Materiały źródłowe

• #1 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] TD is a clinical syndrome that can result from a variety of intestinal pathogens. Bacteria are the predominant enteropathogens and are thought to account for 75%90% of cases. […] The use of multiplex molecular diagnostic assays has suggested that the contribution of viruses to the overall burden of TD disease is underestimated. […] Bacteria are the most common cause of TD. Overall, the most common pathogens identified are diarrheagenic Escherichia coli (most prominently enterotoxigenic E. coli, but also including enteroaggregative E. coli and enteropathogenic E. coli), followed by Campylobacter jejuni, Shigella spp., and Salmonella spp. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD.

• #2 Travelers’ Diarrhea | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/travelers-diarrhea

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] TD is a clinical syndrome that can result from a variety of intestinal pathogens. Bacteria are the predominant enteropathogens and are thought to account for 75%90% of cases. […] The use of multiplex molecular diagnostic assays has suggested that the contribution of viruses to the overall burden of TD disease is underestimated. […] Bacteria are the most common cause of TD. Overall, the most common pathogens identified are diarrheagenic Escherichia coli (most prominently enterotoxigenic E. coli, but also including enteroaggregative E. coli and enteropathogenic E. coli), followed by Campylobacter jejuni, Shigella spp., and Salmonella spp. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD.

• #3 Traveler’s diarrhea | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/travelers-diarrhea?content_id=CON-20166940

  Traveler’s diarrhea is a digestive tract disorder that commonly causes loose stools and stomach cramps. It’s caused by eating contaminated food or drinking contaminated water. […] It’s possible that traveler’s diarrhea may stem from the stress of traveling or a change in diet. But usually infectious agents such as bacteria, viruses or parasites are to blame. You typically develop traveler’s diarrhea after ingesting food or water contaminated with organisms from feces. […] So why aren’t natives of high-risk countries affected in the same way? Often their bodies have become used to the bacteria and have developed immunity to them.

• #4 Traveler’s Diarrhea: What It Is, Treatment & Antibiotics

  https://my.clevelandclinic.org/health/diseases/7315-travelers-diarrhea

  Travelers diarrhea is a brief but unpleasant gastrointestinal infection that affects travelers and others who consume contaminated food or water. It typically causes loose poops (diarrhea) and abdominal cramps. Most of the time, bacteria cause travelers diarrhea, but sometimes viruses and intestinal parasites are to blame. Travelers diarrhea is your immune systems reaction to an infection in your gastrointestinal (GI) tract, in your digestive system. These infections can be bacterial, viral or parasitic. Regardless of the intruder, your immune system reacts by producing an inflammatory response to kill and remove them. That inflammatory response leads to travelers diarrhea. […] Bacteria, viruses and parasites can cause travelers diarrhea. The most common cause is bacteria, especially E. coli. Other common bacteria include: Salmonella, Cholera, Campylobacter jejuni, Shigella. […] Viral infections may include: Norovirus, Rotavirus, Astrovirus. […] Parasitic infections may include: Giardia, Cryptosporidium, Cyclospora.

• #5 Travelers Diarrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459348/

  Traveler’s diarrhea is a common ailment in individuals traveling to resource-limited destinations overseas. It is estimated to affect nearly 40 to 60 percent of travelers and is the most common travel-associated condition. Bacterial, viral, and parasitic infections can cause symptoms, though bacterial sources represent the most frequent etiology. […] The most common bacterial cause is enterotoxigenic Escherichia coli (ETEC), with estimates that the bacteria is responsible for nearly 30% of cases. Other common bacterial causes of travelers diarrhea include Campylobacter jejuni, Shigella, and Salmonella species. Norovirus is the most common viral cause while rotavirus is another source of infection. Giardia intestinalis is the most common parasitic source while Cryptosporidium and Entamoeba histolytica can also cause travelers diarrhea. The most common cause of travelers diarrhea varies by region, though the source is rarely identified in less severe cases.

• #6 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] TD is a clinical syndrome that can result from a variety of intestinal pathogens. Bacteria are the predominant enteropathogens and are thought to account for 75%90% of cases. […] The use of multiplex molecular diagnostic assays has suggested that the contribution of viruses to the overall burden of TD disease is underestimated. […] Bacteria are the most common cause of TD. Overall, the most common pathogens identified are diarrheagenic Escherichia coli (most prominently enterotoxigenic E. coli, but also including enteroaggregative E. coli and enteropathogenic E. coli), followed by Campylobacter jejuni, Shigella spp., and Salmonella spp. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD.

• #7 Travelers’ Diarrhea | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/travelers-diarrhea

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] TD is a clinical syndrome that can result from a variety of intestinal pathogens. Bacteria are the predominant enteropathogens and are thought to account for 75%90% of cases. […] The use of multiplex molecular diagnostic assays has suggested that the contribution of viruses to the overall burden of TD disease is underestimated. […] Bacteria are the most common cause of TD. Overall, the most common pathogens identified are diarrheagenic Escherichia coli (most prominently enterotoxigenic E. coli, but also including enteroaggregative E. coli and enteropathogenic E. coli), followed by Campylobacter jejuni, Shigella spp., and Salmonella spp. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD.

• #8 Travelers Diarrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459348/

  Traveler’s diarrhea is a common ailment in individuals traveling to resource-limited destinations overseas. It is estimated to affect nearly 40 to 60 percent of travelers and is the most common travel-associated condition. Bacterial, viral, and parasitic infections can cause symptoms, though bacterial sources represent the most frequent etiology. […] The most common bacterial cause is enterotoxigenic Escherichia coli (ETEC), with estimates that the bacteria is responsible for nearly 30% of cases. Other common bacterial causes of travelers diarrhea include Campylobacter jejuni, Shigella, and Salmonella species. Norovirus is the most common viral cause while rotavirus is another source of infection. Giardia intestinalis is the most common parasitic source while Cryptosporidium and Entamoeba histolytica can also cause travelers diarrhea. The most common cause of travelers diarrhea varies by region, though the source is rarely identified in less severe cases.

• #9 Traveler’s Diarrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2095.html

  Acute diarrhea affects millions of persons who travel to developing countries each year. Food and water contaminated with fecal matter are the main sources of infection. Bacteria such as enterotoxigenic Escherichia coli, enteroaggregative E. coli, Campylobacter, Salmonella, and Shigella are common causes of travelers diarrhea. […] In contrast to the largely viral etiology of gastroenteritis in the United States, diarrhea acquired in developing countries is caused mainly by bacteria. Enterotoxigenic Escherichia coli is the pathogen most frequently isolated, but other types of E. coli such as enteroaggregative E. coli have been recognized as common causes of travelers diarrhea. […] The prevalence of specific organisms varies with travel destination. Available data suggest that E. coli is the predominant cause of travelers diarrhea in Latin America, the Caribbean, and Africa, while invasive pathogens are relatively uncommon. Enterotoxigenic E. coli and enteroaggregative E. coli may be responsible for up to 71 percent of cases of travelers diarrhea in Mexico. In contrast, Campylobacter is a leading cause of travelers diarrhea in Thailand and also is common in Nepal. […] Food poisoning is part of the differential diagnosis of travelers diarrhea. Gastroenteritis from preformed toxins (e.g., Staphylococcus aureus, Bacillus cereus) is characterized by a short incubation period (one to six hours), and symptoms typically resolve within 24 hours.

• #10 Travellers Diarrhea: Microbiology notes of Sridhar Rao P.N

  https://www.microrao.com/micronotes/travellers_diarrhea.htm

  Travelers’ diarrhea (TD) is the most common illness affecting travelers. […] The most common causative agent isolated is enterotoxigenic Escherichia coli (ETEC). […] Besides ETEC and other bacterial pathogens, a variety of viral and parasitic enteric pathogens also are potential causative agents. […] Other common bacterial causes include Campylobacter jejuni, Shigella, Salmonella, Aeromonas and Yersinia species, Plesiomonas shigelloides and Vibrio parahaemolyticus. […] Infection is acquired by ingestion of food or water contaminated with ETEC. […] The infective dose is 106-1010 bacilli. […] The symptoms of diarrhoea are due to ETEC strains produce enterotoxins. […] Enterotoxins produced by ETEC include the LT (heat-labile) toxin and or the ST (heat-stable) toxin, the genes for which may occur on the same or separate plasmids. […] In several strains, the plasmids carry genes for both enterotoxin and colonization factor production.

