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STAY HEALTHY in Mexico
Vicky Cowal, TheNewsMexico.com Columnist - 9/20/2002
I interviewed an American friend, Dr. Tony Harris, who was a staff anesthesiologist at Sharp Cabrillo Hospital in San Diego. He is now retired and spends part of the year at his home in Mexico City. I thought it would be interesting for readers to get his opinions on how to avoid getting sick in Mexico. A little knowledge can make a stay here so much more pleasant.
Q: What is "Moctezuma's revenge?"
A: When foreigners visit Mexico and get sick for any reason, they call it "Moctezuma's revenge." Jimmy Carter claimed that he suffered from it while on his honeymoon in Mexico and got in lots of trouble for using the term. I'm not sure what they called it when George Bush got sick on the Japanese ambassador's lap, but there were surely no reports of Moctezuma ever visiting Japan.
The point is that if intestinal illness can befall such important people when they travel, it can presumed that they didn't get sick on improperly prepared food or a bad ice cube. Some people never get sick, and others do.
An article in the much respected New England Journal of Medicine concluded that what happens when we travel far from home is that we encounter different strains of E. coli, an intestinal bacteria we all have with us. We get these bacteria because they are ubiquitous in the environment and they make us ill because they are new to us and we haven't formed antibodies against them yet. The proof is that some people moving to new parts of the world may be ill for a month or two, but finally everything normalizes.
I must point out that there are other factors besides strange E. coli acting at the same time on the arriving tourist to Mexico:
-- Traveling is stressful and stress causes illness.
-- Jet lag alters the body's biorhythms in ways that we probably don't understand and can contribute to intestinal upset.
-- Mexico City is at an altitude high enough to cause about 50 percent of newcomers to suffer acute mountain sickness for about three days. The condition involves "sickness" usually in the form of mild nausea, headache, breathlessness, exercise intolerance and fatigue. Acute mountain sickness goes away by itself but can be quite severe and incapacitating in some people.
-- Ingestion of the chemical capsiacin that makes chilies hot causes intestinal upset and explosive diarrhea in many people. It takes no imagination to understand how tourists could overdose on chilies unknowingly.
-- When people are on vacation they frequently overdose on alcohol. Everyone is aware of how this substance affects the digestive tract.
So, in summary, we have mentioned six easily understandable ways a tourist can get sick without ever having to blame a horrible, disease-causing bug.
Q: What medicine should I bring or have on hand?
A: There is a medical school of thought that diarrhea is protective and that it is the body's normal way of eliminating toxic substances. These people would say that medicine to stop it interferes with that process. I would guess that when these people suffer from diarrhea on a trip, they probably take something to stop it like everyone else.
I think it's pretty hard to beat good old Pepto Bismol, taken according to the directions on the bottle. It's available everywhere in the world without prescription and it works. It conveniently comes in tablets too. The only precaution is that it turns the stools black for a couple of days and that can be alarming to the unexpecting user. LoMotil tablets are available without prescription in Mexico and also are quite effective at slowing things down. Basically LoMotil is a narcotic with a mainly constipating effect.
Vomiting and diarrhea cause dehydration. Drinking water frequently and in small amounts is the best medicine for dehydration. The kidneys need to make about an ounce (30cc) of urine an hour to eliminate waste from the blood and that requires three 8-ounce drinking glasses of water per 24 hours. If you can't keep enough water down to achieve this urine output, hospitalization and intravenous fluids may be necessary.
Q: What should I be wary of?
A: If you want to be as safe as possible, eat only well-cooked foods, drink bottled drinks and stick to first-class restaurants. Eating food from stands on the street is a way you might get hepatitis, cholera, staphylococcal food poisoning, typhoid fever or other salmonella illnesses. These stands don't have hand washing facilities, running water, refrigeration or ways of disinfecting vegetables. The workers probably have no concept whatsoever of sanitation and you'll notice that everyone eats from the same unwashed plates.
Q: Is cooked food safe?
A: Safer than uncooked, but if the food handler is a carrier of hepatitis, for example, and has not washed his hands after using the bathroom and prior to handling your cooked food, your food could become contaminated.
Q: Should all raw foods be avoided?
A: First let's examine what we mean by raw foods:
-- Green salads contain raw vegetables notoriously known to contain amoebas that can cause dysentery. These vegetables should be soaked in a disinfectant solution to be safe. Some establishments claim to do this and have a sign saying so. You can also ask and more than likely they will say, "Of course!". Consider the soup instead.
-- Fruits, such as strawberries, that grow on the ground and are eaten without peeling are possible carriers of amoebas also.
-- Ceviche is raw fish and vegetables marinated in lime juice, but not cooked. Risky!
-- Many salsas mexicanas are not cooked. They are mixtures of raw vegetables and chilies. They are served with just about every Mexican meal and contain ingredients that are possible carriers of amoebas.
-- I used to drink orange juice from street stands thinking that there was no way there could be anything wrong with it. Once I bought a glass from a pitcher of juice for a Mexican friend and upon tasting he said that it had been diluted. I asked him how he could tell and he said that it was easy because it was sweeter than it should be. The vendors add sugar and water to stretch profits.
Q: What foods should I avoid in first class restaurants?
A: If you are talking about a restaurant chain such as VIP'S nothing need be avoided in terms of safety. You'll just find lots of things on the menu that are not familiar to you and you'll order something that you know and consider safe like enchiladas only to discover that they are spiced with more chilies than you have ever encountered. For some people they are inedible.
But if you do eat them, the next morning you may find yourself with cramping diarrhea, the normal effect of a chili overdose because capsaicin irritates the digestive tract from beginning to end. Avoiding this problem requires that you ask the waiter if this dish is picoso which is the term in Spanish for hot chili type. The word caliente refers to hot (temperature).
Mexican food also typically has other things health minded people are used to avoiding like lots of fat (either vegetable oil or sometimes lard) and lots of salt. By these standards it is hard to find a truly healthful dish in many Mexican restaurants, although the situation has changed very favorably in the last few years.
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Q: Should a long-term resident have periodic amoeba tests or take periodic antibiotics?
A: An amoeba test is only indicated if the person is sick. Antibiotics, because of their possible severe side effects, should be taken only to treat proven infection and under medical direction.
Q: What do you recommend if a person really needs medical attention?
A: Go to the emergency department (called urgencias) at the Hospital ABC, also known to taxi drivers as el hospital ingles. (Tel: 5230-8000. Address: Sur 136 No. 116, Col. Las Americas). You will easily find very competent doctors on the medical staff, many of whom speak English and many there who have taken graduate training in the United States. I have visited the hospital and it has my recommendation. If you want more information about the hospital, you can click on to www.abchospital.com.
Vicky Cowal has lived in Mexico City for the last 30 years. She has her own catering business and runs a cooking school. She has written extensively on cooking for newspapers and recently published a cookbook called "Las Mejores Recetas de Vicky" (Editorial Trillas). For further information, contact her at vickycowal@aol.com
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