Food and water safety in Ecuador

It's a tough one.

I've traveled extensively throughout Central America (not South America), and elsewhere in the developing world, and I always try to stick to the old mantra that has served me well: boil it, peal it, or forget it. That works, pretty much 100%. It also means you miss out on stuff. I accept that's the bargain I've made.

Sadly, I think if you want to not get sick on your trip, you need to stick to that same discipline. If you're OK getting sick (you did before, you said you didn't mind very much...), then it obviously frees you to toss caution to the wind. Of course, exactly how sick you get depends on the specific pathogens you ingest, so that's a crapshoot too (pardon the expression).

You know the drill - you say yourself you had that experience in Brazil. I would expect things to be more or less the same in Ecuador. Maybe different pathogens, maybe a different kind of sick, maybe nothing at all - there's no way to tell. You can and should of course apply common sense: take a good hard look at how sanitation and food/water safety discipline appears once you're there, but you can only see so far. To a great degree, you have to rely on (nearly) blind faith.

One factor going for you is that you're planning to be in a single, fixed location (presumably a comfy one, from your description) for the bulk of your trip. If you get sick there, at least you can probably lay around in a comfortable bed, have some privacy and personal space, and wile away the hours in your own clean, private bathroom, as opposed to being stuck on a long, bumpy bus ride trying to contain your misery as you move along and try to maintain travel plans (when you're sick overseas, small comforts do help). Ah, the romance and adventure of travel...

Bottom line, it's a roll of the dice. I don't think anyone can tell you anything that changes what you already know (and just because someone else went to Ecuador and got sick - or didn't - doesn't mean you will replicate their experience).

Good luck.

David's advice is what I generally followed when in Ecuador, but relaxed a bit when convinced that the food at a great lodge was safe and enjoyed it immensely. Didn't get sick.

I ate everything, including street food, in Ecuador, but only drank bottled water. Had no issues, but that’s me. I have an iron gut after living in West Africa for 7 years.

Thanks for the replies. After posting this, I remembered that we were at a similar kind of birding lodge in Costa Rica 3 years ago. I’m pretty sure I took all kinds of risks and was totally OK. I have a vague memory of my husband admonishing me while being very careful himself. I’ll have to ask. I do know that he has a general aversion for fruits and vegetables, so his being “good” was, let’s just say, not a hardship.

Also, to be honest, I’m mainly concerned about contracting typhoid fever. It’s not even the illness itself that I fear. I fear being in the 3-5% of people who contract the illness and then, despite treatment, remain carriers. I can’t imagine not being able to cook for my family for the rest of my life.

OK, so this is really unlikely. I think there have been 300 cases in the US last year, 70% of which were associated with travel which works out to 210 cases. So, 5% of 210 is about 10. So, I have a 10 in what chance of this happening? Not the population of the US, but of those who have travelled to third world countries. I have no idea have many this would be but probably ???

I know there is a vaccine for typhoid and we had it 4 1/2 years ago along with a bunch of other things before we went to India. Supposedly it is good for three years, but I am hoping my body has some kind of immune memory if need be. I mean, it’s not like the vaccine is totally effective for 3 years, then suddenly totally ineffective.

Of course, I could also get the booster or another vaccine, but I am currently terrified of vaccines. Why? A couple of years ago, I went suddenly deaf in one ear the day after getting a flu shot. This could be a total coincident, but it still freaks me out. (I’ve never recovered the hearing, BTW.)

Am I overthinking this? Probably....

I have traveled to many out-of-the-way places, including Uzbekistan, Myanmar and a remote area of Tanzania - but not South America. I also follow the mantra: boil it, peel it or forget it. I learned my lesson when I got very sick in eastern Europe (Bulgaria). I think I got careless because it was Europe after all, and the guide claimed the water was safe. I had no energy, lost about 20 pounds, and did not get well until about 4-6 weeks after the trip was over. Eighteen months later, I still have bouts of diarrhea that my doctor says is a residual effect of this experience (since we've ruled out just about everything else under the sun). Apparently I picked up some sort of parasite - the specialized travel clinic that I go to could not pinpoint which one. So I was finally prescribed a very expensive medicine ($470 for six pills) and slowly got better. Those antibiotics you mention would not have cured this kind of thing. The doctor at the travel clinic said: "It amazes me how people will take the word of a random tour guide (chef, hotel employee, whoever) over the CDC!" I will never do that again.

