Health and Safety in Nepal

In Nepal, as in many other developing countries, travelers' diarrhea is one of the most common illnesses affecting travelers. It usually develops during the first week of travel but may occur at any time during a trip, or even after returning home. You can minimize your risk of diarrhea by practicing the following preventive measures:

• Avoid eating foods or drinking beverages purchased from street vendors or other establishments where unhygienic conditions are present.
• Avoid eating raw or undercooked meat and seafood.
• Avoid eating raw fruits and vegetables unless you have peeled them yourself.
• Drink bottled carbonated beverages, or water that you are sure has been boiled or treated with iodine/chlorine. Be aware that water bottles in remote locations are sometimes refilled with tap or stream water. Make sure the seal on the bottle is intact before you open it.

If handled properly, well-cooked and packaged foods usually are safe. Tap water, ice, unpasteurized milk, and dairy products are associated with increased risk of diarrhea. Safe beverages include bottled carbonated beverages, hot tea or coffee, beer, wine, and water boiled or appropriately treated with iodine or chlorine.

If you develop diarrhea, the most important thing to do is drink plenty of clear liquids to replace lost fluids. Oral rehydration salts are readily available at stores and pharmacies, and can be used to help replace electrolytes. Most cases of traveler's diarrhea last about 3-4 days.

Though simple travelers' diarrhea is rarely life-threatening to healthy adults, the symptoms can be caused by a variety of bacteria or parasites. If symptoms persist or are severe, or if you have special health concerns, you should contact a medical professional.

Other common diseases include hepatitis A and B, which are usually acquired from contaminated food, and rabies, which can be acquired from stray animal bites. There is no malaria in Kathmandu Valley or on the usual trekking routes. However, mosquitos and malaria are found in the southern plains of Nepal, including Chitwan National Park. Since the incubation period of these diseases varies, you should inform your health professional that you have been traveling in Nepal if you develop symptoms after returning home.

Precautions against Cholera (July 27, 2006)

Local media outlets have reported cases of Cholera in the Kathmandu Valley in recent weeks.  Food and water precautions that should be followed year-round are effective protective measures against Cholera.

In particular, it is very important to drink only filtered AND boiled water or distilled water from a reliable source.  Additionally, during outbreaks it is prudent to avoid raw or undercooked fish and shellfish, and raw vegetables.  Peeled and or cooked fruits and vegetables do not pose a risk.  Remember that beverages with local ice may pose a risk, unless the ice is made from boiled or distilled water.  Carbonated beverages are usually safe. 

Symptoms are similar to many diarrheal illnesses, and include fever, frequent watery stools, and abdominal cramping.  One of the hallmarks of Cholera however is frequent loose stools that resemble rice water.  Simple oral rehydration is highly effective in treating Cholera. 

The CDC website contains a list of suggested vaccinations for travelers to Nepal.