Restroom Roulette: Navigating Public Bathrooms Around the World

Article Highlights:

• Public restroom cleanliness varies widely by country; Japan and Singapore rank high, while India and Egypt may have more hygiene challenges.
• Travelers can be exposed to illnesses like gastroenteritis, traveler’s diarrhea, and hepatitis A from unclean restrooms abroad.
• Bring essentials like hand sanitizer, disinfectant wipes and toilet paper when traveling to minimize the risk of infections in public bathrooms.

When it comes to cleanliness and hygiene standards in public restrooms, experiences can vary widely from country to country.

During the pandemic, Global Rescue advised travelers to consider bringing a pared-down version of Global Rescue’s COVID-19 travel kit with them into a restroom. It could include small bars of soap and a bottle of water (to wash your hands), travel-size packs of toilet seat covers, paper towels, hand sanitizer and disinfectant wipes.

Today, and any day, unclean public washrooms in foreign countries can expose travelers to various diseases and illnesses, particularly if proper hygiene practices are not followed.

Here are some of the most common diseases and infections that can be contracted:

• Gastroenteritis – Often caused by viral or bacterial infections (such as norovirus or rotavirus), gastroenteritis can result from exposure to contaminated surfaces or food. Symptoms include diarrhea, vomiting and stomach cramps.
• Traveler’s Diarrhea – One of the most common illnesses travelers face, often caused by bacteria like E. coli, salmonella, or parasites. It can be contracted through unclean bathroom facilities or contaminated food and water.
• Hepatitis A – A viral infection that affects the liver and can be contracted through contaminated food or water, including from unsanitary restroom facilities. Vaccination is recommended for travelers to areas where the virus is common.
• Typhoid Fever – Caused by Salmonella Typhi, typhoid fever is transmitted through contaminated food and water. Unclean washroom facilities can contribute to the spread of this illness, especially in developing countries.
• Giardiasis – This parasitic infection is caused by Giardia lamblia and can lead to diarrhea and abdominal discomfort. It can be contracted through contaminated water or surfaces, including public bathroom facilities.
• Cryptosporidiosis – Caused by Cryptosporidium parasites, this illness can be transmitted through contaminated water or surfaces. Symptoms include diarrhea and stomach cramps.
• Schistosomiasis – Caused by parasitic worms, schistosomiasis is often contracted in areas where water sources are contaminated. While it is more commonly associated with freshwater, exposure to unclean restrooms can be a risk factor in some regions.
• Bacterial Infections – Poor hygiene can lead to bacterial infections, including skin and urinary tract infections (UTIs). Using unclean privies can increase the risk of these infections, especially for women.
• Fungal Infections – Unclean and damp environments can lead to fungal infections, such as athlete’s foot or yeast infections, particularly in areas with poor ventilation.

Public Restroom Tips

To minimize the risk of contracting diseases from unclean public bathrooms, consider the following preventive measures:

• Carry Hand Sanitizer: Use hand sanitizer with at least 60% alcohol after using public restrooms.
• Bring Your Supplies: Carry toilet paper, wet wipes, and disinfectant wipes to clean surfaces before use.
• Avoid Contact With Surfaces: Use a paper towel or your foot to flush to avoid touching handles and locks.
• Vaccinations: Ensure you are vaccinated for diseases like Hepatitis A and Typhoid, especially when traveling to areas with poor sanitary conditions.
• Stay Hydrated and Be Cautious With Food and Drink: Drink bottled water and eat at reputable establishments to reduce the risk of gastrointestinal infections.
• Wash Hands Thoroughly: If soap and water are available, wash your hands thoroughly for at least 20 seconds after using the restroom.

Restroom Hygiene Scores by Country

While the risk of contracting diseases from unclean toilets exists, being aware of potential hazards and taking preventive measures can significantly reduce your risk. Always prioritize hygiene and safety when traveling to ensure a healthy and enjoyable experience.

Below is a list of destinations known for having some of the best and worst public bathroom facilities in terms of cleanliness.