• #11 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] TD is a clinical syndrome that can result from a variety of intestinal pathogens. Bacteria are the predominant enteropathogens and are thought to account for 75%90% of cases. […] The use of multiplex molecular diagnostic assays has suggested that the contribution of viruses to the overall burden of TD disease is underestimated. […] Bacteria are the most common cause of TD. Overall, the most common pathogens identified are diarrheagenic Escherichia coli (most prominently enterotoxigenic E. coli, but also including enteroaggregative E. coli and enteropathogenic E. coli), followed by Campylobacter jejuni, Shigella spp., and Salmonella spp. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD.

• #12 Travelers’ Diarrhea | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/travelers-diarrhea

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] TD is a clinical syndrome that can result from a variety of intestinal pathogens. Bacteria are the predominant enteropathogens and are thought to account for 75%90% of cases. […] The use of multiplex molecular diagnostic assays has suggested that the contribution of viruses to the overall burden of TD disease is underestimated. […] Bacteria are the most common cause of TD. Overall, the most common pathogens identified are diarrheagenic Escherichia coli (most prominently enterotoxigenic E. coli, but also including enteroaggregative E. coli and enteropathogenic E. coli), followed by Campylobacter jejuni, Shigella spp., and Salmonella spp. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD.

• #13 Traveler’s diarrhea: Causes, treatment, and prevention

  https://www.medicalnewstoday.com/articles/travelers-diarrhea

  Common causative agents of TD include: enterotoxigenic Escherichia coli(ETEC), Campylobacter jejuni, Shigella species, Salmonella species, norovirus, rotavirus, Giardia intestinalis, Cryptosporidium, Entamoeba histolytica. […] Travelers diarrhea describes a gastrointestinal infection that a person may acquire when visiting an area with different hygiene practices. It typically occurs from consuming food or water contaminated with bacteria, viruses, or parasites.

• #14 TRAVELER’S DIARRHEA

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4764790/

  TD is predominantly a fecal-orally transmitted disease and can be caused by bacterial, viral or protozoal pathogens, with helminths being uncommon. Many of the etiologies for TD are similar to those causing acute diarrhea in young children of low- and middle-income countries. The frequency of each pathogen varies by geographic location and the etiology may be unknown in 40-50% of cases despite microbiologic evaluation, though with increasing use of multiplex molecular testing, this will likely change. Globally, enterotoxigenic Escherichia coli (ETEC) and enteroaggregative E. coli (EAEC) are the most common bacterial pathogens, with the exception of Southeast Asia, where Campylobacter is more common, a high proportion of which are fluoroquinolone resistant. Norovirus and rotavirus are the most common viral etiologies of TD. Of the protozoa, Giardia duodenalis and Entamoeba histolytica are the main pathogens considered, depending on the region of travel. In some instances, TD may be due to more than one pathogen.

• #15 Traveler’s Diarrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2095.html

  Acute diarrhea affects millions of persons who travel to developing countries each year. Food and water contaminated with fecal matter are the main sources of infection. Bacteria such as enterotoxigenic Escherichia coli, enteroaggregative E. coli, Campylobacter, Salmonella, and Shigella are common causes of travelers diarrhea. […] In contrast to the largely viral etiology of gastroenteritis in the United States, diarrhea acquired in developing countries is caused mainly by bacteria. Enterotoxigenic Escherichia coli is the pathogen most frequently isolated, but other types of E. coli such as enteroaggregative E. coli have been recognized as common causes of travelers diarrhea. […] The prevalence of specific organisms varies with travel destination. Available data suggest that E. coli is the predominant cause of travelers diarrhea in Latin America, the Caribbean, and Africa, while invasive pathogens are relatively uncommon. Enterotoxigenic E. coli and enteroaggregative E. coli may be responsible for up to 71 percent of cases of travelers diarrhea in Mexico. In contrast, Campylobacter is a leading cause of travelers diarrhea in Thailand and also is common in Nepal. […] Food poisoning is part of the differential diagnosis of travelers diarrhea. Gastroenteritis from preformed toxins (e.g., Staphylococcus aureus, Bacillus cereus) is characterized by a short incubation period (one to six hours), and symptoms typically resolve within 24 hours.

• #16 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] TD is a clinical syndrome that can result from a variety of intestinal pathogens. Bacteria are the predominant enteropathogens and are thought to account for 75%90% of cases. […] The use of multiplex molecular diagnostic assays has suggested that the contribution of viruses to the overall burden of TD disease is underestimated. […] Bacteria are the most common cause of TD. Overall, the most common pathogens identified are diarrheagenic Escherichia coli (most prominently enterotoxigenic E. coli, but also including enteroaggregative E. coli and enteropathogenic E. coli), followed by Campylobacter jejuni, Shigella spp., and Salmonella spp. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD.

• #17 TRAVELER’S DIARRHEA

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4764790/

  TD is predominantly a fecal-orally transmitted disease and can be caused by bacterial, viral or protozoal pathogens, with helminths being uncommon. Many of the etiologies for TD are similar to those causing acute diarrhea in young children of low- and middle-income countries. The frequency of each pathogen varies by geographic location and the etiology may be unknown in 40-50% of cases despite microbiologic evaluation, though with increasing use of multiplex molecular testing, this will likely change. Globally, enterotoxigenic Escherichia coli (ETEC) and enteroaggregative E. coli (EAEC) are the most common bacterial pathogens, with the exception of Southeast Asia, where Campylobacter is more common, a high proportion of which are fluoroquinolone resistant. Norovirus and rotavirus are the most common viral etiologies of TD. Of the protozoa, Giardia duodenalis and Entamoeba histolytica are the main pathogens considered, depending on the region of travel. In some instances, TD may be due to more than one pathogen.

• #18 Traveler’s Diarrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2095.html

  Acute diarrhea affects millions of persons who travel to developing countries each year. Food and water contaminated with fecal matter are the main sources of infection. Bacteria such as enterotoxigenic Escherichia coli, enteroaggregative E. coli, Campylobacter, Salmonella, and Shigella are common causes of travelers diarrhea. […] In contrast to the largely viral etiology of gastroenteritis in the United States, diarrhea acquired in developing countries is caused mainly by bacteria. Enterotoxigenic Escherichia coli is the pathogen most frequently isolated, but other types of E. coli such as enteroaggregative E. coli have been recognized as common causes of travelers diarrhea. […] The prevalence of specific organisms varies with travel destination. Available data suggest that E. coli is the predominant cause of travelers diarrhea in Latin America, the Caribbean, and Africa, while invasive pathogens are relatively uncommon. Enterotoxigenic E. coli and enteroaggregative E. coli may be responsible for up to 71 percent of cases of travelers diarrhea in Mexico. In contrast, Campylobacter is a leading cause of travelers diarrhea in Thailand and also is common in Nepal. […] Food poisoning is part of the differential diagnosis of travelers diarrhea. Gastroenteritis from preformed toxins (e.g., Staphylococcus aureus, Bacillus cereus) is characterized by a short incubation period (one to six hours), and symptoms typically resolve within 24 hours.

• #19

  https://www.healthxchange.sg/digestive-system/colorectal/travellers-diarrhoea-causes-prevention

  Travellers’ diarrhoea is a common illness that affects 20-60 percent of travellers. […] The risk of travellers’ diarrhoea increases in those who buy food from places with poor hygiene standards. […] Eating and drinking contaminated food and liquids are the main causes of travellers diarrhoea, though other factors such as stress, unfamiliar food and increased alcohol consumption may also play a part. […] According to the Travel Clinic at Singapore General Hospital (SGH), a member of the SingHealth group, most episodes of diarrhoea have an infectious cause. […] Food that is prone to contamination includes: Salads, Uncooked/unpeeled fruits and vegetables, Shellfish and dishes containing uncooked eggs such as those with mayonnaise, Unpasteurised products such as unpasteurised milk and ice cream, Food from street vendors that is not freshly prepared and served hot on clean crockery, Food such as desserts made from ice and unclean and unpurified tap water.

• #20 Traveller’s diarrhoea | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/travellers-diarrhoea

  Many people experience travellers diarrhoea. […] Generally, the cause is consumption of contaminated food or water. […] It is often caused by eating contaminated food or water. […] Micro-organisms that can cause travellers diarrhoea include: Bacteria Escherichia coli (E. coli), primarily enterotoxigenic strains (ETEC). This is one of the most common bacterial causes of travellers diarrhoea. Other bacterial causes of travellers diarrhoea include Campylobacter jejuni, Salmonella species and Shigella species. […] Parasites certain parasitic infections are known to cause diarrhoea, including Giardia intestinalis, Entamoeba histolytica and Cryptosporidium parvum. […] Viruses some estimates suggest that around one in three cases of travellers diarrhoea is caused by or associated with a viral infection, particularly norovirus and rotavirus. […] Unknown causes a cause can’t be found in approximately one-fifth to half of all cases of travellers diarrhoea. It is thought that diarrhoea may be the gastrointestinal system’s response to unfamiliar micro-organisms.

