The Centers for Disease Control and Prevention (CDC) estimates that each year 10 million persons, or between twenty and fifty percent of international travelers, become ill with diarrhea. Travelers’ diarrhea is the most common illness affecting international travelers.
American citizens who travel to such destinations as Latin America, Africa, the Middle East, and Asia are more likely to become ill with travelers’ diarrhea, which usually occurs within the first week of travel but may occur subsequently or even after a person returns home. Although attack rates are similar for men and women and high-risk individuals become ill more than healthy individuals the primary source of travelers’ diarrhea is fecal contamination of food or water.
Travelers’ diarrhea is caused by the ingestion of bacteria or viruses, such as enterotoxigenic Escherichia coli (ETEC), which is different from E. coli O157:H7 and other pathogenic bacteria responsible for E. coli outbreaks in the United States. Watery diarrhea, stomach cramping, and low-grade or no fever are characteristic symptoms of ETEC infection. Other pathogens that can cause illness include other bacterial pathogens, viruses, and parasites.
Most travelers’ diarrhea cases are identified by four to five loose or watery bowel movements each day. Other symptoms associated with travelers’ diarrhea include nausea, vomiting, diarrhea, abdominal cramping, bloating, fever, and malaise.
Public health agencies recommend the following measure to prevent becoming ill with travelers’ diarrhea:
- Avoid eating “street food,” or food purchased from street vendors or other establishments where unhygienic conditions are present.
- Avoid eating raw or under-cooked meat and seafood
- Avoid eating raw fruits and vegetables unless you peel them yourself.
- When in doubt about safety, only drink bottled carbonated beverages, hot tea or coffee, beer, wine, and water that has been boiled or treated with iodine or chlorine.
More information about travelers’ diarrhea, its treatment and prevention can be found on the CDC Web page about travelers’ diarrhea.