Food and Water Safety for Travelers: A Physician's Guide to Eating and Drinking Abroad

The single most useful rule for eating and drinking abroad is short: if it is steaming hot and freshly cooked, it is probably safe; if it is raw, room temperature, or washed in tap water you would not drink, treat it as risky. Most travel-related stomach illness comes from food and water contaminated with bacteria, viruses, or parasites, and the classic phrase "boil it, cook it, peel it, or forget it" still captures the core idea. According to the CDC, traveler's diarrhea is the most common travel-related illness, affecting an estimated 30 to 70 percent of travelers depending on the destination and season. As a PA-C who has treated plenty of travelers after the fact, my honest take is that you do not need to eat fearfully, you just need to make a handful of smart choices automatically. This guide covers which foods and drinks are higher risk, how to find safe water, the realities of street food and ice, and exactly what to do if your stomach turns on you mid-trip.

Why Food and Water Make Travelers Sick

Traveler's diarrhea and most foodborne illness abroad come from swallowing germs that your gut is not used to. The usual culprits are bacteria such as enterotoxigenic E. coli (the leading cause), Campylobacter, Salmonella, and Shigella, along with viruses like norovirus and, less often, parasites such as Giardia. These organisms reach your mouth through contaminated water, undercooked food, unwashed hands (yours or a food handler's), or produce rinsed in unsafe water.

The reason locals can eat the same food without getting sick is straightforward: they have built up partial immunity through repeated low-level exposure over years. You have not. That mismatch, not "dirty food" in some moral sense, is what puts visitors at higher risk. Destinations are commonly grouped into higher-risk regions (much of South Asia, parts of Africa, the Middle East, and Latin America) and lower-risk regions (the United States, Canada, Western Europe, Japan, Australia, and New Zealand). Knowing your destination's risk level tells you how strict to be.

The Core Rule: Boil It, Cook It, Peel It, or Forget It

This decades-old travel-medicine slogan still works because it sorts food into safe and risky by how it was prepared:

• Boil it. Water and drinks that have been boiled (tea, coffee, soup served piping hot) are reliably safe. Heat kills the organisms that cause illness.
• Cook it. Food served steaming hot and cooked all the way through is low risk. Heat is your best friend.
• Peel it. Fruit and vegetables you peel yourself (bananas, oranges, avocados) are safe because the edible part was protected by a skin you removed with clean hands.
• Forget it. Anything raw, lukewarm, sitting out, or washed in questionable water goes in the "skip it" pile.

The practical version I give friends: hot and fresh beats cold and sitting, and "I peeled it myself" beats "someone washed it for me."

Higher-Risk Foods to Approach With Caution

You do not have to avoid these forever, but in higher-risk destinations they cause a disproportionate share of illness:

• Tap water and anything made with it, including ice, fountain drinks, and reconstituted juices.
• Raw or undercooked meat, poultry, seafood, and eggs. Rare burgers, ceviche, raw oysters, and runny eggs are higher risk.
• Raw fruits and vegetables you did not peel yourself, especially leafy salads and pre-cut fruit, which are often rinsed in tap water.
• Unpasteurized dairy, including fresh cheeses, raw milk, and some local yogurts and ice creams.
• Food from buffets or carts that has been sitting at room temperature, where bacteria multiply for hours.
• Cold sauces and condiments left on the table, such as salsas or chutneys made with raw ingredients.
• Bushmeat and food from unrefrigerated street displays.

Lower-Risk Foods You Can Usually Trust

The reassuring news is that a huge amount of travel food is safe when chosen well:

• Food served steaming hot, straight off the grill, out of the fryer, or out of a boiling pot.
• Fruit you peel yourself, like bananas, oranges, and mangoes.
• Dry or packaged items, such as bread, crackers, and sealed snacks.
• Bottled, canned, or hot beverages with intact seals.
• Cooked vegetables served hot, rather than raw salads.
• Pasteurized dairy in sealed containers.

A simple mental filter at every meal: Was it cooked hot and served hot? Did I peel it? Is it sealed? If yes to any of those, it is usually fine.

Is the Water Safe to Drink? How to Tell and What to Do

In many destinations the tap water is not safe for travelers, even when it looks perfectly clear. When you are unsure, assume tap water is unsafe and use one of these instead.

Safest drink choices abroad:

• Commercially bottled water with an intact, factory-sealed cap. Check that the seal has not been tampered with.
• Water that has been brought to a rolling boil for at least one minute (three minutes above roughly 6,500 feet of elevation). Boiling is the most reliable way to make water safe.
• Hot tea, coffee, and other drinks made with boiled water.
• Canned or bottled carbonated drinks, which are sealed and acidic.

