Posts Tagged ‘Escherichia coli’

Know About Traveler’s Diarrhea

Diarrhea (also known as traveler’s diarrhea) is the leading cause of illness among travelers but it is usually self limiting and short-lived. Approximately 40% of affected travelers need to change their scheduled activities and approximately 20% are confined to bed. For travelers diarrhea, the most important which determines the risk is the destination of the traveler. The rate of incidence of diarrhea among travelers is about 8% in developed countries and as high as 55% or higher in parts of Africa, Central and South America, and Southeast Asia for a 2-week stay. Young people and infants are most vulnerable to get diarrhea. A recent study suggests that there is little correlation between dietary indiscretions (eating what traveler like without thinking of health problems) and the occurrence of travelers’ diarrhea.

The commonest identified pathogens for traveler’s diarrhea are entero-toxigenic Escherichia coli (ETEC) and entero-aggregative E. coli. But in some parts of the world traveler’s diarrhea like northern Africa and Southeast Asia, is due to Campylobacter infections. Other organisms found to cause traveler’s diarrhea are Salmonella, Shigella, rotavirus, and norovirus (this virus has caused numerous outbreaks on cruise ships) etc. Parasitic infections like giardiasis may cause traveler’s diarrhea some times, but other parasitic infections are uncommon causes of travelers’ diarrhea. A huge problem that is emerging in case of travelers’ diarrhea is development of antibiotic resistance among many bacterial pathogens (strains of Campylobacter are resistant to quinolones like ciprofloxacin and strains of E. coli, Shigella, and Salmonella resistant to trimethoprim + sulfamethoxazole combination).

The clinical features of traveler’s diarrhea include frequent stool and some times abdominal pain, but these symptoms disappear within few days (self limiting) even without any treatment. Treatment of traveler’s diarrhea is usually not required in maximum number of patients as it goes off by itself with a few days. The dehydration is usually mild and no aggressive rehydration is not required. If it persists or as a precaution oral rehydration salts (ORS) can be taken as required.