Hand sanitizer may spare travelers illness abroad: survey

By Shereen Lehman NEW YORK (Reuters Health) – In a French survey of travelers to countries where diarrheal illnesses are common, the people who used hand sanitizer while abroad were half as likely to have their trips spoiled by a bout with Montezuma’s revenge. “Use of hand sanitizer is highly acceptable by travelers and is associated with a reduction in the incidence of travelers’ diarrhea and/or vomiting,” the authors write in their report published in Travel Medicine and Infectious Disease. Traveler’s diarrhea is experienced by 20-50 percent of international travelers who visit developing tropical areas, according to the study authors. The condition usually occurs after eating food that’s been prepared and served in unsanitary conditions or in high-risk regions, which according to the U.S. Centers for Disease Control and Prevention (CDC) include most of Asia, the Middle East, Africa, Mexico and Central and South America. The CDC advises travelers that carrying small containers of alcohol-based hand sanitizers may make it easier for them to clean their hands before eating (http://1.usa.gov/1g4A2EV). The study, which included two separate surveys, was led by Delphine Henriey, a researcher with the Institut Hospitalo-Universitaire Mediterranee Infection in Marseille, who wanted to assess whether hand sanitizer really offers any protection. Henriey and her colleagues first surveyed 200 French residents returning from developing countries via the Marseille international airport between January and April 2012. They asked travelers a number of questions about their travel duration and conditions, hand sanitizer use and where they got pre-travel advice. They also asked the travelers whether or not they had vomiting or diarrhea during their trip. The study team found that one of every three travelers used alcohol-based hand sanitizers. And about 17 percent of travelers who used hand sanitizers, versus 30 percent who didn’t, reported diarrhea or vomiting at some time during their trips. The second survey was given to patients at the institute’s pre-travel clinic between November 2012 and January 2013. A total of 257 participants were asked about their knowledge and use of alcohol-based hand sanitizers. The study team found that a majority of travelers knew that hand sanitizer may be used for hand hygiene and had already used hand sanitizer. “Six travelers out of ten had hand sanitizer at home and seven out of ten planned to bring hand sanitizer during their next travel,” the authors write. The study was limited by the small number of participants and reliance on travelers’ own reports, but the authors suggest that large randomized studies would be of great interest. “There were some preliminary encouraging trends, although they’re not definitive,” said Dr. Claire Panosian Dunavan, an infectious disease specialist at the David Geffen School of Medicine at UCLA in Los Angeles. “I suspect that the people who use hand sanitizer were more careful in ways that couldn’t be quantified,” she told Reuters Health. Panosian Dunavan, who wasn’t involved in the study, said she likes hand sanitizers and is glad more people are aware of their potential benefits. “I think in general that society has become more conscious of the role that we can all play through hand washing and using hand sanitizers to protect ourselves from anything from colds to food borne infections to transmitting bad bugs in hospitals,” she said. Panosian Dunavan said that bacteria such as E. coli are a common cause of travelers’ diarrhea. “It would be more likely to be acquired through contaminated food and water so additional measures are necessary,” she said. Panosian Dunavan said she always reminds her travel patients to follow precautions, such as eating only hot cooked foods and drinking boiled or bottled beverages instead of local water, including ice cubes. SOURCE: http://bit.ly/1niRsgI Travel Medicine and Infectious Disease, online July 11, 2014.