You just don't know what's really going on in the kitchen or the fields. How was the food handled on the way to market? Do ALL the kitchen workers wash there hands on a regular basis? How are they trained to handle food? ARE they trained? Was the produce washed? With what? Boiled water? Filtered water? Any water at all? Reputable tour companies do their best to vet the places where meals are served, but they can't be supervising all the time. An upscale lodge is more likely than a budget place to provide safe food and drink, but I no longer trust this.

There is still plenty of food to eat without putting yourself at risk. Bananas, mangos, many yummy things can be peeled. But I am okay with passing on things like grapes and strawberries that cannot be peeled. I will always choose a (hot) soup over a salad made of greens. I choose hot entrees. And I eat plenty of desserts! LOL

I also remove all glasses from the bathroom so that I don't accidentally forget and take a big swig of tap water. I keep a water bottle there instead, filled with safe water. I only brush my teeth using the water bottle and, if I happen to forget and rinse my toothbrush with the tap water, I throw it away and get a new one. Call me compulsive, but I want to keep on traveling. . .and stay healthy.

If you're not comfortable with the injection, there is also a typhoid fever vaccine in pill form which our travel clinic offered as an alternative. When we dropped off the prescription, the pharmacist here had never heard of it, but it's definitely available and apparently easy enough to order. It's four doses, spread out over one week. It's not a huge capsule, as I recall, but it was a capsule.

When we were in Ecuador, we tried really hard to stick to all the recommended food/water safety recommendations. I think we gave up on both by day two. We stayed in good hotels (as in well recommended, not necessarily four diamonds or stars or whatever) as well as a lovely eco-lodge down in the Amazon.

At the lodge we drank bottled water, did the tooth brushing with bottled water, etc., because they had a limited fresh water supply. They told us about that before we arrived. We did the same upon our return to Quito, not because we were ill but because the hotel where we were staying before we departed was in the middle of renovations. Some rooms had potable water. Some did not. Luck of the draw on our return to Quito - our room did not have potable water, but it was clearly marked.

Long story short - we did eat street food and tried some incredible local beverages from street vendors. They were suggested by people who lived there, so we felt better going to those stands. Neither my other half or I was ill on this trip, but we might just have been fortunate? I would stay to stick with your comfort level and combine that with common sense and the CDC suggestions. Hotels in Quito are probably okay, unless marked otherwise. Definitely take water with you on transit days between locations. At the lodge - best to ask them.

Have a wonderful trip!!!

I now see your second post about immunizations. I believe that there is both an injection for typhoid and an ORAL immunization. I think I got the oral one. If memory serves, the oral one actually lasts longer than the injection.

Is there a good travel clinic in your area? I always go to one where I live before trips to more "exotic" locations and they are excellent in giving good, practical advice about specific countries. They may be able to help you become less anxious and they will certainly know the latest on all immunizations. This would be a better option than asking the opinion of (lay) people on this board, or friends who have traveled to the same place.

I'm wondering if anyone has used the water bottles with filters or UV light for water in less developed countries?

I walked around Barcelona all night, stumbling drunk, without a money belt, and I was never pick-pocketed.

I went to [insert any developing country], drank tap water, ate street food, had unprotected sex with strangers every day, and I never got sick!

Both of these statements could be completely true. But I would not count on being able to replicate someone else's purported experience myself.

I know there is a vaccine for typhoid...

I got that one - the oral version - before a trip to North Africa. After taking the pills, I (briefly) questioned whether the cure might be worse than the disease...but the vaccine only made me somewhat sick for a few days, which I later realized was an indication of just how really awful it would be to actually get typhoid for real. The vaccine experience itself was nasty enough, I'm glad I went through it to avoid the real thing. I'd check with a good travel medicine clinic and follow their advice based on your itinerary.

@renee - you advice and your approach seems spot-on to me.

Nowadays it's very easy for us all to get lulled into a false sense of security. We see people who look just like us on TV in wild, exotic places. Businesses are happy to sell you tickets for activities in places you never dreamed of. You can get on a plane at your local airport and in 24 hours you can be just about anywhere on the planet (the far corners take 48 hours). But the world still has some wild, un-tamed places, and even in places that are not very wild, basic human needs that we take for granted are still a world away. You gotta be smart, if you don't want to risk spending your trip in a bathroom (or hospital) and possibly bring that condition home with you.

For me, skipping some strawberries and remembering not to allow any water to trickle in my mouth (or nose) as I'm taking a shower is the price I pay to avoid Very Nasty Things.

