask for “Bisleri” (the generic brand name for all bottled water) or “mineral water” or “bottled water”. When at someone’s home, if they don’t have bottled water, request for boiled water. When traveling, carry your own bottled water (which you can purchase from any general store).
Mosquitoes: Buy “GoodKnight” mosquito repellant. This comes in two forms: small pads the size of postage stamps which sit on a electrically heated small thingy that plugs into the wall, and liquid filled small bottle that also is heated electrically. When traveling to rural areas, buy the former, because when you don’t have access to electricity you can instead burn the pads using a lighter or matches. Burning one or two pads per night before you sleep is sufficient. This is the most effective way to kill mosquitoes within a confined space (such as your room). If you aren’t traveling much, you can buy the liquid variety, which lasts about a month. Both options are very cheap, around Rs. 50 or so (prices might have gone up in the few years I’ve been in the US).
If you take care of these two things, you are unlikely to fall ill at all if you otherwise exercise common sense. I’ve had lots and lots of guests from Europe and the US who have stayed for months and returned without any illness. An upset stomach was the most common complaint.
What you are most likely to get is cheated out of your money. Cabbies, guides, anybody offering you any kind of service (except in fixed-price places, such as restaurants with menus) is likely to overcharge you if you are clearly identifiable as a foreigner. Make sure you know the going rate for all the regular stuff (taxi/rickshaw fare, etc.) before you venture out, to avoid this issue.
And whatever you do, DO NOT agree to take a taxi ride from the airport from anyone approaching you as a cabbie. They will charge you 5x the going rate. Instead, ask for the “prepaid taxi” booth and pre-pay for your ride.
In most large cities, you will find English speaking people. Feel free to stop and ask anyone absolutely anything. They will be eager to help. If you’re walking down a street, you might get approached by many people for many different reasons, including trying to sell you stuff, con you, or just out of curiosity for where you’re from. This is normal. Respond politely and keep walking.
Have a fun trip!
Don’t worry. There are very few things you are going to catch there that can’t be fixed. Thousands of Americans live and work in the developing world, and with knowledge and a few basic precautions the vast majority avoid any lasting ill effects on their health. While you will be at risk for some scary sounding stuff, we have good prevention and treatment for most of these things.
Here is a brief rundown of my health training designed to prepare us to live in remote African villages. Some of it may be relevant to you.
You almost certainly will have intestinal troubles, and perhaps quite a bit. I’ve been living abroad for 3 years and have had intestinal troubles for 3 years. Strict attention to water, unpeeled fruit, etc. can keep you from getting the worst stuff. But you will get something. Read up on making dehydration salts and the BRAT diet so that you know how to handle it. If your diarrhea is severe for more than a few days, have a doctor run some tests. Most things that cause diarrhea are pretty easily treated with a short course of the appropriate anti-biotic.
Take your malaria pills diligently. Make sure you really read the instructions. Even minor slip-ups can create quite a bit of risk. Make sure to take it for the recommended period of time before and after your trip. If your medication isn’t working for you for some reason, see a doctor and switch to another. There are a few options. But don’t just stop taking them. And of course, it’s best not to get bitten in the first place. Get a mosquito net and use it.
If the worst happens, make sure you know the signs of malaria. It’s really not that difficult to treat (though the treatment will knock you out for a week) but it’s important to start treating it immediately. To the untrained eye it can seem like a number of other things. But malaria tests are quick and easy- if in doubt, get one. Also, for the next year or so, if you get any malarial symptoms in the US, make sure your doctor understands that you have been to a malaria zone and can recognize malaria. Most US doctors have very limited experience and may not recognize it unless you tell them it is a risk.
Don’t swim in fresh water. You can easily get schisto, which makes you pee blood and causes all kinds of other problems. It can fester for years without you knowing it. And it can be in any natural fresh water. Don’t trust anybody about which lakes or whatever are safe. They don’t know. It’s best just to avoid fresh water entirely. Swimming is fun, but it’s not worth schisto.
Don’t touch any dogs or cats, no matter how cute or domesticated they seem. Rabies is common and is found even in household pets in big cities. Most Indian dogs will run away if you appear like you are bending down to pick up a rock.
Pay attention to your skin. If something starts looking infected, wash it and slather it with anti-biotic gel NOW. Even minor wounds get infected easily and you may be at risk for staph infections, which are ugly and a pain to deal with.
