Skip to main content Accessibility help
×
Hostname: page-component-7c8c6479df-r7xzm Total loading time: 0 Render date: 2024-03-29T01:48:07.126Z Has data issue: false hasContentIssue false

121 - Travelers’ diarrhea

from Part XVI - Travel and recreation

Published online by Cambridge University Press:  05 April 2015

Karen J. Vigil
Affiliation:
The University of Texas Health Science Center
Herbert L. DuPont
Affiliation:
University of Texas
David Schlossberg
Affiliation:
Temple University, Philadelphia
Get access

Summary

Diarrhea is the most frequent health problem encountered by persons going from industrialized to developing countries. Of the 100 million people traveling annually from industrialized to developing countries, approximately 40% will suffer from so-called travelers' diarrhea (TD), many more than once.

Classically, TD is defined as the passage of three or more unformed stools within 24 hours in association with at least one of the following symptoms of enteric infection: nausea, vomiting, abdominal pain or cramps, fever, fecal urgency, tenesmus, or the passage of bloody/mucoid (dysenteric) stools. This definition includes illness occurring up to 10 days after travelers return to their home countries.

Cases of TD can be categorized by severity as being mild (no disturbance in normal activities), moderate (modified travel activities required), or severe (illness requires confinement to bed). Fewer than 1% of patients are admitted to a hospital, but almost 40% are required to change their travel schedule.

Acute TD lasts for less than 2 weeks. Illness lasting more than 2 weeks is considered “persistent” and is seen in 2% to 10% of travelers. Possible etiologies of persistent diarrhea include intestinal infection by protozoal parasites, for example, giardiasis or cryptosporidiosis, and occasionally bacterial enteropathogens can cause a more protracted diarrhea. Unmasked gastrointestinal disease is seen in this setting occasionally, including irritable bowel syndrome, inflammatory bowel disease, and malabsorptive syndromes. Postinfectious irritable bowel syndrome, a recognized complication of bacterial enteric infection, has been shown to occur in as many as 10% of people after an episode of TD.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2015

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

DuPont, HL, Ericsson, CD, Farthing, MJ, et al. Expert review of the evidence base for prevention of travelers' diarrhea. J Travel Med. 2009;16(3):149–160.CrossRefGoogle ScholarPubMed
DuPont, HL, Ericsson, CD, Farthing, MJ, et al. Expert review of the evidence base for self-therapy of travelers' diarrhea. J Travel Med. 2009;16(3):161–171.CrossRefGoogle ScholarPubMed
Jiang, ZD, Dupont, HL, Brown, EL, et al. Microbial etiology of travelers' diarrhea in Mexico, Guatemala, and India: importance of enterotoxigenic Bacteroides fragilis and Arcobacter species. J Clin Microbiol. 2010;48(4):1417–1419.CrossRefGoogle ScholarPubMed
Lopez-Gigosos, R, Campins, M, Calvo, MJ, et al. Effectiveness of the WC/rBS oral cholera vaccine in the prevention of traveler's diarrhea: a prospective cohort study. Hum Vaccin Immunother. 2013;9(3):692–698.CrossRefGoogle ScholarPubMed
Martinez-Sandoval, F, Ericsson, CD, Jiang, ZD, et al. Prevention of travelers' diarrhea with rifaximin in US travelers to Mexico. J Travel Med. 2010;17(2):111–117.CrossRefGoogle ScholarPubMed
Rivera, FP, Medina, AM, Aldasoro, E, et al. Genotypic characterization of enterotoxigenic Escherichia coli strains causing traveler's diarrhea. J Clin Microbiol. 2013;51(2):633–635.CrossRefGoogle ScholarPubMed
Shah, N, DuPont, HL, Ramsey, DJ. Global etiology of travelers' diarrhea: systematic review from 1973 to the present. Am J Trop Med Hyg. 2009;80(4):609–614.Google ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×