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Foodborne and Waterborne Illness during Pregnancy

Pregnant women should be advised of the following:

  • Adhere strictly to food and water precautions in developing countries, because the consequences of foodborne and waterborne illness may be more severe than diarrhea and may have serious sequelae (such as toxoplasmosis or listeriosis).
  • Boil suspect drinking water to avoid long-term use of iodine-containing purification systems. Iodine tablets can probably be used for travel up to several weeks, but congenital goiters have been reported in association with administration of iodine-containing drugs during pregnancy.
  • Oral rehydration (boiled or bottled water) is the mainstay of therapy for travelers’ diarrhea.
  • Bismuth subsalicylate compounds are contraindicated because of the theoretical risks of fetal bleeding from salicylates and teratogenicity from the bismuth.
  • The combination of kaolin and pectin may be used, and loperamide should be used only when necessary.
  • The antibiotic treatment of travelers’ diarrhea during pregnancy can be complicated. Azithromycin or an oral third-generation cephalosporin may be the best option for treatment, if an antibiotic is needed.

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