Worlds Worst Travel Illnesses

Swine flu and other scary diseases might still haunt you, but good old Montezuma's Revenge - and in no way does that refer only to the Mexican strain of travel-induced diarrhea - is by far the most common travel illness threatening a carefree vacation. "About 40 percent of people will get diarrhea when traveling in an undeveloped country, which covers most of the world," says Dr. Stephen Berger, founder and medical advisor for GIDEON, on online infectious diseases database. Exposure to different strains of the E. coli bacteria, present in all of our bodies, says Berger, is what usually causes diarrhea in travelers, and it can happen in any country.

And while most travelers know the ABCs of staving off these unfortunate trips to the restroom, such as avoiding street fruit and vegetables, sticking to bottled water, and eating thoroughly cooked foods, not all travel illnesses come with such clear guidelines for steering clear of trouble.

We rounded up the bugs and bacteria that you need to know about right now, and the ways to protect against them.

See the world's safest destinations.

See more of the world's most common illnesses.

Worlds Worst Travel Illnesses

The most prevalent travel-related illness is also one of the most difficult to prevent. "The number one health complaint of all travelers going internationally is diarrhea," says Dr. Erik McLaughlin, who specializes in travel and health expedition medicine and gives advice in layman's language on his website, www.adventurehealthclinic.com. "I don't know anyone who doesn't get it on some sort of trip, anywhere," says McLaughlin of what's commonly termed Montezuma's Revenge. And staying in luxury hotels in no way makes you immune, he warns. You can lower your chances of getting diarrhea by drinking only purified water and avoiding fresh fruits and vegetables. The E. coli bacteria is very sensitive to heat, so be sure to eat only well-cooked foods, too. In a pinch, says McLaughlin, you can make your own concoction to replace electrolytes by mixing purified water with a couple of teaspoons of sugar and a dash of salt.

Worlds Worst Travel Illnesses

Once limited to tropical areas, a recent outbreak of this mosquito-borne disease in Italy proved that it's spreading from its predominant Indian Ocean locale. The disease's name comes from an African word meaning "that which bends you up." But it's rarely seen in Africa, with most travelers coming down with chikungunya after visiting Indian Ocean destinations such as India, Thailand, the Maldives and Sri Lanka. While rarely fatal, the initial mosquito bite leads to terrible joint and muscle pain, fever and rashes. No vaccines exist to prevent the disease, so travelers should follow similar precautions as with malaria prevention-use insect repellent, sleep under a mosquito net and staying indoors and well-covered at sunset and after.

Worlds Worst Travel Illnesses

Wherever large groups of people congregate in tight quarters, the dreaded norovirus has the potential to rear its ugly head; hence the close association with cruise ships, where the sickness is most likely to affect travelers. Norovirus is rarely fatal, but its effects- nausea, vomiting, and diarrhea -can really rain on the parade. And since the virus spreads through contaminated water and food, there's little you can do to avoid it. "There's no real prevention and no treatment, and the cruise ship industry is going crazy with how to control it," says Dr. Berger, "Some pull back into port and use brutal sterilization of the water system and tanks holding the water, then they'll have another outbreak."

Worlds Worst Travel Illnesses

More fun with mosquitoes! Severe flu-like symptoms following a mosquito bite might mean dengue fever has taken up residence inside you, especially if you've just returned from parts of the Caribbean, South Pacific, Asia, Latin American or Africa. "The incidence of dengue fever is really up the past year or so," says Joan Hersh, a registered nurse at the travel clinic at St. Elizabeth Business Health Center in Edgewood, Ken., "Before, it was unusual for tourists or travelers to get it during short trips, but now they are getting it." The virus, also known as breakbone fever, is very painful, and accompanied by severe muscle and joint pain. Hersh says she is seeing dengue fever in patients returning from Central America and India, in particular.

Worlds Worst Travel Illnesses

For travelers, the most relevant of the insect-borne diseases is malaria, a potentially fatal disease prevalent in much of the developing world (Latin America, Asia, Africa, the South Pacific, Caribbean and parts of Eastern Europe). Teddy Roosevelt contracted the disease during a river trip in Africa and John F. Kennedy caught malaria in the South Pacific during WWII. Travelers to affected areas should take precautions to avoid getting bitten by mosquitoes-use repellent that contains DEET, sleep only in rooms with screened windows and hang a mosquito net around your bed, and wear long sleeves and long pants after sunset to help avoid bites. Most importantly, visit your doctor before departing on your trip to get a prescription for one of the several malaria prevention medications on the market. The World Health Organization advises against traveling with young children and infants to malaria-affected countries.

Worlds Worst Travel Illnesses

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Worlds Worst Travel Illnesses