QA問答：為什么當(dāng)?shù)厝顺越诸^小吃攤的食物不會(huì)生病，而來這個(gè)國(guó)家的外國(guó)人卻可能會(huì)生病？

Terry Dinerman
I spent 40 years working and living in “The Developing World” providing Primary Care and Emergency Medicine….I personally “ate on the local economy” and that includes some very remote, austere and frequently hostile places….
Over that time, most of the cases of foodborne illness I’ve treated in both my Expat and Local patients have come from airline and hotel food, rather than home kitchens, street vendors or small restaurants….
How is this possible…???
Easy…
Home cooks cannot afford to have foodborne illnesses treated, restaurants and street vendors cannot stay in business poisoning their customers…. and they all learn how to properly clean and cook the local foods from the Grandmothers and Mothers…
Personally…???
I never suffered a case of foodborne illness eating “l(fā)ocal” in SE Asia, South and Central America, the Middle East and MOST of west Africa…. but it was a Hilton Hotel buffet in Equatorial Guinea that ended that “l(fā)ucky” streak….
Go figure….

我曾在“發(fā)展中國(guó)家”工作和生活了40年，提供初級(jí)醫(yī)療和急診服務(wù)……我本人也一直“吃當(dāng)?shù)氐慕?jīng)濟(jì)”，包括一些非常偏遠(yuǎn)、艱苦甚至常常充滿敵意的地區(qū)……  
在這段時(shí)間里，我治療的大多數(shù)食物中毒病例，無論是外籍人士還是本地人，都來自航空公司和酒店的食物，而不是家庭廚房、街頭小販或小餐館……  
為什么會(huì)這樣？  
很簡(jiǎn)單……  
家庭主婦負(fù)擔(dān)不起治療食物中毒的費(fèi)用；餐館和小販如果毒害了顧客，也無法繼續(xù)營(yíng)業(yè)……他們都是從祖母和母親那里學(xué)會(huì)了如何正確清洗和烹飪本地食物……  
我自己……？  
我在東南亞、中美洲、南美洲、中東和大部分西非地區(qū)吃“本地”食物從未得過食物中毒……  
但最終打破我這個(gè)“好運(yùn)”的，是赤道幾內(nèi)亞一家希爾頓酒店的自助餐……  
你說奇怪不奇怪……

Bored
I'm from the USA. I had the opportunity to work across the globe which was very scary and I am a very picky eater. I was grossed out by local foods so I chose to stick with actual restaurants and places that seemed well kept. Every damn country I went to I got so sick. About 24 hrs after landing somewhere I was puking, headaches, and in the bathroom for quite some time. There's an elevator in Spain that has my puke that leaked into the crack on the floor where the elevator doors meets the floor that went down a few flights from 10 years ago. I go to Amsterdam to a classy restaurant, next morning the same thing, UK I got lucky and I was able to get foods I'm used to. I don't eat bad, so I wasn't shoveling mass amounts of junk, but I thought there could be some type of bacteria or something that our bodies aren't used to, like when settlers would come over hundred of years ago bringing strains of whatever it was and wiping out the people who were already there.

我來自美國(guó)，有機(jī)會(huì)在全球各地工作，這讓我感到非常害怕，而且我是一個(gè)非常挑食的人。我對(duì)當(dāng)?shù)氐氖澄锔械綈盒?，所以選擇去看起來干凈的餐廳吃飯。可是在我去的每一個(gè)國(guó)家，我都會(huì)生病。通常是在落地后24小時(shí)內(nèi)就開始嘔吐、頭痛，然后一直待在洗手間。十年前在西班牙，我吐在電梯里，還有一部分從電梯門和地板之間的縫隙漏下去了，下樓幾層都能聞到。我去阿姆斯特丹的一家高檔餐廳吃飯，結(jié)果第二天又是老樣子。在英國(guó)我運(yùn)氣好一點(diǎn)，因?yàn)槟抢锬苷业轿沂煜さ氖澄?。我吃得并不差，也沒有吃很多垃圾食品，但我一直以為可能是一種我們身體不習(xí)慣的細(xì)菌，就像幾百年前殖民者把某些病菌帶到新大陸，導(dǎo)致原住民大規(guī)模死亡那樣。

