Epidemiology of travelers’ diarrhea

Acute diarrhea is the most common medical complaint of international travelers to high-risk tropical and semitropical regions of the world. Enterotoxigenic Escherichia coli (ETEC) is the most common cause with strains of Campylobacter jejuni and other invasive bacterial enteropathogens also important causes especially in South Asia. Treatment can shorten the disease. Loperamide and other drugs acting symptomatically can decrease the number of watery stools passed and antimicrobial agents can shorten the overall illness. Because of the significance of acquiring fecal carriage of multidrug-resistant Enterobacteriaceae with antibiotics, most travel authorities only recommend treatment with these drugs when illness is moderate to severe. Mild illness, which allows people to function relatively normally, is best left untreated or treated symptomatically. A major health consequence of travelers’ diarrhea (TD) is development of postinfectious functional bowel disease, which may occur in as many as 5% of those reporting TD.