Morocco

Do you know what the illness was? Hepatitis A and Typhoid fever both have vaccines, and the former is quite common in developing countries. With prior advice from a doctor of course, I would at least get the Hep A shot.

They suspect listeria or salmonella. We have had all our immunizations including typhoid and hep a and b. My friend took Cipro as well as electrolyte powder mixed in water and recovered fairly quickly. I know this can happen anywhere but how big an issue is this with travel in Morocco.

I don't know enough about the sanitation situation to comment in detail. Millions of French tourists go there every year and come back unharmed, though - I certainly hear fewer tales of food poisoning than in, say, India.
Listeria and Salmonella also happen in Western countries, by the way, but usually pose little threat to adults with healthy immune systems.

That sounds like a pretty severe and uncommon case, as well as a tragic one.

If you've got experience traveling in the global south without having many issues, chances are you'll be fine in Morocco. I'm more like your husband and tend to have a sensitive stomach. The first time I was in Morocco ten years ago I got very sick. This summer over the course of the six weeks I got sickish occasionally, and while it was annoying, it was never anything very serious.

It's smart to have your hep A and typhoid vaccines. Smecta works well when things are a little funky, and you can buy cipro OTC in Moroccan pharmacies. A pharmacist in Rabat told me it's not usually what they suggest for stomach issues, but was willing to sell me some.

Hi Amy,

It was indeed a tragic situation. We got Cipro because it seemed like the essential go to drug for anyone traveling to India, South America, etc. and our doctor had no issues with us taking it. We will double check with him before we travel to these places again as to what is the best protocol. We don’t want to overuse the antibiotics but if you need them you need them. We were traveling with a pharmacist in the Galapagos and she was carrying Cipro with her. When my husband (I call him “my delicate flower”) has gotten sick a couple of times with turista in the Galapagos and Cambodia, he took the Cipro and he was right as rain afterwards. I seem to have a cast iron constitution and have been fine on our travels so far knock on wood. My friend on the Morocco tour took Cipro after getting whatever the illness was and he recovered. He also took electrolyte powder for rehydration. Where are you that you were sick for 6 weeks. That’s awful.

Cipro is usually my drug of choice for stomach issues too, just thought it was interesting that the pharmacist suggested something else. I ended up not taking anything that strong, because really it was just some occasional discomfort, never anything urgent! I was with a host family most of the time, so sometimes I was eating things they had bought from street vendors, or water that wasn't necessarily boiled "enough," things like that. During independent travel I tended to have zero problems because I had more control over my food choices!

I am not a doctor.

Most gastro issues are viral. Antibiotics do nothing for viruses, which will nearly always just run their course without medical intervention, though hydration is important. Feeling better a day or two or three after taking antibiotics does not necessarily mean the antibiotics were helpful.

That said, I was laid low by a bacterial infection (confirmed by blood work) in Ljubljana, though I might have been picked it up at an earlier stop in Bolzano or Munich; I know nothing about the incubation period for such things. I assumed the cause was viral and waited until Day 5 to seek medical help. By the time we had the lab results, it was clear I had beaten the thing without drug intervention. I'm still working on figuring out what is viral and what isn't so I react appropriately. A GI doctor once told me that bad cramping usually means a virus.

In a third world country, food practices are not the same as in here the US. Meat is hung out in the air, not refrigerated and exposed to flies, etc. How was the meat butchered and what contamination was it exposed to. Add to the mix, food preparers who may or may not be washing their hands. And yes, you can get salmonella and listeria here as well. And salmonella and listeria are bacteria not viruses. Yes, absent a lab test we do not know if it is a virus or bacteria that is causing the issue. I would rather take an antibiotic to be proactive than wait and see what develops. When you are in a third world country and not close to good medical help, time is of the essence. The person who died on the tour was sent to a local clinic and then transferred at some point to a hospital. By that time, sepsis had set in and moved to his lungs. He died a short while later. This was over a matter of three days.

Thankfully, I would say extreme cases like the one you mentioned are rare, though I can't imagine what that must have been like for the group, and of course the family of the individual who passed away. As a previous commenter said, Morocco is an extremely common and popular tourist destination. The majority of folks are fine, absent possibly a brief gastrointestinal episode. You might prefer traveling independently to have more control over accommodations and food.

Before I went a year ago, the tour guide recommended that everyone bring Imodium, as it often happens that some people get diarrhea several days into the 2-week trip. No one on my tour had any problems, though everyone ate fresh salads and fruit.

With great caution (as we practiced for our three nights in Morocco), you can likely (no guarantees) avoid a similar situation.
We stayed in a highly rated, NYTimes recommended riad, but even then we were personally careful not to drink water that was not bottled/sealed, no fresh fruit that was not peeled, no salads, and only cooked vegetables. While we normally eats LOTS of fresh fruit and salad type foods, we played it very safe. When we had a quick light meal upon arrival, the bartender brought us complimentary frozen drinks (we thanked him and asked if we could take them to our room since we were so tired, arriving late), once we arrived in our room, down the drain they went (they were made from ice).