Jerry Everard
I haven’t been sick from eating food from street vendors — mainly Malaysia, Korea and Singapore. The latter two have very strict hygiene standards, and cafes often have a hygiene rating issued by the government. There are some things I look for. Firstly, is the stall busy? Then the food is constantly being cooked fresh rather than being kept warm. I look for vendors actually cooking it at the stall rather than reheating previously prepared food. In most Asian cooking, the pans are kept VERY hot and the food is seared in boiling oil — this will kill most bugs that can affect digestion (such as E. coli or Salmonella). For meat, I usually go for chicken, beef, or lamb. Pork, less so, as it seems to be more susceptible to bacterial corruption. And of course, vegetarian, as veggies don’t spoil easily. I don’t eat salads from such vendors as the veggies were quite possibly washed in dirty water. But a stir-fry is usually pretty safe as they are cooked at high temperatures. I did get food poisoning once in Malaysia from eating western food in a high-ish end restaurant, but I’ve never had a problem with food vendor markets or street stalls. Obviously, avoid those that are clearly unsanitary, or have little custom, but otherwise, you’ll more likely either have a problem with the spices or with the local water.

我沒有因?yàn)槌越诸^小販的食物而生病過，主要是在馬來西亞、韓國(guó)和新加坡。后兩個(gè)國(guó)家的衛(wèi)生標(biāo)準(zhǔn)非常嚴(yán)格，許多餐廳都有政府頒發(fā)的衛(wèi)生評(píng)級(jí)。我會(huì)注意一些細(xì)節(jié)：首先，攤位是否很忙？這意味著食物是現(xiàn)做的，而不是提前做好后保溫的。我喜歡看食物是在攤位上現(xiàn)場(chǎng)烹飪的，而不是加熱之前做好的。在大多數(shù)亞洲烹飪中，鍋具溫度非常高，食物通常用沸油煎炸，這可以殺死大多數(shù)影響消化的細(xì)菌（如大腸桿菌或沙門氏菌）。對(duì)于肉類，我通常選擇雞肉、牛肉或羊肉，豬肉較少，因?yàn)樨i肉更容易滋生細(xì)菌。當(dāng)然，素食也很安全，因?yàn)槭卟瞬蝗菀鬃冑|(zhì)。我不吃小販提供的沙拉，因?yàn)槭卟撕芸赡苁怯门K水洗的。但炒菜通常比較安全，因?yàn)楦邷嘏腼兡軞⒕?。我在馬來西亞有一次食物中毒，但那次是在一家較高檔的西式餐廳，但從沒在街頭市場(chǎng)或小攤上出過問題。顯然，要避開那些明顯不衛(wèi)生或沒有顧客的攤位，否則你更可能因?yàn)橄懔匣虍?dāng)?shù)氐乃霈F(xiàn)問題。

Ted Dus
as an avid traveller, I can’t really recall a situation when I got sick from local food. I’ve eaten from street stalls in India, Pakistan, in African countries, and elsewhere. I got upset stomach a couple of times, but really nothing serious. My thinking is that, if the locals can eat it, I can eat it too. I’m cautious with water though, and drink only bottled water. In many countries street food is the best the local cuisine can offer. If we’re too prejudiced we’ll miss too much of the local flavour. Oftentimes street stalls serving food can look very simple, but the vendors know how to take care of it and keep it clean. Otherwise they wouldn’t have any customers.

