Epidemiology of Traveler's Diarrhea

Steffen, Robert

doi:10.1086/432948

Cited by 135 publications

(92 citation statements)

References 36 publications

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“…Travel destination was found previously to be the most influential risk factor for travel-associated diarrhea. 21,22 In agreement with our data, destinations in North Africa in particular were described previously to be associated with increased risk for travel-related diarrhea. 9,20 Although ill children returning from other world regions considered to be high-risk areas for travel-associated diarrhea (ie, southern Asia and sub-Saharan Africa) 22 showed evidence of significant risk of disease, no significant proportionate increase was noted, compared with children returning from Europe or North America.…”

Section: Figuresupporting

confidence: 93%

Illness in Children After International Travel: Analysis From the GeoSentinel Surveillance Network

et al. 2010

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OBJECTIVE: By using a large, multicenter database, we investigated the characteristics and morbidities of 1591 children returning from 218 global destinations and presenting for care in 19 countries. METHODS: Data reported to the GeoSentinel Surveillance Network between January 1997 and November 2007 were analyzed, to assess demographic features, travel characteristics, and clinical diagnoses of ill pediatric travelers. Data were compared between children and adults and among 3 pediatric age groups (0–5 years, 6–11 years, and 12–17 years). RESULTS: Children were predominantly tourist travelers returning from Asia, sub-Saharan Africa, or Latin America. Compared with adults, children disproportionately presented within 7 days after return, required hospitalization, lacked pretravel health advice, and had traveled for the purpose of visiting friends and relatives. Diarrhea (28%), dermatologic conditions (25%), systemic febrile illnesses (23%), and respiratory disorders (11%) accounted for the majority of diagnoses reported for children. No fatalities were reported. Diarrhea occurred disproportionately among children after exposure to the Middle East/North Africa, dermatologic conditions after exposure to Latin America, systemic febrile illnesses after exposure to sub-Saharan Africa or Asia, and respiratory disorders after exposure to Europe or North America. The proportionate morbidity rates of travel-associated diseases differed among the pediatric age groups and between children and adults. CONCLUSIONS: The health care utilization patterns before and after travel and the profiles of travel-associated health problems differed between children and adults. Health professionals providing pretravel advice need to consider destination- and age-specific susceptibility to travel-related morbidities and develop prevention strategies accordingly.

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Section: Figuresupporting

confidence: 93%

Illness in Children After International Travel: Analysis From the GeoSentinel Surveillance Network

et al. 2010

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“…Contrary to the widely held belief that travelers to South Africa are at low risk of acquiring traveler's diarrhea, 5,6 our data show that South Africa travelers are just as likely to present with traveler's diarrhea as those from neighboring countries in the region. Acute, unspecified diarrhea was the most common category reported, which may reflect the practice of an empiric trial of treatment with antibiotics before detailed diagnostic studies.…”

contrasting

confidence: 99%

Health Risks in Travelers to South Africa: The GeoSentinel Experience and Implications for the 2010 FIFA World Cup

Mendelson

Davis²,

Jensenius³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract. Using the GeoSentinel database, an analysis of ill patients returning from throughout sub-Saharan Africa over a 13-year period was performed. Systemic febrile illness, dermatologic, and acute diarrheal illness were the most common syndromic groupings, whereas spotted fever group rickettsiosis was the most common individual diagnosis for travelers to South Africa. In contrast to the rest of sub-Saharan Africa, only six cases of malaria were documented in South Africa travelers. Vaccine-preventable diseases, typhoid, hepatitis A, and potential rabies exposures were uncommon in South Africa travelers. Pre-travel advice for the travelers to the 2010 World Cup should be individualized according to these findings.

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“…Travellers' diarrhoea is the most common problem experienced by people visiting developing countries (Steffen, 2005). Bacterial enteropathogens are the most common cause of travellers' diarrhoea.…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of the enteroaggregative Escherichia coli virulence factor dispersin among USA travellers to Cuernavaca, Mexico: a pilot study

Huang

Brown

DuPont

et al. 2008

Journal of Medical Microbiology

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This pilot study examined the change in the seroprevalence of the enteroaggregative Escherichia coli (EAEC) virulence factor dispersin in USA students during a short stay in Cuernavaca, Mexico, between June and August 2004. One hundred and ninety-five students provided paired serum samples -one on arrival to Mexico (pre-serum) and a second on departure from Mexico (post-serum) after a mean stay of 19 days. Serum samples were tested for IgG antibody to a recombinant purified dispersin protein by ELISA. For all travellers, with and without diarrhoea, the mean±SD pre-serum absorbance value (read at 450 and 570 nm) was 0.340±0.212 and the mean post-serum value was 0.513±0.316 (P,0.00001). Both travellers who developed diarrhoea and those who did not develop diarrhoea had an increase in IgG antibody to dispersin from the time of arrival to the time of departure from Cuernavaca (diarrhoea group 0.323±0.197 to 0.501±0.311, P,0.00001, and the asymptomatic group 0.354±0.224 to 0.525±0.321, P,0.00001). The pre-serum absorbance value (read at 450 and 570 nm) for IgG antibody to dispersin was not associated with protection against the development of diarrhoeal illness. These results indicate that USA travellers to Mexico show seroconversion for the EAEC virulence factor dispersin. Further studies are needed to characterize in more detail the host clinical and immunological responses to the dispersin protein.

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Epidemiology of Traveler's Diarrhea

Cited by 135 publications

References 36 publications

Illness in Children After International Travel: Analysis From the GeoSentinel Surveillance Network

Illness in Children After International Travel: Analysis From the GeoSentinel Surveillance Network

Health Risks in Travelers to South Africa: The GeoSentinel Experience and Implications for the 2010 FIFA World Cup

Seroprevalence of the enteroaggregative Escherichia coli virulence factor dispersin among USA travellers to Cuernavaca, Mexico: a pilot study

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