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    One of the pleasures of traveling to foreign countries is enjoying the variety of foods and cultures they offer. When traveling, eating new and different food is an important part of any learning experience. However, eating food in a foreign country can lead to a very unenjoyable experience if the food contains unwanted organisms or chemicals that can make you sick.
    One thing is certain: whether you are traveling on a "vacation of a lifetime" or on a required business trip, you do not want to get sick from the food or water you consume. Becoming sick from contaminated food at home is uncomfortable enough, but getting sick in a foreign country can make for a disastrous experience. There are many precautions a traveler can take to reduce the risk of foodborne illness during travel. This publication focuses on some of the best means for preventing foodborne illness while traveling abroad.

What are the problems?

Where do the problems come from?

• Do not consume undercooked or raw red meat, pork, poultry, seafood, or eggs. Foods that come from animals are naturally contaminated with bacteria and other contaminants that could make you sick. Therefore, these foods are cooked to destroy disease-causing organisms as well as to make the food more palatable. Ground beef, pork, poultry, and seafood should be fully cooked. Ground beef, pork, and poultry should not be "pink on the inside," and juices should be clear. Seafood should flake easily with a fork. Do not eat raw fish or seafood. Eggs should be firm to the touch. Eggs prepared sunny-side-up are not recommended; over-easy eggs are a better choice; fully cooked scrambled eggs are the best choice. Beefsteaks do not need to be "well done" in order to be safe. Bacteria tend to be on the outside of beefsteaks while the inside portion of the meat is usually free of bacteria. Steaks can be prepared medium as long as the outside of the steak is well seared and cooked.

• Be cautious about raw (uncooked) fruits and vegetables. Fruits and vegetables can be contaminated during growth, harvest, transportation, preparation, and service. Remember, many fruits and vegetables are grown close to the soil or in fields that may be treated with manure or sewage. In the past few years, several well-documented outbreaks have been reported from uncooked produce (Salmonella spp. and E. coli 0157:H7 in sprouts, Hepatitis A virus in strawberries, E. coli 0157:H7 in lettuce, Salmonella spp. in melons). The important point to remember about raw fruits and vegetables is that they need to be properly washed. Be sure that YOU wash the produce in clean water or be sure that YOU observe someone else washing the produce in clean water. Use special precautions for produce that is peeled, sliced, or prepared by human hands. Do not rely on restaurant workers or street vendors to wash or handle produce safely.

• Avoid purchasing and eating foods from street vendors, buffets, restaurants, and retail markets that appear unclean, or where the food is not held at safe temperatures. Cleanliness and temperature control are the two key factors in keeping foods safe. Cleanliness is important for anything that may come into contact with food such as a food handler, equipment, utensils, and packages. Look to see that the person handling your food is clean and has on clean clothing. Pay special attention to a food handler's hands. Do a visual inspection of the facility and surroundings. If they do not look clean, do not take a chance. Temperature is important for several reasons. Cooking temperatures are used to destroy disease-causing microbes. Be sure that foods are cooked thoroughly. Temperature is also important during hot and cold storage of foods. Disease-causing bacteria do not grow well below 41oF (5oC) or above 140oF (60oC). Be sure that cooked foods and foods that are held hot are served hot. Be sure that foods held under refrigeration are cold. If hot foods are not hot and/or cold foods are not cold, they should not be eaten. Pay special attention to street vendors. Check to see that they have soap and water facilities to keep their station clean and sanitary. Inspect to make sure they have equipment capable of safely holding foods hot or cold. If not, then do not eat from them.

• Do not eat unpasteurized dairy products (such as milk and cheese), or drink unpasteurized fruit juices. Pasteurization is a heat process used to destroy all disease-causing microbes. In the U.S., regulations for pasteurization of dairy foods have been mandated for several decades. More recently, pasteurization has been recommended for fruit juices due to some foodborne outbreaks (E. coli 0157:H7 in apple cider, Salmonella spp. in orange juice). Other foreign countries may or may not have regulations requiring pasteurization. Check the label and ask questions. If a dairy food or fruit juice is not pasteurized, it is not assured safe.

• Complete a careful inspection for "ready-to-eat foods". Ready-to-eat foods have become extremely popular in the U.S. and are gaining popularity in other countries. Ready-to-eat foods include prepared salads (potato salad, egg salad, cole slaw), luncheon meats and cheeses (sandwiches), and foods held hot (baked chicken, hamburgers). Since these foods may be handled extensively by human hands, they have a high chance of being contaminated. Look to see that the facility is clean and that ready-to-eat foods are held and served at a safe temperature.

• Avoid large fish especially from reef areas. Large reef fish can accumulate chemical toxins during their lifetime. Proper cooling may not inactivate the toxins because the chemicals have a high-heat resistance. Inquire about the type of fish and where the fish is harvested before making a purchase.

What is safe?

• Processed foods that are canned, bottled, or pasteurized. These foods have all been thermally processed to assure safety.
• Well-cooked foods that are served very hot.
• Breads, tortillas and other baked goods. These foods generally do not allow disease-causing bacteria to survive or grow on or in them. Try to carry a package of crackers with you during travel. Crackers are safe and can satisfy the tummy when conditions for eating are not suitable.
• Thoroughly cooked foods that are served hot. Cooking should make the food safe. If you buy prepared food, eat it during one sitting. Do not save leftovers and eat them later.
• Bottled water and soda. Water is commonly a source of illness when traveling in foreign countries. Consumption of water can cause illness from drinking the water, eating fruit and vegetables cleaned with the water, using ice in drinks, while brushing teeth, or taking a shower. Many countries do not have the capability to treat water as we do in the U.S. Bottled water is always a better selection than tap water, and bottled water is available in most countries. Some travelers take purification tablets or boil water during travel. Purification tablets and additional information are available at your local camping supply store. Soda is a great alternative for safe drinking. It can easily satisfy a thirst and is too acidic for harmful microorganisms to survive.

What should you do before traveling?

Be smart about what you eat!

• Check into required and recommended immunizations (CDC hotline: 1-888-232-3228).
• Be sure that foods are cooked properly.
• Your hot foods are served hot.
• Keep cold foods cold and served cold.
• Make sure uncooked fruits/vegetables are washed properly in clean water.
• Check that the food establishment and person preparing and serving the food are clean.
• Do not drink unpasteurized dairy products or fruit juice.

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