• #21 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] TD is a clinical syndrome that can result from a variety of intestinal pathogens. Bacteria are the predominant enteropathogens and are thought to account for 75%90% of cases. […] The use of multiplex molecular diagnostic assays has suggested that the contribution of viruses to the overall burden of TD disease is underestimated. […] Bacteria are the most common cause of TD. Overall, the most common pathogens identified are diarrheagenic Escherichia coli (most prominently enterotoxigenic E. coli, but also including enteroaggregative E. coli and enteropathogenic E. coli), followed by Campylobacter jejuni, Shigella spp., and Salmonella spp. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD.

• #22 Travelers’ Diarrhea | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/travelers-diarrhea

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] TD is a clinical syndrome that can result from a variety of intestinal pathogens. Bacteria are the predominant enteropathogens and are thought to account for 75%90% of cases. […] The use of multiplex molecular diagnostic assays has suggested that the contribution of viruses to the overall burden of TD disease is underestimated. […] Bacteria are the most common cause of TD. Overall, the most common pathogens identified are diarrheagenic Escherichia coli (most prominently enterotoxigenic E. coli, but also including enteroaggregative E. coli and enteropathogenic E. coli), followed by Campylobacter jejuni, Shigella spp., and Salmonella spp. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD.

• #23 Travellers Diarrhea: Microbiology notes of Sridhar Rao P.N

  https://www.microrao.com/micronotes/travellers_diarrhea.htm

  Travelers’ diarrhea (TD) is the most common illness affecting travelers. […] The most common causative agent isolated is enterotoxigenic Escherichia coli (ETEC). […] Besides ETEC and other bacterial pathogens, a variety of viral and parasitic enteric pathogens also are potential causative agents. […] Other common bacterial causes include Campylobacter jejuni, Shigella, Salmonella, Aeromonas and Yersinia species, Plesiomonas shigelloides and Vibrio parahaemolyticus. […] Infection is acquired by ingestion of food or water contaminated with ETEC. […] The infective dose is 106-1010 bacilli. […] The symptoms of diarrhoea are due to ETEC strains produce enterotoxins. […] Enterotoxins produced by ETEC include the LT (heat-labile) toxin and or the ST (heat-stable) toxin, the genes for which may occur on the same or separate plasmids. […] In several strains, the plasmids carry genes for both enterotoxin and colonization factor production.

• #24 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] TD is a clinical syndrome that can result from a variety of intestinal pathogens. Bacteria are the predominant enteropathogens and are thought to account for 75%90% of cases. […] The use of multiplex molecular diagnostic assays has suggested that the contribution of viruses to the overall burden of TD disease is underestimated. […] Bacteria are the most common cause of TD. Overall, the most common pathogens identified are diarrheagenic Escherichia coli (most prominently enterotoxigenic E. coli, but also including enteroaggregative E. coli and enteropathogenic E. coli), followed by Campylobacter jejuni, Shigella spp., and Salmonella spp. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD.

• #25 Travelers’ Diarrhea | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/travelers-diarrhea

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] TD is a clinical syndrome that can result from a variety of intestinal pathogens. Bacteria are the predominant enteropathogens and are thought to account for 75%90% of cases. […] The use of multiplex molecular diagnostic assays has suggested that the contribution of viruses to the overall burden of TD disease is underestimated. […] Bacteria are the most common cause of TD. Overall, the most common pathogens identified are diarrheagenic Escherichia coli (most prominently enterotoxigenic E. coli, but also including enteroaggregative E. coli and enteropathogenic E. coli), followed by Campylobacter jejuni, Shigella spp., and Salmonella spp. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD.

• #26 Travelers’ Diarrhea: Symptoms, Causes, Treatment, More

  https://www.health.com/condition/diarrhea/travelers-diarrhea

  Travelers’ diarrhea causes loose, watery stools, usually brought about by bacteria, viruses, or fungi. […] Travelers’ diarrhea spreads through fecal matter through contaminated food and water. Bacteria, viruses, and parasites cause travelers’ diarrhea. […] Bacteria account for about 80% to 90% of cases, while viruses make up about 5% to 15%. Less commonly, parasites, also known as protozoal pathogens, can cause travelers’ diarrhea. […] Depending on the culprit, travelers’ diarrhea may occur through non-inflammatory or inflammatory pathways. Non-inflammatory pathways reduce the ability of your intestines to absorb nutrients. As a result, your waste products increase. In contrast, inflammatory pathways damage your intestines, which increases bowel movements.

• #27 Travelers’ diarrhea – Wikipedia

  https://en.wikipedia.org/wiki/Travelers%27_diarrhea

  While viruses are associated with less than 20% of adult cases of travelers’ diarrhea, they may be responsible for nearly 70% of cases in infants and children. Diarrhea due to viral agents is unaffected by antibiotic therapy, but is usually self-limited. […] A subtype of travelers’ diarrhea afflicting hikers and campers, sometimes known as wilderness diarrhea, may have a somewhat different frequency of distribution of pathogens.

• #28 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Viral diarrhea can be caused by several pathogens, most notably norovirus, but also including astrovirus, sapovirus, and rotavirus. […] Giardia is the main protozoal pathogen found in TD, followed by Cryptosporidium. […] The risk for Cyclospora is highly geographic and seasonal: the most well-known risks are in Guatemala, Haiti, Nepal, and Peru. […] Inadequate electrical capacity leading to frequent blackouts or poorly functioning refrigeration can result in unsafe food storage and an additional increased risk for disease. […] Where provided, effective food-handling courses have been shown to decrease the risk for TD. […] However, even in high-income countries, food handling and preparation in restaurants has been linked to diarrhea caused by pathogens such as Shigella sonnei.

• #29 Travelers’ Diarrhea | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/travelers-diarrhea

  Viral diarrhea can be caused by several pathogens, most notably norovirus, but also including astrovirus, sapovirus, and rotavirus. […] Giardia is the main protozoal pathogen found in TD, followed by Cryptosporidium. […] The risk for Cyclospora is highly geographic and seasonal: the most well-known risks are in Guatemala, Haiti, Nepal, and Peru. […] Inadequate electrical capacity leading to frequent blackouts or poorly functioning refrigeration can result in unsafe food storage and an additional increased risk for disease. […] Where provided, effective food-handling courses have been shown to decrease the risk for TD. […] However, even in high-income countries, food handling and preparation in restaurants has been linked to diarrhea caused by pathogens such as Shigella sonnei.

• #30 Traveler’s Diarrhea: Causes, Symptoms, and Prevention

  https://www.webmd.com/digestive-disorders/travelers-diarrhea

  Traveler’s diarrhea is an intestinal infection that happens when you eat or drink contaminated food or water. […] About 80% to 90% of travelers’ diarrhea cases are caused by bacteria, such as: E. coli, Salmonella, Shigella, Campylobacter. […] Travelers’ diarrhea may also be caused by viruses, such as: Norovirus, Rotavirus, Astrovirus. […] Parasites are another cause. Giardia intestinalis is the most common of these, but there is a large number of parasites that can cause diarrhea. […] Traveling to places with foods, climates, and cleaning practices that are very different from your home country increases your risk for traveler’s diarrhea. It’s caused by eating or drinking foods or beverages containing bacteria, viruses, or parasites that can make you sick.

• #31 Travelers’ diarrhea – Wikipedia

  https://en.wikipedia.org/wiki/Travelers%27_diarrhea

  While viruses are associated with less than 20% of adult cases of travelers’ diarrhea, they may be responsible for nearly 70% of cases in infants and children. Diarrhea due to viral agents is unaffected by antibiotic therapy, but is usually self-limited. […] A subtype of travelers’ diarrhea afflicting hikers and campers, sometimes known as wilderness diarrhea, may have a somewhat different frequency of distribution of pathogens.

• #32 Traveler’s Diarrhea – Digestive Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/digestive-disorders/gastroenteritis/traveler-s-diarrhea

  Travelers diarrhea can be caused by bacteria, parasites, or viruses. […] Organisms that cause the disorder are usually acquired from food or water, especially in countries where the water supply may be inadequately treated. […] Travelers diarrhea occurs when people are exposed to bacteria, viruses, or, less commonly, parasites to which they have had little exposure and thus no immunity. The organisms are usually acquired from food or water (including water used to wash foods). […] Travelers diarrhea occurs mostly in countries where the water supply is inadequately treated. […] The bacteria Escherichia coli (E. coli) is the organism most likely to cause travelers diarrhea, particularly the types of E. coli that produce certain toxins, and viruses such as norovirus, which has been a particular problem on some cruise ships.

