Rats in kitchens, cockroaches and a wardrobe being used as a toilet are among recent complaints against a Sussex tour operator, a watchdog group said.
Travellers on some trips with Crawley-based First Choice suffered salmonella and dysentery due to "atrocious hotel standards", said Holiday TravelWatch.
The problem destinations were in Tunisia, Turkey, Goa in India, Fuerteventura in the Canaries and the Caribbean island of Margarita.
One couple who complained to Holiday TravelWatch were Derek and Benita Free, from Telford, Shropshire, who stayed with First Choice at the Club Caleta Las Villas apartments in Caleta de Fuste on Fuerteventura last October.
They and their three children, Laura, 15, Curtis, 13, and Sebastian, seven, all suffered nausea and stomach upsets during their stay.
Mrs Free, 42, said: "Laura was still having stomach pains at Christmas and we learnt from doctors that we had suffered from cryptosporidium, a water-borne parasite.
"We did contact First Choice but we have been forced to get on to Holiday TravelWatch to get anything done."
Complaints received by Holiday TravelWatch include 24 from people who stayed at the apartments where the Free family stayed; 309 from the Hotel Soviva in Port El Kantaoui, Tunisia; 36 from the Pueblo Caribe hotel on Margarita; 30 from the Club Bellamare in Turkey; and 17 from the Sun Village resort in Goa.
The watchdog's founder, Brenda Wall, is to meet First Choice representatives at the beginning of February.
Mrs Wall said today: "Hundreds of sick holidaymakers who have recently travelled with First Choice have complained about appalling standards of accommodation and disgusting hygiene.
"The hotels in Margarita and Goa where 42 holidaymakers stayed constitute serious health hazards.
"The standards are barbaric and these hotels should never have been offered to British holidaymakers by First Choice."
Holiday TravelWatch is appealing to First Choice to increase the number of hotel inspections and to monitor the hotels on a more regular basis.
Mrs Wall said: "First Choice have chosen to ignore the many complaints of hundreds of their customers."
First Choice said: "We take all aspects of health and safety very seriously and endeavour to follow guidelines set down by the Federation of Tour Operators to ensure that properties meet the required high safety standards.
"However, should passengers have any concerns on holiday, they are advised to contact their representative as soon as possible, enabling any issues to be addressed quickly and efficiently."
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