|General rules of hygiene|
In a restaurant:
1. Eat only freshly prepared cooked or fried food served hot
2. Never eat uncooked or poorly cooked shellfish
3. Avoid raw salads and unpeeled fruit
4. Do not have ice in your drinks except in the best hotels
5. Use boiled or bottled water
6. Wash fruit and vegetables and soak for ten minutes in a chlorine solution (one tablespoon of liquid chlorine bleach per gallon)
7. Chlorinate and filter drinking water (giardiasis and cryptosporidiosis are not susceptible to chlorination but can be removed by filtration)
8. Ensure proper sanitation
Diarrhoea can be caused by a long list of bacteria, viruses and parasites. The commonest is an unfamiliar toxigenic strain of E.Coli; the long term resident tends to become acclimatized to these different E.Coli strains within 3 to 6 months.
Simple diarrhoea, with no mucus or blood, is usually self-limiting and no specific treatment is needed; to avoid dehydration drink plenty of water, stay out of the heat, and avoid strenuous exercise. Rehydration salts are available in Cambodia but you can make your own by adding to one litre of clean water, four teaspoons of sugar, half a teaspoon of table salt and half a teaspoon of baking soda. Do not take Lomotil or Imodium as this delay the elimination and excretion of the disease organism, and may increase the mucosal contact time with any toxin (poison) produced by the bacteria; they also increase the likelihood of bleeding with invasive amoebas. Diarrhoea is nature’s way of getting rid of infection. However, travelling by bus or plane does necessitate the use of a diarrhoea stopper. Diarrhoea with a high fever, diarrhoea with mucus and blood (dysentery), and prolonged diarrhoea (more than 10 days), are indications to see a doctor.
This infection is so common that persons over 30 years of age are quite likely to be immune. It therefore is a good idea to be tested for IgG anti-HAV before getting vaccinated. If antibodies are present then vaccination with the Hepatitis A vaccine, or passive protection with immune serum globulin, is not necessary.
Hepatitis – others
Hepatitis C, D, E, and G viruses exist and can cause liver inflammation.