• #33 TRAVELER’S DIARRHEA

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4764790/

  TD is predominantly a fecal-orally transmitted disease and can be caused by bacterial, viral or protozoal pathogens, with helminths being uncommon. Many of the etiologies for TD are similar to those causing acute diarrhea in young children of low- and middle-income countries. The frequency of each pathogen varies by geographic location and the etiology may be unknown in 40-50% of cases despite microbiologic evaluation, though with increasing use of multiplex molecular testing, this will likely change. Globally, enterotoxigenic Escherichia coli (ETEC) and enteroaggregative E. coli (EAEC) are the most common bacterial pathogens, with the exception of Southeast Asia, where Campylobacter is more common, a high proportion of which are fluoroquinolone resistant. Norovirus and rotavirus are the most common viral etiologies of TD. Of the protozoa, Giardia duodenalis and Entamoeba histolytica are the main pathogens considered, depending on the region of travel. In some instances, TD may be due to more than one pathogen.

• #34 RacingThePlanet – Traveler’s Diarrhea

  https://www.racingtheplanet.com/traveler-s-diarrhea

  Diarrhea is the most common illness encountered by travelers. Between 20-70% of travelers will suffer from diarrhea (about 10 million people a year), hence the diagnosis of Travelers Diarrhea (TD). […] TD can be caused by a wide range of viruses, bacteria, and protozoa. While most domestic diarrhea is the result of viruses (such as the norovirus), 80-90% of TD is caused by bacteria, with E. coli being the most common culprit. Protozoa, such as Giardia or Amebas, can cause up to 10% of TD, usually in travelers on trips longer than 2 weeks.

• #35 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  The incubation period between exposure and clinical presentation can provide clues to etiology. Toxin-mediated illness, for example, generally causes symptoms within a few hours. […] An acute (less than 2 weeks) bout of TD can lead to persistent enteric symptoms, even in the absence of continued infection. […] Prophylactic antibiotics are not recommended for most travelers. […] Prophylactic antibiotics afford no protection against nonbacterial pathogens and can remove normally protective microflora from the bowel, increasing the risk for acquisition of resistant bacterial pathogens. […] Protozoa are the pathogens more likely to be isolated from patients with persistent diarrhea (i.e., diarrhea lasting 2 weeks). […] The most common parasitic cause of TD is Giardia duodenalis, and treatment options include metronidazole, nitazoxanide, and tinidazole.

• #36 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Viral diarrhea can be caused by several pathogens, most notably norovirus, but also including astrovirus, sapovirus, and rotavirus. […] Giardia is the main protozoal pathogen found in TD, followed by Cryptosporidium. […] The risk for Cyclospora is highly geographic and seasonal: the most well-known risks are in Guatemala, Haiti, Nepal, and Peru. […] Inadequate electrical capacity leading to frequent blackouts or poorly functioning refrigeration can result in unsafe food storage and an additional increased risk for disease. […] Where provided, effective food-handling courses have been shown to decrease the risk for TD. […] However, even in high-income countries, food handling and preparation in restaurants has been linked to diarrhea caused by pathogens such as Shigella sonnei.

• #37 Travelers’ Diarrhea | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/travelers-diarrhea

  Viral diarrhea can be caused by several pathogens, most notably norovirus, but also including astrovirus, sapovirus, and rotavirus. […] Giardia is the main protozoal pathogen found in TD, followed by Cryptosporidium. […] The risk for Cyclospora is highly geographic and seasonal: the most well-known risks are in Guatemala, Haiti, Nepal, and Peru. […] Inadequate electrical capacity leading to frequent blackouts or poorly functioning refrigeration can result in unsafe food storage and an additional increased risk for disease. […] Where provided, effective food-handling courses have been shown to decrease the risk for TD. […] However, even in high-income countries, food handling and preparation in restaurants has been linked to diarrhea caused by pathogens such as Shigella sonnei.

• #38 Traveller’s diarrhoea | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/travellers-diarrhoea

  Many people experience travellers diarrhoea. […] Generally, the cause is consumption of contaminated food or water. […] It is often caused by eating contaminated food or water. […] Micro-organisms that can cause travellers diarrhoea include: Bacteria Escherichia coli (E. coli), primarily enterotoxigenic strains (ETEC). This is one of the most common bacterial causes of travellers diarrhoea. Other bacterial causes of travellers diarrhoea include Campylobacter jejuni, Salmonella species and Shigella species. […] Parasites certain parasitic infections are known to cause diarrhoea, including Giardia intestinalis, Entamoeba histolytica and Cryptosporidium parvum. […] Viruses some estimates suggest that around one in three cases of travellers diarrhoea is caused by or associated with a viral infection, particularly norovirus and rotavirus. […] Unknown causes a cause can’t be found in approximately one-fifth to half of all cases of travellers diarrhoea. It is thought that diarrhoea may be the gastrointestinal system’s response to unfamiliar micro-organisms.

• #39 Parasitic causes of prolonged diarrhoea in travellers Diagnosis and management

  https://www.racgp.org.au/afp/2012/october/parasitic-causes-of-prolonged-diarrhoea-in-travell

  Prolonged infectious diarrhoea in the returning traveller is generally caused by protozoal and occasionally by helminth parasites. […] A large proportion of disease is caused by Giardia lamblia, Cryptosporidium parvum and Entamoeba histolytica. […] Giardia lamblia (also known as G. duodenalis or G. intestinalis) is the most common aetiological agent of persistent diarrhoea. […] Cryptosporidium parvum is the second most commonly isolated protozoal pathogen in travellers. […] Entamoeba histolytica is the causative agent of amoebiasis. […] Persistent diarrhoea in the traveller is most commonly caused by protozoan parasites. […] Giardia is the most common organism, followed by Cryptosporidium and E. histolytica.

• #40 Parasitic causes of prolonged diarrhoea in travellers Diagnosis and management

  https://www.racgp.org.au/afp/2012/october/parasitic-causes-of-prolonged-diarrhoea-in-travell

  Prolonged infectious diarrhoea in the returning traveller is generally caused by protozoal and occasionally by helminth parasites. […] A large proportion of disease is caused by Giardia lamblia, Cryptosporidium parvum and Entamoeba histolytica. […] Giardia lamblia (also known as G. duodenalis or G. intestinalis) is the most common aetiological agent of persistent diarrhoea. […] Cryptosporidium parvum is the second most commonly isolated protozoal pathogen in travellers. […] Entamoeba histolytica is the causative agent of amoebiasis. […] Persistent diarrhoea in the traveller is most commonly caused by protozoan parasites. […] Giardia is the most common organism, followed by Cryptosporidium and E. histolytica.

• #41 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Viral diarrhea can be caused by several pathogens, most notably norovirus, but also including astrovirus, sapovirus, and rotavirus. […] Giardia is the main protozoal pathogen found in TD, followed by Cryptosporidium. […] The risk for Cyclospora is highly geographic and seasonal: the most well-known risks are in Guatemala, Haiti, Nepal, and Peru. […] Inadequate electrical capacity leading to frequent blackouts or poorly functioning refrigeration can result in unsafe food storage and an additional increased risk for disease. […] Where provided, effective food-handling courses have been shown to decrease the risk for TD. […] However, even in high-income countries, food handling and preparation in restaurants has been linked to diarrhea caused by pathogens such as Shigella sonnei.

• #42 Travelers’ Diarrhea | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/travelers-diarrhea

  Viral diarrhea can be caused by several pathogens, most notably norovirus, but also including astrovirus, sapovirus, and rotavirus. […] Giardia is the main protozoal pathogen found in TD, followed by Cryptosporidium. […] The risk for Cyclospora is highly geographic and seasonal: the most well-known risks are in Guatemala, Haiti, Nepal, and Peru. […] Inadequate electrical capacity leading to frequent blackouts or poorly functioning refrigeration can result in unsafe food storage and an additional increased risk for disease. […] Where provided, effective food-handling courses have been shown to decrease the risk for TD. […] However, even in high-income countries, food handling and preparation in restaurants has been linked to diarrhea caused by pathogens such as Shigella sonnei.

• #43

  https://link.springer.com/article/10.1007/s11908-003-0067-x

  Travel is a risk factor for acquiring infection with a sporeforming protozoa: Cryptosopridium, Cyclospora, Microsporidia, and Isospora. […] Very mild infections may be underdiagnosed and may cause typical travelers diarrhea. […] If immune status is normal and the disease is mild, symptomatic therapy may suffice. Effective treatment is available for Cyclospora, Microsporidia, and Isospora. […] This experienced investigator in Cryptosporidium infection reviews the evidence that parasites cause travelers diarrhea. All four of the sporeforming protozoa are reviewed. […] Cryptosporidium was the cause of 3% of acute diarrhea in travelers to Mexico in this prospective study of 127 US adult travelers. […] Travel is a strong risk, but it was excluded because the source of water cannot be controlled for.