作為一個(gè)熱愛旅行的人，我?guī)缀跤洸黄鹱约阂驗(yàn)槌援?dāng)?shù)厥澄锒〉慕?jīng)歷。我在印度、巴基斯坦、非洲國(guó)家和其他地方的街頭小攤吃過飯。偶爾有幾次胃部不適，但都不嚴(yán)重。我的想法是，如果當(dāng)?shù)厝四艹?，我也可以吃。不過我對(duì)水比較小心，只喝瓶裝水。在很多國(guó)家，街頭食物才是當(dāng)?shù)孛朗车木A。如果我們太偏見，就會(huì)錯(cuò)過很多地道風(fēng)味。很多時(shí)候，那些賣食物的攤位看起來很簡(jiǎn)單，但攤主知道如何照顧食物并保持清潔。否則他們就不會(huì)有顧客了。

SwiftOne SonOfSun
Since India is strangely singled out, in such discussions, let me answer as a local
There are 2 factors - ingredients & hygiene, Which get conflated.
Locals are accustomed to the ingredients like spiciness and body habituated to it, so locals don't fall sick, neither do visitors from similar cultural profiles. A Mexican would handle Indian food better than say a Norwegian.
As to hygiene, locals no less suffer if they make the mistake of consuming unhygienic food. Just that visitor might not notice that.
The poor in any country do not have options and consume whatever food is available.
But anybody up the economic chain are taught to avoid street food in general, unboiled water etc.,
But Western visitors chasing adventure, think street food is exotic and make foolish mistakes.
Local or visitor, people should be capable of watching out for lack of hygiene and that's true in any country.

既然這種討論中印度總是被特別提出來，那我就以本地人的身份來回答一下吧。  
有兩個(gè)因素——食材和衛(wèi)生，這兩個(gè)常常被混為一談。  
當(dāng)?shù)厝艘呀?jīng)習(xí)慣了食材，比如辛辣程度，身體也適應(yīng)了，所以當(dāng)?shù)厝瞬粫?huì)生病，來自類似文化背景的游客也不會(huì)。一個(gè)墨西哥人吃印度食物可能比挪威人更能接受。  
至于衛(wèi)生，如果吃了不衛(wèi)生的食物，當(dāng)?shù)厝艘矔?huì)生病，只是游客可能沒注意到。  
在任何國(guó)家，窮人沒有選擇，只能吃能獲得的食物。  
而經(jīng)濟(jì)條件較好的人，都會(huì)被教導(dǎo)要避免街頭食物、未煮沸的水等。  
但西方游客為了追求冒險(xiǎn)，認(rèn)為街頭食物很異國(guó)情調(diào)，于是犯下愚蠢的錯(cuò)誤。  
無論是本地人還是游客，都應(yīng)該具備識(shí)別不衛(wèi)生的能力，這在任何國(guó)家都一樣。

Annie Ruth Harrison (夏安)
I ate food from street vendors while in Southeast Asia. I ate at hawker centers and open air restaurants too. I didn’t get sick from eating anything. In fact, the only time I got sick was before breakfast because I took my morning medicine before leaving the hotel and didn’t eat until I arrived at the morning market to eat breakfast. Too much time had lapsed so the medicine on my stomach said, “No thanks, see you later,” and I was sick on my stomach on the side of the road. That was…embarrassing. But it wasn’t anything I ate. It was because I hadn’t ate. In fact, I had a bowl of bah keh teh right after that and felt much better.

我在東南亞時(shí)吃過街頭小販的食物。我也在小販中心和露天餐館吃過。我沒有因?yàn)槌詵|西而生病。事實(shí)上，唯一一次我生病是在早餐前，因?yàn)槲译x開酒店前吃了早上的藥，但直到到達(dá)早市才吃早餐。時(shí)間隔得太久，藥在胃里“抗議”了，我就在路邊吐了。那……很尷尬。但那不是我吃的東西的問題，而是我沒吃東西。事實(shí)上，我之后立刻喝了一碗“肉骨茶”，感覺好多了。  

Typically what can upset your stomach in a new place is that your body’s gut biome isn’t desensitized to the spices or chemicals in the food being consumed. Locals are used to it so they have no problem. Of course if they visited your country they might also experience an upset stomach. If it’s actual food poisoning from undercooked or expired food then even the locals will get sick. E coli isn’t exactly a respecter of persons to my knowledge.

