Prevention and Self-Treatment of Traveler's Diarrhea

Abstract

SUMMARYOf the millions who travel from the industrialized world to developing countries every year, between 20% and 50% will develop at least one episode of diarrhea, making it the most common medical ailment afflicting travelers. Although usually a mild illness, traveler's diarrhea can result in significant morbidity and hardship overseas. Precautions can be taken to minimize the risk of developing traveler's diarrhea, either through avoidance of potentially contaminated food or drink or through various prophylactic measures, including both nonpharmacological and antimicrobial strategies. If diarrhea does develop despite the precautions taken, effective treatment—usually a combination of an antibiotic and an antimotility agent—can be brought by the traveler and initiated as soon as symptoms develop. In the future, vaccines—several of which are in the advanced stages of clinical testing—may be added to the list of prophylactic measures.

Pre-travel Health Care Utilization Among Travelers Who Visit Friends and Relatives

“…This may be because more VFRs planned travel to Africa, Asia, and the Middle East, where antidiarrheal precautions are more strongly recommended. 18 A limitation of the current study is the small number of VFRs; it was not possible to include VFRs who did not seek pre-travel care at the TTMC. It is possible that the VFRs included in this study were a relatively more motivated and health-literate subgroup; therefore, the differences in pretravel vaccinations between VFRs and non-VFRs may have been underestimated.…”

Strategies for the development of vaccines conferring broad-spectrum protection

“…Approximately 20-50% of all travelers to developing countries will experience diarrhea (Diemert, 2006). The majority (approximately 80%) of travelers' diarrhea (TD) cases are caused by bacteria, with ETEC, Shigella, Campylobacter, and Salmonella being the most prevalent causative agents.…”

Turista: diarrhées du voyageur

“…Une autre piste, non disponible en Europe mais accessible aux États-Unis, est l'utilisation d'antibiotiques non absorbables (donc à risque d'effets secondaires très limités) tels que la rifaximine [11]. À terme, la mise à disposition de vaccins, actifs notamment contre ETEC (un vaccin anticholéra, dont l'efficacité annoncée contre ETEC doit être confirmée, est déjà disponible) aura un effet réel mais il sera loin de régler le problème de la turista [12]. …”

“…Certains auteurs ont proposé des traitements en dose unique (2 comprimés) avec des résul-tats satisfaisants. Plus récemment l'azithromycine a également fait la preuve de son efficacité, notamment en dose unique [11,12,14]. Les antiseptiques intestinaux (nitrofurane, quinoléine) n'ont a priori pas leur place, leur efficacité n'ayant jamais été démontrée.…”