• #44

  https://link.springer.com/article/10.1007/s11908-003-0067-x

  Cyclospora species- a cause of diarrhoea among Irish travellers to Asia. […] Cyclospora in patients with travellers diarrhea. […] Identification of Encephalitozoon intestinalis in travelers with chronic diarrhea by specific PCR amplification. […] Detection of microsporidia in travelers with diarrhea. […] Microsporidiosis in travelers with diarrhea from the tropics. […] Chronic travelers diarrhea in a normal host due to Isospora belli. […] Travelers diarrhea associated with Cyclospora sp. […] Travelers diarrhea in two families. […] Cryptosporidium as a causative agent of travellers diarrhea.

• #45 TRAVELER’S DIARRHEA

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4764790/

  TD is predominantly a fecal-orally transmitted disease and can be caused by bacterial, viral or protozoal pathogens, with helminths being uncommon. Many of the etiologies for TD are similar to those causing acute diarrhea in young children of low- and middle-income countries. The frequency of each pathogen varies by geographic location and the etiology may be unknown in 40-50% of cases despite microbiologic evaluation, though with increasing use of multiplex molecular testing, this will likely change. Globally, enterotoxigenic Escherichia coli (ETEC) and enteroaggregative E. coli (EAEC) are the most common bacterial pathogens, with the exception of Southeast Asia, where Campylobacter is more common, a high proportion of which are fluoroquinolone resistant. Norovirus and rotavirus are the most common viral etiologies of TD. Of the protozoa, Giardia duodenalis and Entamoeba histolytica are the main pathogens considered, depending on the region of travel. In some instances, TD may be due to more than one pathogen.

• #46

  https://www.healthxchange.sg/digestive-system/colorectal/travellers-diarrhoea-causes-prevention

  Travellers’ diarrhoea is a common illness that affects 20-60 percent of travellers. […] The risk of travellers’ diarrhoea increases in those who buy food from places with poor hygiene standards. […] Eating and drinking contaminated food and liquids are the main causes of travellers diarrhoea, though other factors such as stress, unfamiliar food and increased alcohol consumption may also play a part. […] According to the Travel Clinic at Singapore General Hospital (SGH), a member of the SingHealth group, most episodes of diarrhoea have an infectious cause. […] Food that is prone to contamination includes: Salads, Uncooked/unpeeled fruits and vegetables, Shellfish and dishes containing uncooked eggs such as those with mayonnaise, Unpasteurised products such as unpasteurised milk and ice cream, Food from street vendors that is not freshly prepared and served hot on clean crockery, Food such as desserts made from ice and unclean and unpurified tap water.

• #47 Traveler’s diarrhea: Causes, treatment, and prevention

  https://www.medicalnewstoday.com/articles/travelers-diarrhea

  Travelers diarrhea refers to a common travel-related illness. It typically describes a gastrointestinal infection after consuming contaminated food or water in an area that is not local to the person traveling. […] Many different conditions can cause diarrhea, but travelers diarrhea occurs due to acquiring a gastrointestinal infection from contaminated food or water. Often, this occurs when visiting new areas that may have different sanitization standards. For example, water pollution can contaminate water and result in it harboring bacteria that can be responsible for diarrhea. […] TD typically occurs following the consumption of contaminated food or water. Different types of pathogens, such as bacteria, viruses, or parasites, can cause TD. However, most cases occur predominantly due to bacteria in areas with poorer hygiene. Contamination of food and water may result from: not properly washing hands, unsafely storing food, handling and preparing food unsafely, not cleaning surfaces and utensils safely.

• #48 Traveler’s Diarrhea Causes, Symptoms, Contagious & Treatment

  https://www.medicinenet.com/travelers_diarrhea/article.htm

  Traveler’s diarrhea usually is contracted by the ingestion of contaminated food or water. Contrary to common belief, food not water is the primary cause. The CDC estimates up to 80% of cases of traveler’s diarrhea are caused by bacteria. The most common bacterium that causes traveler’s diarrhea is enterotoxigenic E. coli, one of six classes of enterovirulent E. coli. […] Other bacterial species implicated in traveler’s diarrhea include Campylobacter jejuni, Shigella, and Salmonella. Viruses (including Rotavirus, Norwalk virus, and other enteric viruses) less commonly are causes of traveler’s diarrhea. Parasitic infections are an uncommon cause except for Giardia lamblia, which should be suspected in individuals traveling to Russia or mountainous regions of the Northern Hemisphere. Cryptosporidum, another parasite, also has been implicated as a common cause of diarrhea in visitors to St. Petersburg, Russia, and elsewhere.

• #49 Traveler’s Diarrhea: Treatment, Symptoms, Contagious & Antibiotics

  https://www.emedicinehealth.com/travelers_diarrhea/article_em.htm

  Travel to developing countries increases a person’s risk of developing traveler’s diarrhea. […] Diarrhea occurs in a significant number of people who travel to foreign countries. Travelers to developing countries of the world become ill from eating or drinking food or water contaminated by infected human bowel waste. […] A person can become infected by eating or drinking food or water that has come in contact with feces. Food and water become contaminated when they are handled by people with fecal content on their hands – not in direct contact with feces. […] A majority of traveler’s diarrhea is caused by bacteria. The remaining cases are caused by viruses and protozoa. The most common organism causing traveler’s diarrhea is Escherichia coli accounting for most of cases in some regions.

• #50 Traveler’s Diarrhea: Treatment, Symptoms, Contagious & Antibiotics

  https://www.emedicinehealth.com/travelers_diarrhea/article_em.htm

  Travel to developing countries increases a person’s risk of developing traveler’s diarrhea. […] Diarrhea occurs in a significant number of people who travel to foreign countries. Travelers to developing countries of the world become ill from eating or drinking food or water contaminated by infected human bowel waste. […] A person can become infected by eating or drinking food or water that has come in contact with feces. Food and water become contaminated when they are handled by people with fecal content on their hands – not in direct contact with feces. […] A majority of traveler’s diarrhea is caused by bacteria. The remaining cases are caused by viruses and protozoa. The most common organism causing traveler’s diarrhea is Escherichia coli accounting for most of cases in some regions.

• #51 Travelers Diarrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459348/

  Traveler’s diarrhea appears to be most common in warmer climates, in areas of poor sanitation and lack of refrigeration. In addition, the lack of safe water and taking short cuts to preparing foods are also major risk factors. In areas where food handling education is provided, rates of traveler’s diarrhea are low.

• #52 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Viral diarrhea can be caused by several pathogens, most notably norovirus, but also including astrovirus, sapovirus, and rotavirus. […] Giardia is the main protozoal pathogen found in TD, followed by Cryptosporidium. […] The risk for Cyclospora is highly geographic and seasonal: the most well-known risks are in Guatemala, Haiti, Nepal, and Peru. […] Inadequate electrical capacity leading to frequent blackouts or poorly functioning refrigeration can result in unsafe food storage and an additional increased risk for disease. […] Where provided, effective food-handling courses have been shown to decrease the risk for TD. […] However, even in high-income countries, food handling and preparation in restaurants has been linked to diarrhea caused by pathogens such as Shigella sonnei.

• #53 Travelers’ Diarrhea | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/travelers-diarrhea

  Viral diarrhea can be caused by several pathogens, most notably norovirus, but also including astrovirus, sapovirus, and rotavirus. […] Giardia is the main protozoal pathogen found in TD, followed by Cryptosporidium. […] The risk for Cyclospora is highly geographic and seasonal: the most well-known risks are in Guatemala, Haiti, Nepal, and Peru. […] Inadequate electrical capacity leading to frequent blackouts or poorly functioning refrigeration can result in unsafe food storage and an additional increased risk for disease. […] Where provided, effective food-handling courses have been shown to decrease the risk for TD. […] However, even in high-income countries, food handling and preparation in restaurants has been linked to diarrhea caused by pathogens such as Shigella sonnei.