Destinations with the Best Public Bathrooms for Cleanliness

• Japan – Japan is renowned for its clean and high-tech toilets, often featuring bidets, heated seats, and self-cleaning functions. Public washrooms are generally well-maintained.
• Germany – Germany has a reputation for cleanliness, and public restroom facilities are usually well-kept. Many facilities require a small fee, which contributes to their maintenance.
• Sweden – Public bathrooms in Sweden are typically clean and well-maintained. Many are equipped with modern amenities.
• Singapore – Known for its strict cleanliness standards, Singapore has clean and well-maintained public lavatories, often with attendants ensuring hygiene.
• South Korea – South Korea offers clean public washrooms, many equipped with high-tech features, similar to those in Japan.
• Finland – Public restrooms in Finland are generally clean and well-maintained, reflecting the country’s high standards of public hygiene.
• Switzerland – Switzerland is known for its cleanliness, and public privies are typically well-kept and hygienic.
• Netherlands – Public bathrooms in major cities tend to be clean and well-maintained, with many facilities requiring a small fee.
• Australia – Australia generally has clean public restrooms, especially in urban areas and tourist destinations.
• New Zealand – New Zealand is known for its clean public facilities, including washrooms, especially in tourist areas.

Destinations With the Worst Public Bathrooms for Cleanliness

• India – Public bathrooms can vary widely in cleanliness, and many facilities may be poorly maintained. It’s advisable to use facilities in hotels or reputable establishments.
• Egypt – Many public washrooms in Egypt may lack cleanliness and proper maintenance, especially in rural areas.
• Mexico – While some tourist areas have decent facilities, public restrooms can be hit or miss with cleanliness often lacking.
• Indonesia – Public lavatories may be poorly maintained, particularly outside major tourist areas. Expect varying levels of cleanliness.
• Morocco – Many public restrooms can be quite basic and may not meet high cleanliness standards, especially in rural areas.
• Brazil – Public bathrooms can be inconsistent in cleanliness, with many facilities lacking proper maintenance in less touristy areas.
• Vietnam – Public restrooms may not always meet cleanliness standards, especially in less developed areas. It’s advisable to use facilities in hotels or larger establishments.
• Turkey – Many public washrooms, especially in rural areas, can be less clean and poorly maintained.

The Global Rescue Solution

With more than a million members, you can imagine the number of calls Global Rescue fields. Not every call, however, is a distress signal from the top of Everest. Some questions, like, “I have nonstop diarrhea” or “I have severe abdominal pain” arise during typical travel situations.

Medical advisory services are included with every Global Rescue travel protection services membership.

“Medical advisory services provide medical advice to travelers to decrease environmental risks and increase prevention of injury or infectious disease during travel,” Garret Dejong, senior specialist in medical operations at Global Rescue.”

No request is too small. A spreading rash or troublesome gastrointestinal issues while traveling can make any trip uncertain and the next leg of a journey a stressful expectation.

“Call us whenever you have a medical question during your travels. Ask immediately before the situation or the symptoms worsen,” Dejong said. If travelers wait to call until their gastrointestinal issue becomes unbearable, they might lose more time on the trip and possibly risk their health.

Traveler’s diarrhea hits international travelers harder because they don’t have immunity to the germs in the country they are visiting. The climate and the sanitary systems might be different, allowing bacterial pathogens, intestinal viruses and protozoal pathogens easier access to your water, food — and gastrointestinal system.

Poor hygiene practice in local restaurants (and their restrooms) is likely the largest contributor to the risk for TD, according to Johns Hopkins Medicine. This is especially true in the developing countries of Africa, the Middle East, Latin America and Asia. There’s lesser risk in Eastern Europe, South Africa and the Caribbean, and low risk in Northern and Western Europe, Japan, Canada, Australia, New Zealand and the United States.

A Global Rescue travel protection services membership means members can access 24/7/365 advisory services staffed by experienced nurses, paramedics and military special operations veterans. Global Rescue also has partnerships with the Johns Hopkins Emergency Medicine Division of Special Operations, Elite Medical Group and Partners HealthCare, the Harvard Medical School affiliate.