Food and water on the road
Travel folklore sorts places into safe and dangerous by the sign over the door, the number of local customers or how familiar the dish is. Food risk is decided by something more prosaic: water, temperature, storage and clean hands.
During the cholera outbreak of 1854, John Snow plotted cases on a map of Soho in London. They clustered around a water pump on Broad Street. Snow did not discover the bacterium and did not run a modern randomised trial, but he compared the distribution of the disease, the sources of water and the natural differences between groups of residents.
The story of the removed pump handle became a symbol of epidemiology, although the outbreak was already fading. Its value lies not in one heroic gesture but in the move from a general fear of “bad air” to a testable route of transmission.
The risk of a foodborne infection depends on water, storage, temperature and the cleanliness of hands and surfaces. Not all of that can be judged from the decor or the popularity of a place.
On a trip it is sensible to choose food that:
- is cooked through;
- is served hot;
- has not stood for long at room temperature;
- is protected from being contaminated again;
- is made with safe water.
Raw food, ice and drinks from open containers call for more caution where the quality of the water is unknown. Fruit is safer washed in water you trust and, where possible, peeled by yourself.
A sealed bottle still needs the cap checking. Local resourcefulness sometimes runs ahead of the factory seal.
The house speciality or a popular dish may be replenished more often, but that is no guarantee. An exotic ingredient has not necessarily been in the freezer since the previous tourist season. Better to ask what is in it and how it is cooked than to judge by how familiar the name sounds.
Kosher, halal, vegetarian or any other special diet does not automatically become more hygienic. Certification applies to particular rules of production, not to whether someone dropped the packet.
With severe diarrhoea the main immediate danger is the loss of fluid and salts. Oral rehydration solution is more use than a homemade guess at how much salt to add. Children and the elderly dehydrate especially fast.
Medical help is needed for severe symptoms, blood, a high temperature, marked weakness, an inability to drink, or signs of dehydration.
A journey should not turn into a gastronomic test of courage. But eating nothing but biscuits from your suitcase in a country with wonderful food is also a fairly expensive way of staying at home.
What is around the dish is usually more dangerous than the dish. The ice in the glass is made from the water you were told not to drink. The salad was rinsed in it. The sauce in the open bowl on the table stood there from lunch and waited for dinner at street temperature. A buffet is convenient in exactly the way it is dangerous: the food stands warm for hours and a queue touches it. The restaurant, meanwhile, may be excellent, and the water supply may be the very one.
The practical conclusion is dull: hot, freshly cooked, peeled by your own hands, water from a sealed bottle. Your own clean hands settle more here than a lucky choice of establishment, but choosing an establishment is far more pleasant, so that is usually what gets discussed.