• #54 Traveller’s Diarrhoea (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/travellers-diarrhoea-pro

  Traveller’s diarrhoea encompasses diarrhoea caused by numerous enteropathogens (bacteria, parasites and viruses) picked up from contaminated food and water in the new, foreign environment. […] The risk and aetiology are determined by the place of destination. The pathogen is often not determined but, where it is, the most common cause is one of a number of bacteria. Globally, enterotoxigenic Escherichia coli is the most common bacterial cause, with Campylobacter jejuni and Salmonella and Shigella species also often culprits. Rotaviruses and noroviruses are also common causes. Protozoa such as Giardia lamblia or Cyclospora spp. are more likely to cause persistent diarrhoea, lasting over two weeks. […] Other than geography, other risk factors include: Age less than 6 years. Nature of trip (certain types of trip carry higher risk – eg, cruise ship holidays, holiday resorts, backpacking). Taking acid suppressant medication: H2-receptor antagonists or proton pump inhibitors (PPIs). Abnormal upper gastrointestinal anatomy. Genetic factors.

• #55 Traveler’s Diarrhea: Treatment, Symptoms, Contagious & Antibiotics

  https://www.emedicinehealth.com/travelers_diarrhea/article_em.htm

  Yes, no matter what the pathogenic cause (bacterial, viral or parasitic, see above) traveler’s diarrhea is contagious. The vast majority of individuals obtain the pathogens by orally ingesting them. Common routs that lead to oral ingestion are by eating food or drinking water contaminated with the pathogens. […] Certain items are considered high risk for transmission and include the following: Raw or undercooked meats, Raw leafy vegetables, Seafood, Unpeeled fruits, Unpasteurized dairy products, Tap water. […] Traveler’s diarrhea is not life-threatening to an otherwise healthy person. In the very young, very old, and people with weakened immune systems, it can be dangerous.

• #56

  https://www.healthxchange.sg/digestive-system/colorectal/travellers-diarrhoea-causes-prevention

  Travellers’ diarrhoea is a common illness that affects 20-60 percent of travellers. […] The risk of travellers’ diarrhoea increases in those who buy food from places with poor hygiene standards. […] Eating and drinking contaminated food and liquids are the main causes of travellers diarrhoea, though other factors such as stress, unfamiliar food and increased alcohol consumption may also play a part. […] According to the Travel Clinic at Singapore General Hospital (SGH), a member of the SingHealth group, most episodes of diarrhoea have an infectious cause. […] Food that is prone to contamination includes: Salads, Uncooked/unpeeled fruits and vegetables, Shellfish and dishes containing uncooked eggs such as those with mayonnaise, Unpasteurised products such as unpasteurised milk and ice cream, Food from street vendors that is not freshly prepared and served hot on clean crockery, Food such as desserts made from ice and unclean and unpurified tap water.

• #57 Traveler’s Diarrhea | Student Wellbeing | Division of Student Life | University of Delaware

  https://www.udel.edu/students/health-wellbeing/healthy-living/traveler-diarrhea

  Travelers Diarrhea (TD) is extremely common, striking 30-70 percent or more of travelers to developing countries. The best evidence is that nearly all cases are caused by infectious agents such as viruses, bacteria and protozoa. […] TD is spread through food contaminated with human waste and water. The infection can also be spread by way of dirty hands (yours or others). Other potential sources include contaminated recreational water, sewage-polluted water (e.g., sea, lake or rivers) and eating fish or shellfish caught in these waters. […] The risk of contamination is highest in places without adequate sanitation facilities. Warmer climates increase the chance of food spoiling and in places where electricity is unreliable resulting in frequent breakdown of walk-in coolers and refrigerators. High risk foods include raw and undercooked meats, seafood, raw fruits and vegetables. Tap water, ice and unpasteurized milk and dairy products such as cheese may be associated with increased risk of TD.

• #58 Traveler’s diarrhea | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/travelers-diarrhea?content_id=CON-20166940

  Traveler’s diarrhea is a digestive tract disorder that commonly causes loose stools and stomach cramps. It’s caused by eating contaminated food or drinking contaminated water. […] It’s possible that traveler’s diarrhea may stem from the stress of traveling or a change in diet. But usually infectious agents such as bacteria, viruses or parasites are to blame. You typically develop traveler’s diarrhea after ingesting food or water contaminated with organisms from feces. […] So why aren’t natives of high-risk countries affected in the same way? Often their bodies have become used to the bacteria and have developed immunity to them.

• #59 Traveller’s diarrhoea | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/travellers-diarrhoea

  Many people experience travellers diarrhoea. […] Generally, the cause is consumption of contaminated food or water. […] It is often caused by eating contaminated food or water. […] Micro-organisms that can cause travellers diarrhoea include: Bacteria Escherichia coli (E. coli), primarily enterotoxigenic strains (ETEC). This is one of the most common bacterial causes of travellers diarrhoea. Other bacterial causes of travellers diarrhoea include Campylobacter jejuni, Salmonella species and Shigella species. […] Parasites certain parasitic infections are known to cause diarrhoea, including Giardia intestinalis, Entamoeba histolytica and Cryptosporidium parvum. […] Viruses some estimates suggest that around one in three cases of travellers diarrhoea is caused by or associated with a viral infection, particularly norovirus and rotavirus. […] Unknown causes a cause can’t be found in approximately one-fifth to half of all cases of travellers diarrhoea. It is thought that diarrhoea may be the gastrointestinal system’s response to unfamiliar micro-organisms.

• #60 The Most Common Causes of Traveler’s Diarrhea – DiaResQ

  https://diaresq.com/blog/the-most-common-causes-of-travelers-diarrhea/

  The term travelers diarrhea pretty much defines itself, and theres a good chance youve experienced it at one time or another. Travelers diarrhea is typically characterized by loose stools and abdominal cramps and is often caused by human contact or consuming contaminated food or water. […] Travelers diarrhea is most often experienced during trips abroad, as your body is being exposed to new microorganisms and sometimes, less-than-optimal hygiene conditions, but it can also happen when traveling domestically. […] Its not uncommon while traveling to come across unsanitary conditions riddled with unwanted or unfamiliar microorganisms which can cause diarrhea. You might be exposed to unfamiliar microorganisms in airports, restaurants and public transit while traveling and also in food that is prepared in different manners than you may be used to.

• #61 Traveller’s diarrhoea | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/travellers-diarrhoea

  Many people experience travellers diarrhoea. […] Generally, the cause is consumption of contaminated food or water. […] It is often caused by eating contaminated food or water. […] Micro-organisms that can cause travellers diarrhoea include: Bacteria Escherichia coli (E. coli), primarily enterotoxigenic strains (ETEC). This is one of the most common bacterial causes of travellers diarrhoea. Other bacterial causes of travellers diarrhoea include Campylobacter jejuni, Salmonella species and Shigella species. […] Parasites certain parasitic infections are known to cause diarrhoea, including Giardia intestinalis, Entamoeba histolytica and Cryptosporidium parvum. […] Viruses some estimates suggest that around one in three cases of travellers diarrhoea is caused by or associated with a viral infection, particularly norovirus and rotavirus. […] Unknown causes a cause can’t be found in approximately one-fifth to half of all cases of travellers diarrhoea. It is thought that diarrhoea may be the gastrointestinal system’s response to unfamiliar micro-organisms.

• #62 TRAVELER’S DIARRHEA

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4764790/

  TD is predominantly a fecal-orally transmitted disease and can be caused by bacterial, viral or protozoal pathogens, with helminths being uncommon. Many of the etiologies for TD are similar to those causing acute diarrhea in young children of low- and middle-income countries. The frequency of each pathogen varies by geographic location and the etiology may be unknown in 40-50% of cases despite microbiologic evaluation, though with increasing use of multiplex molecular testing, this will likely change. Globally, enterotoxigenic Escherichia coli (ETEC) and enteroaggregative E. coli (EAEC) are the most common bacterial pathogens, with the exception of Southeast Asia, where Campylobacter is more common, a high proportion of which are fluoroquinolone resistant. Norovirus and rotavirus are the most common viral etiologies of TD. Of the protozoa, Giardia duodenalis and Entamoeba histolytica are the main pathogens considered, depending on the region of travel. In some instances, TD may be due to more than one pathogen.

• #63 Traveler’s diarrhea | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/travelers-diarrhea?content_id=CON-20166940

  Traveler’s diarrhea is a digestive tract disorder that commonly causes loose stools and stomach cramps. It’s caused by eating contaminated food or drinking contaminated water. […] It’s possible that traveler’s diarrhea may stem from the stress of traveling or a change in diet. But usually infectious agents such as bacteria, viruses or parasites are to blame. You typically develop traveler’s diarrhea after ingesting food or water contaminated with organisms from feces. […] So why aren’t natives of high-risk countries affected in the same way? Often their bodies have become used to the bacteria and have developed immunity to them.

