Expert: Jay - 10/17/2008

Question
QUESTION: I realize that you are not a doctor but I figure your experiences will help you or you will know whom to consult.

My 24 year old daughter has relocated to China (Shenzhen) to teach English for a year.  We are not worried about her and she spent nearly a month there traveling before.

But she has developed a severe and pretty persistent diarrheal illness since she has been back over the past month.  She started with fever and respiratory congestion.  This has improved a little, as I understand, but the diarrhea is apparently pretty terrible.  The fever has gone away.

If she were in the US, I'd presume this was just "a virus" -but overseas, I don't know what are the likely possibilities.  I know it could be anything from just a new germ that she will recover from to some amoeba or parasite in the water to hepatitis B.

So, what's likely?  She's been told to not drink tap water and not even use it for brushing teeth.  What's in the tap water?  She's trying symptomatic relief with increased fiber, and drinking bottled water.  She sounds ok on the phone.

Is something like this so common that local pharmacies just sell some treatment?  I don't want her to take antibiotics willy-nilly.

I'm sure I'll have more questions, but I appreciate any help.

-A slightly worried dad who knows too much for his own good

ANSWER: You are right, I am not a doctor so I'm not even going to have a guess what is wrong with your daughter but I will give my opinion on what you should do.

When I was living in China (moved back to Australia December last year)almost every one I know ended up with diarrhoea that lasted anywhere from a few days to a month.  This is quite common not only because of the water but also because of the different kinds of foods and cooking methods.  One of my friends however had diarrhoea for just over 6 months.  He became very ill.  He was already very skinny but he lost a lot of weight and in the end found it difficult to move even short distances before needing to go to the toilet.  Throughout these 6 months he visited doctors in Guangzhou, Shenzhen and Hong Kong and no one could find the reason as to why this was happening.  Eventually he managed to get back to New York where it took the doctors there another few months to properly treat him.  Unfortunately that was 5 years ago so I don't remember what was wrong and I've lost contact with him.

I personally don't think the respiratory congestions and diarrhoea are related.  Shenzhen, like most of the busy cities in China is extremely polluted which would be the cause for that one.  My advise would be to try a doctor in Hong Kong first.  If that does not work then get her home.  Living in China is a wonderful experience but not if your sick.

I hope this helps,

Jay

---------- FOLLOW-UP ----------

QUESTION: But why do people say to avoid tap water?  Is it infested with something?  I sure would like to know what became of your friend who had to get diagnosed in New York.....

Also, if she visits a doctor in Hong Kong, how does she get seen?  She goes to an emergency department in a hospital?  Is this socialized care or does she have to pay?  How does it work?  (My daughter may know some of this, but I want to be helpful if she doesn't.)

Answer
The tap water in China is not treated the way we treat water in the west.  Every one in China, including local avoid drinking the water.  I brushed my teeth in it but that was about it.

In Hong Kong she would have to pay for treatment and I don't know how much that would be.  In places like Star Bucks in Hong Kong you can get free magazines called That's Hong Kong.  In the magazines it will give listing of hospitals with Western doctors or able to communicate English.  She could get one of these magazines and give some of them a call to find out on prices or to make a booking.