I have clear memories from 20 years ago of traveling through Morocco and Western Sahara for weeks, craving fresh veggies, and losing my resolve one night, ordering a salad in a nice, upscale restaurant where they assured me everything was 100% safe and washed with purified water. That salad was delicious, I remember the crisp, cool lettuce, so satisfying, it almost made me dizzy. Then I did get dizzy, and spent the next 3 days in a bathroom. Lesson learned (and re-learned). I can get strawberries and salads with crisp lettuce at home.

Stay strong.

I heard back from the lodge. They said that their water comes from a natural spring and that they also filter the water in the main lodge. They suggest bringing water bottles to fill up for trips off site.

I was actually thinking about buying and bringing one of those portable water purifiers, but now I’m thinking we may be OK. We will not be staying overnight in Quito at all, just at the lodge.

I’m pretty sure we had the oral typhoid vaccine. It’s good to know it lasts longer. I’m not sure what exactly I reacted to in the flu shot, so I’m not sure that getting a vaccine in pill form would be any safer for me. Obviously, I’ll eventually have to take the risk ... or stop traveling to third world countries. Just not ready to take that risk yet.

It’s also true thst food safety is not some simple binary situation — in third world countries you get sick whereas staying in the US you will be perfectly fine. I mean we just had a problem with our Romaine lettuce supply. Also, apparently 30% of the typhoid fever cases in the US are home grown!

I heard back from the lodge. They said that their water comes from a natural spring and that they also filter the water in the main lodge. They suggest bringing water bottles to fill up for trips off site.

Well, not to be snarky, but...what did you expect them to say? "We get our water from a muddy creek that's just downstream from the latrines and a pasture where cattle graze."?

Their response sounds nice and somewhat reassuring, and it's the sort of things I'd expect, but the real question is, do you feel confident enough in them that you're willing to put your health in their hands? FWIW, every establishment that serves its guests water that makes them sick will give all the assurances they can that they take every possible step to safeguard things. The places where I've eaten just before I got sick while traveling did too.

I think with regards to food and water safety, it is better to be somewhat paranoid and distrustful of what you are told by locals than a lot sick. Plus, travelers can get sick from water that is perfectly safe for locals but does not agree with their own digestive system. Water problems can happen anywhere- people in Atlanta have just been told to boil their water.

You are going to LOVE birding Ecuador! I spent a month there 4 years ago in Amazon, Galapagos, Mindo Cloud forest, Otavalo and 2 sessions in Quito. I organized it all myself, and never got sick. But, I always book well reviewed lodgings.

As to typhoid immunization, oral is good for 7 years and shots 2-3. Check your records. Chances are it states "oral' or not; then you know whether you are covered. If not, then head to a travel clinic.
Let's put this into perspective. If you are going with a group tour, you can bet they have addressed the potable water and expectations for fresh food. Any lodge wanting repeat business is going to work hard to comply. If you are on your own and were recommended by another, you can bet somewhere on the internet there are reviews. In fact, I suggest heading over to TripAdvisor and read the reviews. Even join up to 'Ask a Question' at the bottom of the reviews. When you do this, TripAdvisor sends a note to people who reviewed the place asking them to answer your question. That way, you get replies from the company and from the users.
When I traveled, they told me if I needed bottled water and provided it. Amazon lodge provided filtered water we all drank with no problem. I also ate all that was put in front of me. It was a highly reputed lodge and well versed on cooking for non-locals.

Another consideration is that South American food is typically cooked and cooked well. So your 'fresh' portions may be smaller than at home.
I understand the caution and practice it when starting off in a new place, but after a time - like you in Costa Rica - you realize they have things under control. They would not be having repeat North American business if they didn;t. Birding is big money in Ecuador.
What I have done (before I was as experienced traveling globally), I followed the no salad sort of thing, and would buy bananas and avacados from local markets. Brought salt and a pen knife from home. This allowed me to have fresh, vitamin rich snacks.
When volunteering in Africa 6 years ago, I was told the city water was potable, but not recommended; moreso because of old pipes. The other volunteers tended to buy water, but I didn't want to contribute to the plastic situation. I had brought chlorine water purifying tablets (REI is bound to have them), bought one 2 litre bottle of water and when that was finished, refilled it, tossed in a tab, left the lid off and left it overnight. The lid off allowed the chlorine gasses to evaporate and it reduced the smell. Didn't taste super great, but did the job. The UV filters work well, but it is going to be a pain filtering every 16 oz of water you and your husband want to drink on a day out. Fill some Platypus reusable water bottles from the lodge, or buy a couple of 5 litre water bottles and fill in the morning before heading out.