If bottled or boiled water is not available, you can treat water yourself:

• A portable water filter rated to remove bacteria and protozoa (look for an absolute pore size around 0.1 to 0.4 microns). Most filters do not remove viruses on their own.
• Chemical disinfection with chlorine dioxide or iodine tablets, following the label's contact time. In cloudy or cold water, let it sit longer.
• For the most thorough protection, filter first, then disinfect, which covers bacteria, protozoa, and viruses.

A few habits matter as much as your drink choice: brush your teeth with bottled or treated water in high-risk areas, keep your mouth closed in the shower, and do not assume a clear mountain stream is clean.

The Truth About Ice, Salads, and Street Food

These three trip people up the most, so here is the realistic version.

Ice. Ice is just frozen tap water, and freezing does not kill the germs that cause illness. In higher-risk destinations, skip ice in your drinks unless you know it was made from purified or bottled water. Many travelers do everything right and then undo it with a cold soda over ice.

Salads and raw produce. Raw leafy greens and pre-cut fruit are among the riskiest items because the surface area is large, they are eaten raw, and they are usually washed in tap water. Cooked vegetables served hot are a much safer way to get your greens on the road.

Street food. Street food is not automatically dangerous, and some of the safest meals you will eat are cooked to order over high heat in front of you. The signals I look for: a busy stall with high turnover (food is not sitting around), cooking that happens hot and to order while you watch, and clean handling. The riskier street options are pre-cooked items sitting at room temperature, raw garnishes, and sauces that have been out all day.

Hand Hygiene: The Step Travelers Forget

You can choose food perfectly and still get sick from your own hands. Wash with soap and water before eating and after using the bathroom, and carry an alcohol-based hand sanitizer with at least 60 percent alcohol for the many times soap is not available. Sanitize before street-food snacks, before handling that banana you are about to peel, and after touching shared surfaces like menus, railings, and cash. It is the least glamorous travel-health habit and one of the most effective.

What to Pack: A Simple Food and Water Safety Kit

A small kit covers the realistic scenarios:

• Alcohol-based hand sanitizer (at least 60 percent alcohol).
• A water treatment method: purification tablets, a portable filter, or both for higher-risk trips.
• Oral rehydration salts (ORS), the single most important item if you do get sick.
• Loperamide (Imodium) for symptom control when you need to travel or sleep.
• Bismuth subsalicylate (Pepto-Bismol), which can both ease symptoms and modestly reduce your risk when taken preventively.
• A standby antibiotic for moderate-to-severe traveler's diarrhea, if your clinician has prescribed one for your destination.

For higher-risk destinations, the most common antibiotics for traveler's diarrhea are azithromycin and a fluoroquinolone such as ciprofloxacin, and which one is appropriate depends on where you are going. A Wandr clinician can review your itinerary and, when appropriate, call a standby prescription in to your local pharmacy for pickup before you leave, so the medication is in your bag if you need it. Talk to a Wandr clinician about a travel health kit and standby prescription.

What to Do If You Get Sick Anyway

Even careful travelers get traveler's diarrhea, so have a plan.

For mild cases (loose stools but you can still function): focus on fluids. Drink bottled or treated water and use oral rehydration salts to replace lost salts and water. Most cases resolve on their own within one to five days.

For moderate cases (symptoms interfering with your plans): loperamide can control symptoms, and bismuth subsalicylate can help. If your clinician prescribed a standby antibiotic, this is the situation it is meant for, especially when diarrhea is frequent or keeping you from traveling.

Seek medical care promptly if you have any of the following warning signs, which point to something more serious than routine traveler's diarrhea:

• Bloody stools or black, tarry stools.
• A high fever (above 102°F or 39°C).
• Signs of dehydration: very little urine, extreme thirst, dizziness, or confusion.
• Severe abdominal pain.
• Symptoms lasting more than a few days, or any diarrhea in an infant, older adult, or pregnant traveler.

Rehydration is the priority in nearly every case. People rarely get into trouble from the diarrhea itself; they get into trouble from the dehydration that comes with it. For a deeper walkthrough of treatment, see our complete guide to traveler's diarrhea and our comparison of the antibiotics used to treat it.