通常在新地方讓你胃不舒服的原因是，你的腸道菌群還沒有適應(yīng)那里的香料或化學(xué)成分。當(dāng)?shù)厝艘呀?jīng)習(xí)慣了，所以沒問題。當(dāng)然，如果他們來你的國(guó)家，也可能胃不舒服。如果是真的食物中毒，比如食物沒煮熟或過期，那連當(dāng)?shù)厝艘矔?huì)生病。大腸桿菌可不會(huì)“挑人”。

Khengchat Ng
Most overseas Chinese when visiting China said the food is far too oily, causing many to have queasy stomachs. Some visitors to Malaysia are not used to eating spicy food in the afternoon heat, resulting in migraines. I took street food against advice in New Delhi but did not get the “ Delhi Belly “ because my stomach was already conditioned by local Indian food. However, I did get bad stomach bloating when arriving in Melbourne to start my studies. The problem was traced to lactose intolerance because I had glasses of milkshakes with classmates after school.

大多數(shù)海外華人回中國(guó)都說食物太油膩，導(dǎo)致很多人胃不舒服。一些去馬來西亞的游客不習(xí)慣在炎熱的午后吃辣，導(dǎo)致偏頭痛。我曾不顧勸告在新德里吃了街頭食物，但并沒有得“德里肚”，因?yàn)槲业奈敢呀?jīng)被印度本地食物“訓(xùn)練”過。然而，當(dāng)我剛到墨爾本開始學(xué)業(yè)時(shí)，卻出現(xiàn)了嚴(yán)重的胃脹。問題被追蹤到乳糖不耐受，因?yàn)槲曳艑W(xué)后和同學(xué)一起喝了幾杯奶昔。

David Chen
The major difference is that locals have the know-how which street food vendors to avoid and which ones to patronize!
If you're a tourist, having a local contact will definitely spare you from stomach flu, while still being able to sample tasty delicacies in a country.
Also check the food vendor's utensils/cart if they're clean and if the cooking was done/is being done in the cart or if the food has been precooked and left exposed to the elements.
Lastly, when buying food from street vendors, always purchase local cuisine rather than Western inspired dishes. The vendors are more knowledgeable in cooking local foods and how to preserve them. Obviously, mainstream dishes are safer, than exotic ones - there have been cases of people killed from eating food which have been wrongly prepared and cooked - for example, pufferfish.

最大的區(qū)別是，當(dāng)?shù)厝酥滥男┙诸^小販該避開，哪些值得光顧！  
如果你是游客，有一個(gè)本地朋友會(huì)幫你避開胃病，同時(shí)還能品嘗到當(dāng)?shù)氐拿朗场?nbsp; 
另外，檢查小販的餐具或推車是否干凈，食物是否在推車上現(xiàn)場(chǎng)制作，還是提前做好后暴露在空氣中。  
最后，買街頭食物時(shí)，盡量選擇本地菜肴而不是西式料理。小販更擅長(zhǎng)烹飪本地食物，也更懂得如何保存。顯然，主流的菜肴比稀奇古怪的更安全，比如河豚魚，如果處理不當(dāng)可能會(huì)致命。

Gaab Thobo
Because those people’s digestive systems and gut flora are highly adapted to whatever street food they have been eating since their childhood. Basically the locals have become highly resistant to any potential pathogens that might be present in the street food of their local street food vendors.

