Epidemiology of travellers' diarrhoea

Travellers' diarrhoea is the most frequent health problem encountered during a stay in developing countries. A recent study based on interviews with 16,568 charter-flight passengers returning to Europe from 13 destinations in various climatic regions provides epidemiological data on a worldwide scale. Significant differences in diarrhoeal incidence varied not only between individual destinations, but also between hotels in the same area. Travel characteristics, and a record of former tropical journeys influenced the incidence to a minor degree. Persons under 30 were more often affected than older travellers. Within international groups meeting in developing countries, the risk varied according to the patient's country of origin, with the residents of industrialised nations being most often affected. The various regions show non-essential differences in chronology and symptomatology. This is consistent with quantitative rather than qualitative geographical variations in causative agents. Potentially life-threatening gastrointestinal infections, such as typhoid and cholera, are very rarely acquired by tourists.