• #64 Traveler’s Diarrhea | Travel Medicine Consultations NYC

  https://www.travelsurenyc.com/travelers-diarrhea/

  Travelers diarrhea is one of the most common diseases affecting international travelers. This is a digestive tract disorder that leads to abdominal cramps and loose stools, generally caused by eating or drinking contaminated food and water. […] Travelers diarrhea usually happens when you eat or drink contaminated food or water with certain bacteria, viruses, or parasites. These infections usually occur after eating or drinking contaminated food or water. […] People who live in high-risk countries are not always affected by these organisms because their bodies may have developed some degree of immunity to harmful bacteria, viruses, and parasites.

• #65 Traveler’s diarrhea diet: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/002433.htm

  Traveler’s diarrhea causes loose, watery stools. People can get traveler’s diarrhea when they visit places where the water is not clean or the food is not handled safely. This can include developing countries in Latin America, Africa, the Middle East, and Asia. […] Bacteria, parasites, and other substances in the water and food can cause traveler’s diarrhea. People who live in these areas don’t often get sick because their bodies are used to the bacteria or parasites. […] You can lower your risk of getting traveler’s diarrhea by avoiding water, ice, and food that may be contaminated.

• #66 Traveler’s Diarrhea – Gastrointestinal Infections – Intestinal Diseases – Gastrointestinal Diseases – Gastroenterology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.4.24.1.5.

  Travelers diarrhea refers to signs and symptoms caused by ingestion of food or water contaminated with pathogens. It develops in individuals traveling to regions with poor hygiene and sanitary standards, although in some patients it may be due to travel-related dietary changes or stress. […] Etiologic agents vary with geographic regions. Approximately 80% of cases are caused by bacteria, predominantly enterotoxigenic Escherichia coli and Campylobacter spp. […] Epidemiology (risk of developing the disease depends on the region): Low risk (8% of visiting individuals develop the disease within 1-2 weeks): Japan, Australia, New Zealand, Northern and Western Europe, Canada, the United States. Moderate risk (10%-20%): Central and Eastern Europe, Portugal, Greece, the Balkans, Russia, China, Israel, South Africa, Pacific Islands, most of the Caribbean islands, Argentina and Chile, Thailand. High risk (20%-56%): Africa, Latin America, South Asia, Middle East.

• #67 Traveler’s Diarrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2095.html

  Acute diarrhea affects millions of persons who travel to developing countries each year. Food and water contaminated with fecal matter are the main sources of infection. Bacteria such as enterotoxigenic Escherichia coli, enteroaggregative E. coli, Campylobacter, Salmonella, and Shigella are common causes of travelers diarrhea. […] In contrast to the largely viral etiology of gastroenteritis in the United States, diarrhea acquired in developing countries is caused mainly by bacteria. Enterotoxigenic Escherichia coli is the pathogen most frequently isolated, but other types of E. coli such as enteroaggregative E. coli have been recognized as common causes of travelers diarrhea. […] The prevalence of specific organisms varies with travel destination. Available data suggest that E. coli is the predominant cause of travelers diarrhea in Latin America, the Caribbean, and Africa, while invasive pathogens are relatively uncommon. Enterotoxigenic E. coli and enteroaggregative E. coli may be responsible for up to 71 percent of cases of travelers diarrhea in Mexico. In contrast, Campylobacter is a leading cause of travelers diarrhea in Thailand and also is common in Nepal. […] Food poisoning is part of the differential diagnosis of travelers diarrhea. Gastroenteritis from preformed toxins (e.g., Staphylococcus aureus, Bacillus cereus) is characterized by a short incubation period (one to six hours), and symptoms typically resolve within 24 hours.

• #68 TRAVELER’S DIARRHEA

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4764790/

  TD is predominantly a fecal-orally transmitted disease and can be caused by bacterial, viral or protozoal pathogens, with helminths being uncommon. Many of the etiologies for TD are similar to those causing acute diarrhea in young children of low- and middle-income countries. The frequency of each pathogen varies by geographic location and the etiology may be unknown in 40-50% of cases despite microbiologic evaluation, though with increasing use of multiplex molecular testing, this will likely change. Globally, enterotoxigenic Escherichia coli (ETEC) and enteroaggregative E. coli (EAEC) are the most common bacterial pathogens, with the exception of Southeast Asia, where Campylobacter is more common, a high proportion of which are fluoroquinolone resistant. Norovirus and rotavirus are the most common viral etiologies of TD. Of the protozoa, Giardia duodenalis and Entamoeba histolytica are the main pathogens considered, depending on the region of travel. In some instances, TD may be due to more than one pathogen.

• #69 Traveler’s Diarrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2095.html

  Acute diarrhea affects millions of persons who travel to developing countries each year. Food and water contaminated with fecal matter are the main sources of infection. Bacteria such as enterotoxigenic Escherichia coli, enteroaggregative E. coli, Campylobacter, Salmonella, and Shigella are common causes of travelers diarrhea. […] In contrast to the largely viral etiology of gastroenteritis in the United States, diarrhea acquired in developing countries is caused mainly by bacteria. Enterotoxigenic Escherichia coli is the pathogen most frequently isolated, but other types of E. coli such as enteroaggregative E. coli have been recognized as common causes of travelers diarrhea. […] The prevalence of specific organisms varies with travel destination. Available data suggest that E. coli is the predominant cause of travelers diarrhea in Latin America, the Caribbean, and Africa, while invasive pathogens are relatively uncommon. Enterotoxigenic E. coli and enteroaggregative E. coli may be responsible for up to 71 percent of cases of travelers diarrhea in Mexico. In contrast, Campylobacter is a leading cause of travelers diarrhea in Thailand and also is common in Nepal. […] Food poisoning is part of the differential diagnosis of travelers diarrhea. Gastroenteritis from preformed toxins (e.g., Staphylococcus aureus, Bacillus cereus) is characterized by a short incubation period (one to six hours), and symptoms typically resolve within 24 hours.

• #70 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  The incubation period between exposure and clinical presentation can provide clues to etiology. Toxin-mediated illness, for example, generally causes symptoms within a few hours. […] An acute (less than 2 weeks) bout of TD can lead to persistent enteric symptoms, even in the absence of continued infection. […] Prophylactic antibiotics are not recommended for most travelers. […] Prophylactic antibiotics afford no protection against nonbacterial pathogens and can remove normally protective microflora from the bowel, increasing the risk for acquisition of resistant bacterial pathogens. […] Protozoa are the pathogens more likely to be isolated from patients with persistent diarrhea (i.e., diarrhea lasting 2 weeks). […] The most common parasitic cause of TD is Giardia duodenalis, and treatment options include metronidazole, nitazoxanide, and tinidazole.

• #71 Traveler’s Diarrhea | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2095.html

  Acute diarrhea affects millions of persons who travel to developing countries each year. Food and water contaminated with fecal matter are the main sources of infection. Bacteria such as enterotoxigenic Escherichia coli, enteroaggregative E. coli, Campylobacter, Salmonella, and Shigella are common causes of travelers diarrhea. […] In contrast to the largely viral etiology of gastroenteritis in the United States, diarrhea acquired in developing countries is caused mainly by bacteria. Enterotoxigenic Escherichia coli is the pathogen most frequently isolated, but other types of E. coli such as enteroaggregative E. coli have been recognized as common causes of travelers diarrhea. […] The prevalence of specific organisms varies with travel destination. Available data suggest that E. coli is the predominant cause of travelers diarrhea in Latin America, the Caribbean, and Africa, while invasive pathogens are relatively uncommon. Enterotoxigenic E. coli and enteroaggregative E. coli may be responsible for up to 71 percent of cases of travelers diarrhea in Mexico. In contrast, Campylobacter is a leading cause of travelers diarrhea in Thailand and also is common in Nepal. […] Food poisoning is part of the differential diagnosis of travelers diarrhea. Gastroenteritis from preformed toxins (e.g., Staphylococcus aureus, Bacillus cereus) is characterized by a short incubation period (one to six hours), and symptoms typically resolve within 24 hours.

• #72 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  The incubation period between exposure and clinical presentation can provide clues to etiology. Toxin-mediated illness, for example, generally causes symptoms within a few hours. […] An acute (less than 2 weeks) bout of TD can lead to persistent enteric symptoms, even in the absence of continued infection. […] Prophylactic antibiotics are not recommended for most travelers. […] Prophylactic antibiotics afford no protection against nonbacterial pathogens and can remove normally protective microflora from the bowel, increasing the risk for acquisition of resistant bacterial pathogens. […] Protozoa are the pathogens more likely to be isolated from patients with persistent diarrhea (i.e., diarrhea lasting 2 weeks). […] The most common parasitic cause of TD is Giardia duodenalis, and treatment options include metronidazole, nitazoxanide, and tinidazole.

