Moctezuma's Revenge

IS IT REALLY MOCTEZUMA THAT GETS REVENGE?
by Bob Brooke

One of the proverbial concerns of tourists traveling to Mexico is getting sick while on vacation. And they should be concerned, for 20 to 50 percent of travelers to Mexico get Moctezuma's Revenge (MR), according to a recent study by the Office of Medical Applications of Research.

The leading cause of discomfort, Escherichia coli, otherwise known as E. coli bacteria, can be injested in drink as well as food. While many attacks are blamed on unpurified water, just as many are caused by ineffectual food handling.

I've traveled to Mexico many times in the last 17 years and have contracted every bug the country has to offer. After a while, I realized there had to be a way of avoiding digestive diorders while there. So I began asking Mexicans that I met what they would recommend.

What Mexicans Say
Al G. Cardena, owner and operator of Chee Chee's Restaurant and Big Al Tours in Puerto Vallarta told me, "One reason tourists sometimes get sick is they have the attitude, 'Let's do whatever we want, let's have a great time,' and they overdo it. They try to do too much at once."

He went on to say, "Spices are different here, and tourists aren't used to the many kinds of chiles we have. Tequila in the States isn't as strong as it is in Mexico. Many people don't even drink tequila back home. The speed at which we drink in Mexico is slower, and so is the pace. Visitors often drink at the speed they're used to back home, not realizing the heat can affect them."

I've learned that abstaining from any purely Mexican food, as well as abstaining from eating any tropical fruit for twenty-four hours helps my digestive system get acclimated. Papaya fruit and juice are especially bad and should be avoided for a couple of days.

Arturo Melgoza, manager of a large Mexico City hotel, recommended, "Stay away from fancy drinks and rich foods for the first few days. If you have to drink, Mexican beers and wines are best, served cold without ice. I find that there isn't as much of a problem in Mexico City as in the beach resorts where guests drink margaritas in the hot sun by the pool all day.

One of the best ways to prevent MR was told to me by Marita Adair, a friend and fellow writer from Texas. "Several years ago, I began to take acidophilus (the bacteria in yogurt) tablets several days before going to Mexico. This seems to build up the bacteria in my digestive tract and helps prevent or at least lessen the effects of Moctezuma's Revenge."

Some Common Remedies
Acidophilus is available in capsule and chewable tablet form at all health-food stores, drug stores and supermarkets. Taking it has no other effect but to balance your digestive tract. If MR should strike, it can be taken as many times as you need to in order to build up the bacteria.

Even the Mexicans agree that one of the best solutions to MR is common Pepto Bismol (bismuth subsalicylate), either in liquid or tablet form. However, recent tests have shown that there can be severe side effects if this medication is taken too often. Another product, Imodium D, seems to work better and faster, without the accompanying side effects.

Episodes of MR begin abruptly, often without warning. They can occur during travel as well as after returning home and are not contagious. It's slightly more common in young adults rather than older people. The reason for this is unclear, but may be because of a lack of acquired immunity, more adventurous lifestyles, and different eating and drinking habits. Attack rates are similar in men and women. The most common day of onset is the third day after arrival in Mexico, but onset may occur at any time during the visit, and even after returning home.

Both cooked and uncooked foods may be implicated if improperly handled. Especially risky foods include raw vegetables, raw meat and raw seafood. Tap water, ice, unpasteurized milk and dairy products, and unpeeled fruits are also associated with an increased risk of MR. Bottled, carbonated beverages, especially flavored ones, beer, wine, hot coffee or tea are safe.

Infectious agents are the primary cause of MR. Once they're in the digestive tract and depending on how long the victim goes without treatment, the effects can be severe.

Another long-time friend of mine, Carlos Hampe, director of the Mexico Travel Board office in Vancouver, advised, "I recommend taking Bactrim (an antibiotic) when the symptoms become severe. I believe overindulgence in our food has a lot to do with it."

Dolores Lopez Lira, another long-time friend and resident of Cancun, said, "We don't have a problem with water pollution here since all of our water comes from deep wells or is desalinated. Too many tourists come here and do everything they don't do at home, including drinking too much, dancing all night and eating rich foods."

Good Advice
My years of travel to Mexico has taught me a lot about MR. When it does strike, I head for the nearest First Class pharmacy, with a pharmacist who speaks English, or with a Mexican friend to interpret for me. This is no time to practice my Spanish. One of the best local medicines I have found is a green chalky liquid sold under the name of Diarim.

In all my years of traveling, my doctor, who's gotten used to treating me for exotic diseases, has told me time and again to let MR take its course so that I develop an immunity. This advice has certainly worked for me. Now, I seldom get sick in Mexico, and, if I do, I know it had to be from bad food.

Mexican doctors also have told me to avoid getting dehydrated. Chicken broth or soup, as well as beer, contain enough salt to alleviate the problem while fighting MR.

I drink only purified water. Several years ago, the Mexican Congress passed a law requiring purified water for everyone. Now, travelers can buy bottled water just about anywhere, even in smallest tienda (shop). At nearly the same time, the Mexican Congress passed a national hygiene act, which requires all larger restaurants to adhere to strict standards for food handling. Food service workers in resort hotels now all must wear masks and protective head gear. And inspectors visit restaurant kitchens frequently.

When I'm in doubt, I ask for aqua minerale. This applies not only to drinking but to brushing my teeth and rinsing my contact lenses. Those pesky bacteria can get in just about anywhere.

I also wash my hands as often as possible, and especially before meals. Germs can be transmitted from all sorts of things, even paper currency. I learned this the hard way on a trip to Peru, where I contacted amebic dysentery.

Lastly, one of the foods to be especially careful of in Mexico is chicken. Often Mexican chickens, which are the free-ranging variety, contract a virus. Usually, this happens in June and July in the warmer locales. At that time, I avoid eating chicken. An attack of salmonellae gastroenteritis has taught me otherwise.

It doesn't pay to get paranoid about getting MR. A little common sense goes a long way.