Contaminated food, water and ice can result in hepatitis A, typhoid, and travelers' diarrhea (TD).  About 50% of travelers will experience symptoms of travelers' diarrhea.

Eating at street vendors is considered high risk, eating at restaurants moderate risk and eating in private homes the least risky.  Foods which can be handled and served uncooked, like vegetables and fruits, may be contaminated with hepatitis A, E. coli, or other bacteria.

 1. Wash before meals with soap and/or waterless gel cleaner.

 2. If drinking bottled water, ask that the bottle to brought to your table unopened and check the seal yourself.  Refilling used water bottles with untreated tap water and selling them is a common practice in some areas.

 3. Processed beverages such as sodas, beer and wine are considered safe. 

 4. Use water "purifiers" rather than filters.  High quality purifiers eliminate parasites, bacteria and virus particles.  Examples and explanation at filter-purifiers.

 5. Avoid ice unless made from treated water.  Drink beverages warm if you must and do not pour into a glass.  Boiled drinks, such as, tea and coffee are OK.  Tainted ice is a common source of travelers' diarrhea.

 6. Avoid food that is lukewarm.  Food setting out in a buffet, without proper warming can grow bacteria.  Anything well cooked and served hot is OK.

 7. Avoid uncooked vegetables.  These may become contaminated with parasites and bacteria during growing time, harvest or preparation.  For example, watercress is popular in Asia and always eaten raw;  it is associated with Opisthorchiasis or liver fluke infections.  Lettuce may be contaminated by E. coli.

 8. Peel fruits yourself.  Foods handled by others and not requiring cooking are risky for travelers' diarrhea.  Wash fruits well to prevent contamination of the flesh when peeling or cutting. 

Eat fruits only from reliable sources, as water melon and other juicy type fruits are sometimes injected with local water to increase the selling weight.

 9. Do not eat poorly cooked meats or eggs.  These are associated with bacterial infections and travelers' diarrhea.

10. Do not eat raw oysters, crab or fish.  Sushi may contain parasites.  Oysters may be contaminated with cholera, hepatitis A or B.  Numerous outbreaks of bacterial infections (Vibrio parahaemolyticus) occur worldwide from poorly cooked or raw shellfish.  

In Central America, raw crab (or fish) is marinated in lime juice and called ceviche or "drunken crab." It is popular but associated with a parasitic infestation called Gnathostomiasis.  This parasite infection is also common in parts of South-East Asia, China, Japan, Indonesia, Australia and Mexico. 

Ceviche is also associated with lung fluke (flat worm or trematode) infection called Paragonimiasis,  which is most prevalent in China, Korea, Japan, Taiwan, and Thailand but occurs in Central and South America.  Raw fish is associated with Opisthorchiasis

11. Do not consume unpasturized milk or ice cream.  This can be a source of typhoid, salmonella and other bacterial infections.  Brucellosis is common in some countries (especially the Middle East) and associated with unpasturized dairy products.