• #73 TRAVELER’S DIARRHEA

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4764790/

  TD is predominantly a fecal-orally transmitted disease and can be caused by bacterial, viral or protozoal pathogens, with helminths being uncommon. Many of the etiologies for TD are similar to those causing acute diarrhea in young children of low- and middle-income countries. The frequency of each pathogen varies by geographic location and the etiology may be unknown in 40-50% of cases despite microbiologic evaluation, though with increasing use of multiplex molecular testing, this will likely change. Globally, enterotoxigenic Escherichia coli (ETEC) and enteroaggregative E. coli (EAEC) are the most common bacterial pathogens, with the exception of Southeast Asia, where Campylobacter is more common, a high proportion of which are fluoroquinolone resistant. Norovirus and rotavirus are the most common viral etiologies of TD. Of the protozoa, Giardia duodenalis and Entamoeba histolytica are the main pathogens considered, depending on the region of travel. In some instances, TD may be due to more than one pathogen.

• #74 TRAVELER’S DIARRHEA

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4764790/

  TD is predominantly a fecal-orally transmitted disease and can be caused by bacterial, viral or protozoal pathogens, with helminths being uncommon. Many of the etiologies for TD are similar to those causing acute diarrhea in young children of low- and middle-income countries. The frequency of each pathogen varies by geographic location and the etiology may be unknown in 40-50% of cases despite microbiologic evaluation, though with increasing use of multiplex molecular testing, this will likely change. Globally, enterotoxigenic Escherichia coli (ETEC) and enteroaggregative E. coli (EAEC) are the most common bacterial pathogens, with the exception of Southeast Asia, where Campylobacter is more common, a high proportion of which are fluoroquinolone resistant. Norovirus and rotavirus are the most common viral etiologies of TD. Of the protozoa, Giardia duodenalis and Entamoeba histolytica are the main pathogens considered, depending on the region of travel. In some instances, TD may be due to more than one pathogen.

• #75 Travelers’ diarrhea – Wikipedia

  https://en.wikipedia.org/wiki/Travelers%27_diarrhea

  While viruses are associated with less than 20% of adult cases of travelers’ diarrhea, they may be responsible for nearly 70% of cases in infants and children. Diarrhea due to viral agents is unaffected by antibiotic therapy, but is usually self-limited. […] A subtype of travelers’ diarrhea afflicting hikers and campers, sometimes known as wilderness diarrhea, may have a somewhat different frequency of distribution of pathogens.

• #76 Travelers’ diarrhea – Wikipedia

  https://en.wikipedia.org/wiki/Travelers%27_diarrhea

  While viruses are associated with less than 20% of adult cases of travelers’ diarrhea, they may be responsible for nearly 70% of cases in infants and children. Diarrhea due to viral agents is unaffected by antibiotic therapy, but is usually self-limited. […] A subtype of travelers’ diarrhea afflicting hikers and campers, sometimes known as wilderness diarrhea, may have a somewhat different frequency of distribution of pathogens.

• #77 Traveller’s diarrhea | HealthLink BC

  https://www.healthlinkbc.ca/healthlinkbc-files/travellers-diarrhea

  An oral vaccine to help protect against travellers diarrhea caused by (ETEC) is available but not routinely recommended unless you are at increased risk of complications from travellers diarrhea. The vaccine also protects against cholera. […] The current vaccine only protects against 1 type of bacteria that causes travellers diarrhea.

• #78 Traveller’s diarrhea | HealthLink BC

  https://www.healthlinkbc.ca/healthlinkbc-files/travellers-diarrhea

  An oral vaccine to help protect against travellers diarrhea caused by (ETEC) is available but not routinely recommended unless you are at increased risk of complications from travellers diarrhea. The vaccine also protects against cholera. […] The current vaccine only protects against 1 type of bacteria that causes travellers diarrhea.

• #79 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  The incubation period between exposure and clinical presentation can provide clues to etiology. Toxin-mediated illness, for example, generally causes symptoms within a few hours. […] An acute (less than 2 weeks) bout of TD can lead to persistent enteric symptoms, even in the absence of continued infection. […] Prophylactic antibiotics are not recommended for most travelers. […] Prophylactic antibiotics afford no protection against nonbacterial pathogens and can remove normally protective microflora from the bowel, increasing the risk for acquisition of resistant bacterial pathogens. […] Protozoa are the pathogens more likely to be isolated from patients with persistent diarrhea (i.e., diarrhea lasting 2 weeks). […] The most common parasitic cause of TD is Giardia duodenalis, and treatment options include metronidazole, nitazoxanide, and tinidazole.

• #80 Travelers’ Diarrhea | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/travelers-diarrhea

  The incubation period between exposure and clinical presentation can provide clues to etiology. Toxin-mediated illness, for example, generally causes symptoms within a few hours. […] An acute (less than 2 weeks) bout of TD can lead to persistent enteric symptoms, even in the absence of continued infection. […] Older controlled studies showed that use of antibiotics reduced diarrhea attack rates by 90%. […] Prophylactic antibiotics might rarely be considered for short-term travelers who are high-risk hosts (e.g., immunocompromised people or people who have significant medical comorbidities). […] Prophylactic antibiotics afford no protection against nonbacterial pathogens and can remove normally protective microflora from the bowel, increasing the risk for acquisition of resistant bacterial pathogens. […] Travelers can become colonized with extended-spectrum beta lactamase-producing enterobacteriaceae (ESBL-PE), a risk that is increased by exposure to antibiotics while abroad. […] Antibiotics are effective in reducing the duration of diarrhea by approximately 12 days in cases caused by bacterial pathogens susceptible to the antibiotic prescribed. […] However, concerns about the adverse consequences of using antibiotics to treat TD remain.

• #81 Travelers’ Diarrhea | CDC Yellow Book

  https://relief.unboundmedicine.com/relief/view/cdc-yellow-book/204162/all/Travelers%E2%80%99_Diarrhea

  Travelers diarrhea (TD) is a clinical syndrome that can result from a variety of intestinal pathogens. Bacterial pathogens are the predominant risk, thought to account for up to 80%90% of TD. Intestinal viruses may account for at least 5%15% of illnesses, although multiplex molecular diagnostic assays increase their detection. Infections with protozoal pathogens are slower to manifest symptoms and collectively account for approximately 10% of diagnoses in longer-term travelers. Bacteria are the most common cause of TD. Overall, the most common pathogen identified is enterotoxigenic Escherichia coli, followed by Campylobacter jejuni, Shigella spp., and Salmonella spp. Enteroaggregative and other E. coli pathotypes are also commonly found in cases of TD. There is increasing discussion of Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Acrobacter, Larobacter, enterotoxigenic Bacteroides fragilis) as potential causes of TD as well. The risk for Cyclospora is highly geographic and seasonal: the most well-known risks are in Nepal, Peru, Haiti, and Guatemala. The primary agent studied for prevention of TD, other than antimicrobial drugs, is bismuth subsalicylate (BSS), which is the active ingredient in adult formulations of Pepto-Bismol and Kaopectate. Studies from Mexico have shown that this agent reduces the incidence of TD by approximately 50%. Although prophylactic antibiotics can prevent some TD, the emergence of antimicrobial resistance has made the decision of how and when to use antibiotic prophylaxis for TD difficult. Controlled studies have shown that use of antibiotics reduces diarrhea attack rates by 90% or more. The prophylactic antibiotic of choice has changed over the past few decades as resistance patterns have evolved. Fluoroquinolones have been the most effective antibiotics for the prophylaxis and treatment of bacterial TD pathogens, but increasing resistance to these agents among Campylobacter and Shigella species globally limits their potential use.

• #82 Traveler’s diarrhea diet – UF Health

  https://ufhealth.org/conditions-and-treatments/travelers-diarrhea-diet

  Traveler’s diarrhea causes loose, watery stools. People can get traveler’s diarrhea when they visit places where the water is not clean or the food is not handled safely. This can include developing countries in Latin America, Africa, the Middle East, and Asia. […] Bacteria, parasites, and other substances in the water and food can cause traveler’s diarrhea. People who live in these areas don’t often get sick because their bodies are used to the bacteria or parasites. […] There is no vaccine against traveler’s diarrhea. […] Taking 2 tablets of Pepto-Bismol 4 times a day before you travel and while you are traveling can help prevent diarrhea. […] In some cases, your provider may provide a prescription for an antibiotic to be taken if you develop severe diarrhea, especially if it is accompanied by fevers or if there is blood in the stool. Azithromycin is the most common option, though ciprofloxacin may also be recommended.

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