Special Situations: Kids, Pregnancy, and Sensitive Stomachs

Some travelers should be stricter. Infants and young children dehydrate faster and need prompt rehydration. Pregnant travelers should be especially careful with unpasteurized dairy and undercooked meat because of listeria and other risks, and several anti-diarrheal and antibiotic options are limited in pregnancy, so a pre-trip plan matters more. Travelers who take acid-reducing medications (such as proton pump inhibitors) lose some of the stomach acid that normally kills swallowed germs, which can raise their risk. If you fall into one of these groups, it is worth reviewing your plan with a clinician before you go rather than improvising abroad.

Build Your Plan Before You Leave

Food and water safety is mostly a set of small, automatic choices: hot and fresh over cold and sitting, peel-it-yourself over washed-for-you, sealed or boiled water over tap, and hand hygiene before every bite. Pack a simple kit, know your destination's risk level, and have a treatment plan in your bag instead of in your head.

If you want that plan built for you, Wandr's physician-founded team can review your itinerary, recommend the right kit, and, when appropriate, send a standby prescription to your local pharmacy for pickup before your trip. Get a pre-trip health check with Wandr and travel knowing your stomach is covered.

Frequently Asked Questions

Can you drink tap water in other countries? It depends on the destination. Tap water is generally safe in the United States, Canada, Western Europe, Japan, Australia, and New Zealand, but in many parts of South Asia, Africa, the Middle East, and Latin America it is not safe for travelers. When you are unsure, assume tap water is unsafe and drink bottled, boiled, or treated water instead.

Is it safe to have ice in my drinks while traveling? In higher-risk destinations, no, unless you know the ice was made from purified or bottled water. Ice is frozen tap water, and freezing does not kill the bacteria, viruses, or parasites that cause illness. Skipping ice is one of the easiest ways to lower your risk.

Is street food safe to eat abroad? Street food can be very safe when it is cooked to order over high heat and served steaming hot, especially at busy stalls with high turnover. The riskier options are pre-cooked items sitting at room temperature, raw garnishes, and sauces left out all day. Watch your food being cooked hot and eat it hot.

What does "boil it, cook it, peel it, or forget it" mean? It is a travel-medicine rule for sorting food by safety. Drinks that are boiled and food that is cooked steaming hot are safe; fruit you peel yourself is safe; and anything raw, lukewarm, or washed in questionable water should be skipped. Heat and self-peeling are what make food reliably safe.

How can I make water safe to drink if I can't buy bottled water? The most reliable method is bringing water to a rolling boil for one minute (three minutes at high elevation). If you cannot boil, use a portable filter rated to remove bacteria and protozoa, then add chemical disinfection with chlorine dioxide or iodine tablets to also handle viruses. Following the label's contact time matters.

Are raw fruits and vegetables safe to eat while traveling? Fruit you peel yourself, like bananas and oranges, is safe. Raw leafy salads and pre-cut fruit are higher risk because they are eaten raw and usually rinsed in tap water. Cooked vegetables served hot are a safer way to get produce on the road.

Will taking Pepto-Bismol prevent traveler's diarrhea? Bismuth subsalicylate (Pepto-Bismol) can modestly reduce the risk of traveler's diarrhea when taken preventively several times a day, and it can ease symptoms if you do get sick. It is not a substitute for safe food and water habits, and it is not recommended for everyone, so check with a clinician about whether it fits your plan.

Should I bring antibiotics for traveler's diarrhea? For higher-risk destinations, many clinicians prescribe a standby antibiotic to carry and start only if you develop moderate-to-severe diarrhea. Azithromycin and fluoroquinolones like ciprofloxacin are the usual choices, and the right one depends on your destination. A Wandr clinician can review your trip and call an appropriate prescription in to your local pharmacy for pickup before you leave.

---

Sources

• Centers for Disease Control and Prevention. "Food and Water Safety." CDC Travelers' Health. https://wwwnc.cdc.gov/travel/page/food-water-safety
• Centers for Disease Control and Prevention. "Travelers' Diarrhea." CDC Yellow Book 2024, Chapter 2. https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/travelers-diarrhea
• Centers for Disease Control and Prevention. "Water Disinfection for Travelers." CDC Yellow Book 2024. https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/water-disinfection
• World Health Organization. "Food safety." WHO Fact Sheets. https://www.who.int/news-room/fact-sheets/detail/food-safety
• World Health Organization. "Five Keys to Safer Food." https://www.who.int/teams/nutrition-and-food-safety/five-keys-to-safer-food

---

Medical disclaimer: This article is for general educational purposes and is not a substitute for individualized medical advice. Talk to a licensed clinician about your specific destination, health history, and any medications before you travel.