So, there you are in some out of the way corner of Mexico and your belly is empty. You have been out walking all day, and on the corner is a taco stand that has obviously been sitting there since the days of Poncho Villa. In fact, there is a really good chance that the guy cooking up those tacos remembers Poncho. There is nothing that even resembles a restaurant in the area and those tacos smell soooooo good. However, you are no fool and you swore you learned your lesson last year and would never eat street food again. What are you going to do?
Of course, you have to make your own decision. And yes, there is a risk. In fact, every time you eat, no matter where you are, there is a risk of food poisoning. The CDC estimates that each year roughly 1 in 6 Americans (48 million people) get sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases….in the USA. I was in Jackson, Mississippi and ate at the Bonefish Grill…a very nice place. The 24 hour period after that meal…I won’t bother you with the less than pretty details. But, If I can find street food that meets some very simple criteria, I will chow down.
First and foremost…for food that needs to be cooked, don’t eat anything that you did not actually see being cooked. As with any production line, street vendors might cook up some of their product and keep it sitting on the cart waiting for you to show up. Take a pass. Ask him to cook up a fresh one, and if he won’t, move on. After that food starts to cool off just a bit, it becomes a dual purpose bacteria incubation chamber and insect runway. That would be bad.
Make sure the food was cooked hot and well done. If he is cooking meat, it better sizzle. You should feel the heat coming off of it. If it is soup, it better be too hot to put in your mouth.
Pass on any uncooked, fresh veggies. They will get you. If you really want your veggies, make him cook them.
If you have the time, stand and watch to see if any of the locals buy food from this guy. A lonely street vendor is a bad sign. In many parts of the world, the food cart is a social gathering place at mealtime, but only at the good ones.
Avoid shellfish…end of story. Shellfish is dangerous enough in the US (16% of all foodborne illness). You just don’t want to mess with it from a street vendor.
If you can help it, don’t use their utensils or plates. Those things are washed in the local tap water and you aren’t drinking that…are you?
Now, you made the decision to fill your belly and it was good. You did everything right, and knowing the risks, you ate. And then, despite your best efforts you feel that rumbling way down there. Now what?
Let’s talk about food poisoning. There are really two basic types. First, you can eat something that contains some toxin. It might be a chemical, or a toxin produced by an organism (most likely a bacteria) that may or may not still be alive. No amount of cooking will make this go away. You eat it, you get sick. Call this type 1. Fortunately, this is probably somewhat less common in street food. Second, you can eat something that contains a living organism. Might be a bacteria, or a parasite. This organism is either going to make you sick by producing a toxin in your gut, or simply by being there. Food cooked well and hot deals with this most of the time. Calls this type 2.
If you get type 1, antibiotics are not going to help you. There is nothing there to kill. Unfortunately, without a trip to the doctor you can’t be sure, and most doctors won’t bother checking anyway. They will just give you antibiotics on the hope they will help. Food poisoning can be fatal, but if it is not, you can wait out type 1 food poisoning. The toxin will eventually move on through. Waiting it out…not fun. What you need is something to counteract or absorb the toxin. While you won’t hear this from most US doctors, I never travel without activate charcoal tablets. At the very first feeling of discomfort, if you believe it is food poisoning…swallow 3-4 tablets. Most times you will feel better in an hour or two. This may essentially be a cure and works on many poisons, even those not food borne.
If you get type 2, charcoal may help. Remember, type 2 is due to an organism in your gut and it might be producing toxins. However, charcoal is not going to kill the organism. It might make you feel better, but it will probably be temporary. You will eventually need to get treated with something to kill off what you have. Whether you try and wait until you get home is up to you.
Since you will never be sure if you have type 1 or type 2, you need a way to make a guess. You can treat with the charcoal, and if it fixes you…great. If not, or if you feel better for a while and it comes back, you you can take an antibiotic if you have one. REMEMBER….AND THIS IS IMPORTANT….you can’t take both at the same time. The charcoal may absorb the antibiotic…and any other medication you might be taking. That is what it does…it absorbs stuff. If you have taken charcoal and you are not getting better, you have to wait at least a couple hours before taking any other medication
You can use anti-diarrhea meds if need be (as per your doctor or manufacturers instructions). Spending hours sitting on a toilet (or squatting over a hole in the floor) is no way to spend a vacation day. These meds work, but they do not really treat the problem. It is up to you if you use them.
Some general things to keep in mind…throwing up and diarrhea are common symptoms of food poisoning and will make you dehydrated. Dehydration is dangerous. If you become seriously dehydrated that is reason for going to the hospital. As soon as you start puking or pooping, start drinking…a lot. (NOT ALCOHOL).
Never take any medication (including charcoal) without first discussing it with your doctor. Do your own research and then decide. Plan ahead and ask your doctor about this before you leave.
Take all medications are prescribed by your doctor. Taking more of something is not necessarily better.
Treating with charcoal