Travelers' Diarrhea: Epidemiology, Microbiology, Prevention, and Therapy

DuPont, Herbert L.; Khan, Fida Muhammad

doi:10.1111/j.1708-8305.1994.tb00568.x

Cited by 33 publications

(19 citation statements)

References 86 publications

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“…Patients may be managed by either self-treatment during or after travel, or by empiric antibiotic treatment following travel from their provider without pursuing routine stool cultures/studies and thus precluding the detection of the more common bacterial aetiologies (e.g. enterotoxogenic/enterohaemorrhagic Escherichia coli , S almonella spp, Shigella spp, Campylobacter spp (3,14,15)). The frequent use of empiric antibiotics among international travellers with diarrhoea may have favoured the identification of Giardia spp.…”

Section: Discussionmentioning

confidence: 99%

Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel

et al. 2014

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Background US residents make 60 million international trips annually. Family practice providers need to be aware of travel-associated diseases affecting this growing mobile population. Objective To describe demographics, travel characteristics and clinical diagnoses of US residents who present ill after international travel. Methods Descriptive analysis of travel-associated morbidity and mortality among US travellers seeking care at 1 of the 22 US practices and clinics participating in the GeoSentinel Global Surveillance Network from January 2000 to December 2012. Results Of the 9624 ill US travellers included in the analysis, 3656 (38%) were tourist travellers, 2379 (25%) missionary/volunteer/research/aid workers (MVRA), 1580 (16%) travellers visiting friends and relatives (VFRs), 1394 (15%) business travellers and 593 (6%) student travellers. Median (interquartile range) travel duration was 20 days (10–60 days). Pre-travel advice was sought by 45%. Hospitalization was required by 7%. Compared with other groups of travellers, ill MVRA travellers returned from longer trips (median duration 61 days), while VFR travellers disproportionately required higher rates of inpatient care (24%) and less frequently had received pre-travel medical advice (20%). Illnesses of the gastrointestinal tract were the most common (58%), followed by systemic febrile illnesses (18%) and dermatologic disorders (17%). Three deaths were reported. Diagnoses varied according to the purpose of travel and region of exposure. Conclusions Returning ill US international travellers present with a broad spectrum of travel-associated diseases. Destination and reason for travel may help primary health care providers to generate an accurate differential diagnosis for the most common disorders and for those that may be life-threatening.

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Section: Discussionmentioning

confidence: 99%

Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel

et al. 2014

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“…This indicates a cumulative risk of diarrhea during travel, 21 and differs from other studies which have suggested decreased risk, at least from enterotoxigenic Escherichia coli, with longer duration of stay. 14,22 Although regional differences in incidence were noted, it is most important to focus on prevention and treatment of diarrhea, no matter which region a traveler plans to visit.…”

Section: Discussionmentioning

confidence: 99%

Occurrence and self-treatment of diarrhea in a large cohort of Americans traveling to developing countries.

Hill¹

2000

Am J Trop Med Hyg

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Abstract. There is little information available regarding traveler's diarrhea that affects a large number of Americans who differ widely in age and travel destination, and little or no information exists on self-treatment. This paper describes the clinical features, self-treatment, and outcome of diarrhea in 784 (95% follow-up) Americans who traveled for Յ 90 days, and who received detailed pre-travel advice. Diarrhea was reported by 46%. Of these, 34% (n ϭ 270) had traveler's diarrhea (TD) defined as Ն 3 unformed stools/day Ϯ enteric symptoms or Ͻ 3 stools/day with Ն 1 enteric symptom, and 11% (n ϭ 88) had loose motions (LM). Diarrhea was often severe and nearly a quarter of people with TD experienced fever and vomiting and 35% were required to alter their plans. The duration of travel and the destination itself were the strongest influences on diarrhea. Most travelers treated the illness themselves, whether or not they had LM (72%) or TD (83%). Those with LM took an antimotility agent or bismuth subsalicylate alone more frequently than those with TD (71% versus 48%, P Ͻ 0.002). Conversely, antibiotics were taken more frequently by those with TD (47% versus 27%, P Ͻ 0.03). Overall, 83% indicated self-treatment was effective (91% with LM and 80% with TD). Diarrhea is common despite pre-travel advice. Because travelers usually treat themselves, they should be provided with clear instructions on appropriate self-treatment.

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“…In developing countries, Campylobacter enteritis incidence rates as high as 0.4 episode per child per year have been reported (8,9,19,30). C. jejuni or Campylobacter coli organisms were isolated from approximately 50% of stool samples obtained from military personnel exhibiting diarrhea while deployed in Thailand (16,18,20).…”

mentioning

confidence: 99%

“…None of the 12 total controls had a serum IgG or IgA response, whereas two (16.7%) had a transient fecal IgA response, with a mean peak increase (nfold) in titer of 9.2 Ϯ 0.8 at day 14 that returned to baseline at day 21. In a previous study, 10 9 to 10 11 CFU of the nonpathogenic E. coli strain HS did not cause diarrhea in this model (13).…”

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confidence: 99%

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New World Monkey Aotus nancymae as a Model for Campylobacter jejuni Infection and Immunity

et al. 2006

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Travelers' Diarrhea: Epidemiology, Microbiology, Prevention, and Therapy

Cited by 33 publications

References 86 publications

Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel

Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel

Occurrence and self-treatment of diarrhea in a large cohort of Americans traveling to developing countries.

New World Monkey Aotus nancymae as a Model for Campylobacter jejuni Infection and Immunity

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