Traveler's diarrhea

It is a gastrointestinal disorder due to food poisoning. It manifests itself with an increased frequency of bowel movements that lead to three or more evacuations of poorly formed stools per day, generally during a trip abroad, often in a developing country.

What are the etiological agents?

In more than half of the cases the cause is not investigated because the symptoms disappear before returning home. When, on the other hand, the causative agent is sought, these bacteria are almost always found:

• Escherichia coli enterotoxic is the most common bacterium responsible for traveler's diarrhea whose infection presents with abdominal cramps, hardly ever feverish.
• Frequent is also theEscherichia coli enteroaggregant.

• This year Campilobacter jejuni it manifests itself as watery and bloody diarrhea, abdominal cramps and fever.

• Salmonella they are responsible for acute diarrhea, temperature, vomiting and abdominal cramps.

• La Shigella presents with acute diarrhea, abdominal cramps, bloody stools, tenesmus and fever.

In minor cases, viruses may also be involved, come i norovirus e rotavirus, and protozoa such as the Giardia lamblia. Other parasites that cause diarrhea are Cryptosporidium spp, Entamoeba histolytica and Cyclospora catayensis.

geography:

The countries most at risk are those of South and Southeast Asia, of North Africa, eastern and western, of South America and Central America. Intermediate risk are considered South Africa, Caribbean, Russia and China.

Which subjects are most at risk of this disorder?

Children under the 6 years, the immunosuppressed, people with inflammatory bowel disease or diabetes, those taking H2 blockers or antacids. In addition, some situations are more risky, like camping or cruising, where outbreaks of viral and bacterial gastroenteritis are frequent. There is also a genetic predisposition: subjects with blood type 0 they are more exposed to shigellosis and severe forms of cholera.

How can it be prevented?

It is suggested to follow the following indications:

1- avoid food from vendors who do not guarantee hygiene standards;

2- consume water and soft drinks in sealed bottles upon purchase and avoid adding ice;

3- do not eat raw or undercooked meats or fish;

4- avoid eating raw vegetables and fruits without peeling them.

5- A vigorous hand washing with soap and water is always recommended to reduce the risk of infection.

Prophylaxis:

In healthy individuals, prophylactic administration of antibiotics is not only not recommended, but exposes you to the risk of developing Candida infections or diarrhea Clostridium difficile. In the case of subjects with impaired immune defenses or with other pathologies, antibiotic prophylaxis should be evaluated with the attending physician.

Treatment:

Usually the problem is solved without specific treatments, however, oral rehydration is often helpful in restoring lost fluids. In mild forms (1-2 discharges of diarrheal stools in the 24 ore) BMJ experts recommend taking loperamide.

Travelers who experience three or more episodes of diarrhea in a period of 8 ore, especially when associated with nausea, He retched, abdominal cramps, fever or blood in the stool, may benefit from antimicrobial therapy. In any case, a doctor should be consulted.

Have a good trip to those who can!

Source:

https://www.epicentro.iss.it/tossinfezioni/diarreahttps://doi.org/10.1136/bmj.i1937