Did we need to be that cautious? Maybe not. But, it was what we chose to do.

A day later, we attended a cooking class through the riad (at an additional facility they own outside the medina). WOW. The cleanliness was incredible, and we did not pass on any of the foods (and we had no issues). The chef constantly reminded everyone to not use their knives used for chicken with the vegetables, and often those utensils were collected after use, and even cutting boards were changed during the class. Retrospectively we probably could have enjoyed any foods that had been offered at the riad itself, but we did not know the standards that were used.

As part of an excursion we had arranged ourselves, (as part of a hot air ballon trip, we visited a Berber house and we offered hot tea and local foods they had prepared. We discretely passed on most and enjoyed just the hot-from-the-stone-oven bread. When we entered the restroom facilities at the residence, let's just say that I decided I did not need to use them (pretty gross). I do not know if another sink was used for food, but maybe not...the place was small.

But, that said, there are people who visit Morocco who do not hold back on any foods/drink, and live to tell about it.

We had all advised immunizations and we always travel with Z-packs of antibiotics, a small bottle of prescribed pills for travelers intestinal issues (lucky have not had to use), and a couple of over-the-counter things in small quantities. But, we had been doing a bit of globe trotting those years, and my spouse is a cancer survivor, so we had to be very careful with his immune system (at that time).

But, mention of the market above is so very true....shocking (to us based on our standards) how much meat/fish, etc. sits out in the open without refrigeration. Flies and cats all over vegetables, etc. In Vietnam, we saw a rat run thru the market, and after that particular trip, it was the air pollution that seemed to take its toll on my spouse (in bed for a week with a really bad sinus infection of some sort) on that trip.

But, despite all the differences, we as travelers are richer for the experiences of understanding how much of the world lives. If our power goes out for a few hours after a storm, we realize the issue is definitely a First World Problem.

Take the trip, but really vet the places you stay and use super caution with what you eat. We love cooking classes, because we can enjoy great foods while also seeing how they are cleaned and prepared (along with how the utensils are cleaned).

Thanks, everyone for your thoughtful replies. I was looking for responses and advice from travelers with first hand knowledge. We are planning to travel with a very reputable tour company that we have used before. I know one of its employees whose job is to vet these places so I will question him as well. He is the one who recommended Morocco to me. In all my travels in the world, I have never had an issue thankfully. And I know that even eating in the highest end places is no guarantee that you won’t get sick. I have eaten plenty of places (salads, fresh fruit, etc.) in the world and been fine. I certainly wouldn’t have wanted to miss out on some of those wonderful food experiences. Yes, after touring the local markets in third world countries it is shocking. So if I go I will be a lot more vigilant in my food choices. I guess I hadn’t worried about food safety too much until my friend’s very shocking tour report. This hasn’t stopped him from traveling, however. He is off to India, Nepal and Bhutan in a month.

I have seen plenty of flies sitting on food (raw meat and prepared pastries) at outdoor markets in western Europe. I am no expert, but I suspect the major difference between western Europe and Morocco is water cleanliness. If the water isn't clean, washing ones hands and salad vegetables will not necessarily be effective.

My mother and I traveled to Morocco independently around 1990. We agreed before the trip that we'd eat only in the restaurants of tourist hotels, which was the opposite of our usual practice. It was a bit frustrating because there were clean-looking outdoor stalls cooking food on the spot that looked interesting, but we stuck to our plan. We drank bottled water and avoided both uncooked vegetables and ice. Neither of us had any problems.

We both had Hepatitis A vaccinations or before the trip--or whatever passed for such a vaccine at the time. I think it was gamma globulin (aka immune globulin), not the currently available vaccine. I was given the new Hepatitis A/B vaccine last year prior to my trip to Ukraine. I think the CDC now recommends at least Hepatitis A for all travelers, no matter the destination.

We traveled with Friendly Planet a couple of years ago, and had no problems with food at all. In addition, we extended our trip to Essuaria(?) on the coast, stayed at a Riad, ate at Yelp restrurants, and again, no issues.

Staying sane in an ultra high hassle country like Morocco is the main priority, not disease. Your concerns are misplaced.

Hi Tom,

I have traveled in high hassle countries like Egypt, Jordan and Turkey and Greece. So it is annoying but I can handle myself.

Morocco is not a diseasy country for food, you can eat fine off the street including leafy salads.

Have you been to Morocco, Tom? I would love to eat the salads, etc. without worrying. I loved the fattoush in Egypt and Jordan as well as the hummus, lentil soup and bread among other things.

Mary: yes I have. I always ate the brochettes and salads cooked and served in the street. I don’t think there’s great risk in doing so, it’s not a country where tourists frequently get sick.

As I hinted I found a lot of the people really rough.