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Travellers' diarrhoea

R C Arduino1, H L DuPont

  • 1Center for Infectious Diseases, University of Texas Medical School, Houston 77030.

Bailliere'S Clinical Gastroenterology
|June 1, 1993
PubMed
Summary

Traveler's diarrhea (TD) affects many traveling to less developed countries, often caused by ETEC. Prevention includes food safety, bismuth subsalicylate, and antibiotics, with fluid replacement crucial for treatment.

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Area of Science:

  • Infectious Diseases
  • Travel Medicine
  • Microbiology

Background:

  • Traveler's diarrhea (TD) affects 30-50% of travelers to less developed countries.
  • Enterotoxigenic E. coli (ETEC) is the primary cause, identified in 40-70% of cases.
  • Symptoms typically manifest within the first two weeks of arrival, with watery diarrhea being most common.

Purpose of the Study:

  • To review the causes, prevention, and treatment of traveler's diarrhea.
  • To highlight the efficacy of various prophylactic and therapeutic agents.
  • To discuss emerging prevention strategies like vaccination.

Main Methods:

  • Literature review of studies on traveler's diarrhea etiology, prevention, and treatment.
  • Analysis of antimicrobial resistance patterns and geographical variations.
  • Evaluation of prophylactic agents including bismuth subsalicylate and antibiotics.
  • Assessment of emerging vaccine candidates.

Main Results:

  • ETEC is the most frequent cause of TD.
  • Bismuth subsalicylate is safe and effective for prophylaxis and treatment.
  • Antibiotics like doxycycline, trimethoprim/sulphamethoxazole, and quinolones are effective but have limitations.
  • A new oral vaccine shows promise against ETEC-associated diarrhea.
  • Fluid replacement is the cornerstone of TD management.

Conclusions:

  • Careful food and beverage selection is key for TD prevention.
  • Antimicrobial choice for treatment depends on geographical resistance patterns.
  • New vaccines offer a promising future direction for TD prevention.
  • Integrated strategies combining hygiene, medication, and potentially vaccination are essential for managing TD.

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