There isn’t a ton you can do to prevent TB exposure. It’s certainly a possibility, but it is unlikely to make you sick. Chances are you’d just have to do the meds (no drinking for 9 months!).
There is filaria in India. If you are in a filaria area, there are prophylactic medications you can take.
Use a condom.
You’ll be fine!
Have fun!
Like the people said before, watch out for water and ice cubes. Also make sure they open bottle in fornt of you, otherwise you don’t know what you’re drinking.
What the food is concerned, it can also work the other way around. My sister usually has stomach troubles quite a lot, unless she has prepared the food herself she is likely to end up with an upset stomach. When she spent 6 months in India she didn’t seem to have any stomach aches at all; it was actually a lot better than at home.
btw hmmm curry…
I got sick in Brazil once from eating salad/veggies that had been rinsed in local water.
I got sick in China the same way. Don’t eat any dish that might include uncooked vegetables.
Brush your teeth with bottled water and wear your rubber sandals in the shower, every time!
You’re not going to get anything incurable/dangerous as long as you take precautions, as xash notes. How dangerous the water is going to be depends on where you’re going; in most of the country you need to be sensible to avoid typhoid and cholera, but you’re not likely to catch anything communicable via airborne transmission or skin contact.
Same goes for malaria, really; the incidence of malaria in the far northern states (Kashmir, etc.) is virtually nil. It increases as you move south, but it’s still minimal in Maharastra and Gujarat.
Since you’re looking for some reassurance, note that less than two thousand people die of malarial infection in India every year, and there are only about 1.5 million total cases per year, mostly thanks to aggressive use of insecticides by the government. Given that there are comfortably over a billion people in India and you won’t even be there for a whole year, your risk of contracting malaria is comfortably under 1%.
In other words, take your pills, but don’t worry.
For what it’s worth, I had a highly compromised immune system when I was younger, but never caught anything in six trips to India.
ETA: I presume you got typhoid, Hep A and B and polio booster vaccines?
What do people who live there do? Having to ask for boiled water in someones home suggests that they might have considered drinking untreated tap water themselves. Is this true, and locals would simply be used to the water, or do they have to take the same precautions?
As a rule they boil it. And when you ask for some, they will have it ready at hand. Probably because they boiled a large kettle of it, at length, first thing in the morning, then put in the fridge to chill.
In the last 3 years, my family and I have travelled to China, Mexico, Egypt, Jamaica, and lastly India. It’s been country After country of non-potable water so we all know the routines. India’s the only place where we got the trots. We kept the immodium AD handy (and would stock up at pharmacies there too). My recommendation is to stay on the constant lookout for bathrooms (as you never know when you’ll need one) and bring a couple rolls of tp without the carboard tube or some wet wipes as both can be a bit of a rarity.
Don’t let this dissuade you from India, the juice is definitely worth the squeeze.
This is what I was going to say. Most families either have a reverse osmosis filtration system or they boil their water or both. If you’re staying in hotels and hostels, make sure you have bottled water, as indicated above.
Oh, and when you get there, I’d recommend getting a tube of Odomos. Use it constantly. It works really, really well against mosquitos.
The two things we had problems with in India (we were there for a month with our son, then 18 months) were loose bowels and bed bugs. The loose bowels were more a function of the huge amounts of fried food and ghee people eat there every day. Most meals are served with pappards, parathas or puris or a combination, all of which are deep fried. Coffee is often served with boiled whole water buffalo milk (though you can find skimmed). It was so fatty that our son would drink milk and refuse food for the rest of the day because he was so full.
Anyway, as for the bed bugs - well, if you stay in a hotel, even an exclusive one, make sure that they give you a sheet to sleep under. It’ll help a lot. If they just offer a blanket, you’ll probably be bitten. We stayed at a really exclusive academic club in Agra with my husband’s family friends and got the crap bitten out of us, even though I was dressed in full-length yoga pants and a fleece. It was the wool blankets they gave us. We forgot to ask for a sheet, so we were in direct contact with the blankets, which were full of bugs we couldn’t see. They won’t make you sick, of course - they’re just a nuisance.
They didn’t give you mosquito nets?
Is there anywhere in India where the tap water is OK? It’s surprising to me that they don’t have clean water even in the big cities.