這是因?yàn)楫?dāng)?shù)厝说南到y(tǒng)和腸道菌群從小就適應(yīng)了當(dāng)?shù)氐慕诸^食物，因此對(duì)可能存在于街頭食物中的潛在病原體具有很高的抵抗力。

Pete Cresswell
I think part of it is that one's intestinal flora changes depending on where one lives and that, somehow, the immune system adapts to that flora.
I got this notion when visiting The Dominican Republic and a Quebecois guy was commiserating with me vis-a-vis my case of Moctezuma's Revenge.
He pointed out that people from Quebec got sick for a few days when they moved to the DR, but he and other long-term residents also got sick when they went back to visit Quebec.

我認(rèn)為一部分原因是，一個(gè)人的腸道菌群會(huì)隨著居住地的變化而變化，而免疫系統(tǒng)也會(huì)適應(yīng)這種菌群。  
我在多米尼加共和國(guó)旅行時(shí)，有個(gè)魁北克人跟我一起在抱怨“蒙特祖瑪?shù)膹?fù)仇”（即旅游者腹瀉）。  
他指出，當(dāng)魁北克人搬到多米尼加共和國(guó)時(shí)，他們會(huì)生病幾天，但像他這樣的長(zhǎng)期居民如果回魁北克探親，也會(huì)生病。

Wilson Goh
I think of it as their bacteria is different from your bacteria. Hence you will get sick but the natives don’t

我認(rèn)為這是因?yàn)樗麄凅w內(nèi)的細(xì)菌和你的不一樣。所以你會(huì)生病，但本地人不會(huì)。

Paul C.
The locals are already used to type of oils and unsanitary water these vendors use. Many third world countries have chemical that clarifies burned oil so merchants can make them look like fresh oil. Raw foods may have germs and bacteria which your home country may eliminate before serving. When people are used to E-coli, listeria, Salmonella from early age, even if they are exposed to them, worst that can happen would be a diarrhea. But, they can sicken foreigners or in rare occasions kill.

當(dāng)?shù)厝艘呀?jīng)習(xí)慣了這些小販?zhǔn)褂玫挠秃筒桓蓛舻乃ＴS多第三世界國(guó)家使用一種化學(xué)物質(zhì)，可以讓用過的廢油看起來像新鮮的油。生食中可能帶有細(xì)菌和病原體，而在你的國(guó)家，這些通常在上桌前就被消滅了。如果一個(gè)人從小就接觸大腸桿菌（E. coli）、李斯特菌（Listeria）、沙門氏菌（Salmonella）等細(xì)菌，即使再次暴露，最壞的情況也只是腹瀉而已。但對(duì)于外國(guó)人來說，這些細(xì)菌可能會(huì)導(dǎo)致嚴(yán)重疾病，甚至在極少數(shù)情況下致命。

Aero Dynamico
Bereft of Western arrogance, the fact is: visitors (only from the West, and Japan) have evolved shitty immune systems where the slightest bug sends them into paroxysms of reactions.
This is characteristic of Western “development”: lock yourself into an ecosystem which you create, lose all your nature-given defenses, and call yourself “developed.”
As a result, the moment they are out of that ecosystem, they are dead, or nearly dead.
Worry not, my friend.
If they “hygienesize” themselves into extinction, you are certainly not responsible.

拋開西方的傲慢，事實(shí)是：只有來自西方和日本的游客，進(jìn)化出了脆弱的免疫系統(tǒng)，稍微接觸一點(diǎn)細(xì)菌就會(huì)引發(fā)劇烈反應(yīng)。  
這就是西方所謂“發(fā)展”的特征：把自己封閉在一個(gè)自己構(gòu)建的生態(tài)系統(tǒng)中，失去了與生俱來的自然免疫力，還自稱為“發(fā)達(dá)”。  
結(jié)果就是，一旦他們離開這個(gè)系統(tǒng)，他們就變得非常脆弱，甚至瀕臨崩潰。  
別擔(dān)心，朋友。  
如果他們把自己“講衛(wèi)生”到滅絕的地步，那你也無需感到責(zé)任在身。