traveler’s diarrhea

Causes: TD is often caused by contaminated food or water, with common pathogens including bacteria like Escherichia coli, Salmonella, and Shigella. Viruses (e.g., norovirus) and parasites can also be responsible in some cases. The lack of immunity to local pathogens plays a key role.

Diagnosis: In most cases, diagnosis is clinical based on symptoms. Stool culture may be indicated for patients with fever or bloody diarrhea but is typically reserved for those who do not respond to initial treatment.

Treatment:

• Hydration: Oral rehydration solutions are crucial.
• Antimotility agents (e.g., loperamide): Can help reduce stool frequency, though caution is advised in cases of fever or blood in stools due to the risk of complications like hemolytic uremic syndrome.
• Antibiotics: Recommended for moderate-to-severe cases. Common choices include azithromycin or a fluoroquinolone (e.g., ciprofloxacin). Children may receive similar treatment as adults, though specific dosing should be adjusted by weight.

Prevention:

• Avoid tap water and uncooked foods that may have been washed in contaminated water.
• Consider prophylactic antibiotics for high-risk travelers, but this is not routinely recommended due to resistance concerns. Hand hygiene and food safety practices are essential preventive measures.

For more details on specific treatments or prevention strategies, consult the latest guidelines from organizations like the Infectious Diseases Society of America (IDSA) or the Centers for Disease Control and Prevention (CDC).