How to Stay Healthy and Safe on Your Trip to Japan

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For the most part, Japan is a very clean and safe country. But there are a few health issues to navigate when you visit.

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A plate of food in Japan Photo © Richard I'Anson

One of the world’s most advanced nations, Japan is a safe, clean and orderly travel destination. But tourists still need to prepare for its unique toilets, communal wash rooms, and the threat of food poisoning. Here are some insider tips to help you.

How to use Japan's tricky toilets

Japan’s quirkiness is often exaggerated by tourists and travel writers. But what is undeniable is that this country’s high-tech toilets, widely called washlets, can be confusing. Some are so sophisticated they cost up to USD $8,000 and have heated seats, air fresheners, automatic flushing, built-in bidets, carbon filters to kill bad odours, an air dryer for your intimate parts, and a self-cleaning system featuring titanium oxide glaze and ultraviolet light.

The country’s toilets are separated into three categories – Japanese toilets, Western toilets and washlets. Japanese toilets are basic squat versions, essentially a porcelain hole in the ground, which tourists will only encounter in old buildings, some public parks, and in rural areas. Western toilets, exactly like those common in Europe, US, Canada and Australia, are also somewhat rare.

The reason for that is because, in 1980, Japanese company Toto invented the washlet, an advanced version of the Western toilet which is now common in Japanese homes, hotels, restaurants, bars and shopping centres. These are the toilets tourists will use the majority of the time.

At first glance, the washlet looks like a regular Western toilet. Except that many of them have what looks like a TV remote attached to the side. Printed on this device are a range of settings and actions, represented by symbols.

The first button is normally a black square, which represents “stop”, the pressing of which will cease any of the toilet’s actions you have activated. Those actions include a bidet stream for your behind, which is released by a small wand, and is represented by a button which shows a bum being sprayed by water.

A similar spray shown striking a sitting human is the button you press if you want the bidet to target the front of your private parts. Three wavy lines indicate the dryer button, a tilted wand image is what you press to make the bidet spray change direction, and a wand with a wider spray emerging from it represents the button for altering water pressure.

At beginning and end you can press the wand with two stars above it, which then washes this bidet device. And if you become particularly finicky about your preferred washlet settings, you can save them using the memory function at the bottom.

Beware of eating raw fish in Japan

While many tourists to Southeast Asia prepare themselves for potential cases of food poisoning, such as infamous Bali Belly, Japan is not so commonly associated with such illnesses due to Japan’s strictly-enforced Food Sanitation Act which motivates restaurant and cafe operators to maintain good standards of hygiene.

Customers who become ill after eating at a dining venue can report this incident to Japan’s food sanitation inspectors, who will then audit the premises. Whereas in Southeast Asia it might be lax hygiene standards that can cause sickness, in Japan the risk typically comes from raw fish.

And it’s not just tourists who need to be careful. In 2022, Japanese media reported a spike in illness caused by ingesting Anisakis, a parasite found in sashimi, the popular Japanese raw fish dish. This bug causes severe pain by attacking the walls of the stomach and intestines.

In Japan, there are now more than 7,000 annual cases of Anisakis, which is the country’s most common form of food poisoning. Although, when you consider Japan has a population of 125 million people, and sashimi is hugely popular there, that isn’t a very high number.

Regardless, the only way to protect against this illness is by avoiding eating uncooked fish or squid. Even a restaurant with the highest hygiene standards can still unwittingly serve you a slice of raw seafood infected by Anisakis.

How to navigate Japan’s communal bathrooms

I was thoroughly confused the first time I entered a sentō, or communal wash room, in Japan. My single room at a Tokyo guesthouse didn’t have its own bathroom, and I expected the group facilities to have shower cubicles which afforded privacy.

Instead,ronan I walked into a male-only wash room to see two large baths – each big enough for a group of men – and a line of tiny stools and buckets next to shower heads installed at waist height. Luckily, I guessed correctly that, instead of showering upright, the custom was to sit on the stool and wash myself there by filling the bucket with water from the shower head.

Sentō are common in guesthouses, hostels and budget hotels in Japan, and are separated into male and female facilities. They are different to onsen – communal baths of natural hot spring water – which are designed for relaxation more than washing.

Inside the entrance to a Sentō is a changing area with lockers for your clothes and valuables, and with towels and flip flops available. To be polite, wrap a towel around your waist and put on some flip flops before you walk over and pick a shower. Also avoid talking loudly, using your phone, or encroaching on anyone else’s space.

Use your own toiletries – soap and loofahs often aren’t provided at sentō – to scrub yourself before then hopping into a bath. These are for soaking not washing. One will be surprisingly hot, designed to loosen your muscles and relieve stress. The other bath lets you cool down before you head back to your locker relaxed, clean and ready either for a big day of sightseeing, or a sound night’s sleep.

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