It never hurts to ask your driver to stop at a market or grocery store and buy some 'safe' water and food until you get into the groove of the lodge. I expect within 4 days you will be eating just like the others, but at least having some alternative will give you peace of mind while admiring all this great aves.

Actually, I had just thought of going back and checking the reviews before I read your post. Indeed we checked them before we reserved and wouldn't have reserved if they hadn't been really good. On tripadvisor they have 4.5 stars with 119 reviews. I went back and specifically checked the bad ratings to see if anyone complained about the food/water/being sick. Nope, none at all.

Janet,

As the others have said, it would be prudent to use bottled or treated water in Ecuador, and there are a number of other issues to be aware of also. Your profile doesn't indicate where you're located, but this information from the Canadian government website may be helpful - https://travel.gc.ca/destinations/ecuador (click on the "Health" tab and then "Food & Water"). Be sure to visit a travel medicine clinic and obtain any necessary vaccines or whatever. Have a look at the "Safety & Security* tab as there's some important information there also.

You could also check https://www.iamat.org/ (the website seems to be "down" tonight but should be back tomorrow).

I spent a week in Ecuador this year. I didn't stay in fancy places. As recommended by others, I drank only bottled water and used it for tooth brushing. I ate fruit (mostly peeled), street food, and even a meal prepared by people in an indigenous village. The only food I avoided (at the suggestion of my tour guide) was lettuce. I had no problems. Others in my group who practiced similar patterns were sick for the entire trip. So, it's how much you are willing to risk sickness on your vacation. Bring over the counter meds to counteract the issues you anticipate you could have.

As for preparing for the trip, get the recommended vaccines - typhoid (yes, there are oral options), hep A, tetanus. This is a very, very small price to pay to avoid something nasty. The bigger issues are avoiding mosquito bites (check to be sure you are not visiting a yellow fever zone, bring mosquito spray) and adjusting to the elevation (keep hydrated, don't overdo it).

The yellow fever zone is an important note. I had the yellow fever vaccine before we left for Ecuador. My other half (older than I am) did not because of the age factor. If you're above 60, I think it is? Any way, at some age they start suggesting that you might not want the yellow fever vaccine.

Like another poster above, the worst experience I ever had with traveling was in Morocco. I think I drank something or ate something early in the trip...but I never had to fall back on the antibiotics. Generic Imodium fixed it for me, but OMG I was miserable until we reached London.

However rugged an explorer you are, do not think you can tough out the other health risks in Ecuador. Always prime is malaria. There are so many hybrids of this disease that surviving one tour of a malaria-plagued country won't make you any safer in a different region. The Centers for Disease Control site is easy to use and quite clearly asserts that malaria can be a risk outside built-up areas. That means beginning a routine of prophylaxis before your trip starts.
https://wwwnc.cdc.gov/travel/destinations/traveler/none/ecuador

I walked around Barcelona all night, stumbling drunk, without a money belt, and I was never pick-pocketed.
I went to [insert any developing country], drank tap water, ate street food, had unprotected sex with strangers every day, and I never got sick!

Yea, I could play Russian Roulette!

We are safely back from the trip.

We ate and drank everything without any problem. We did not feel like we were playing “Russian roulette” with our health because every meal we ate and all the water we drank came from a single birding lodge well-known for its good management and excellent cuisine. When we took day trips they packed us a lunch and we carried along water from the lodge. They even packed us a delicious lunch to eat at the Quito airport on our way back.

We did not take malaria meds because we were not in a malari zone (the lodge was at 6,500 feet).

In retrospect, our biggest health risks turned out to be:

1) Falls. We did a lot of hiking/birding in mountainous subtropical rainforest with lots of slippery surfaces. My husband fell twice and I simply gave up at one point rather than risk my neck.

2) Altitude. The itinerary on our very first day included a hike/walk at 14,000 feet. Seeing as how we live on the coast, this was almost too much for us. We made it, but it was not pleasant.

Thanks for reporting back. Glad it was a great trip. Yes, altitude and falls. Can't do a lot to prevent those, other than take it easy....and pack a tensor bandage or two.

If you err on water and food safety issues, it can seriously impact your enjoyment. Better to err on the side of caution.

To be honest, I have suffered from food-borne illness in both Brazil and in India (in both cases I was trying to be careful but screwed up). In neither case did it ruin my trip. On the other hand, I have been extremely ill from food-borne illness in the US. If you wanted to play it really safe, you’d avoid all leafy greens in the US too. (Remember the e-coli outbreak not so long ago). Or never drive. Driving in the US and/or abroad is probably more dangerous than eating an unpeeled veggie in Ecuador.