Traveler's diarrhea

As traveler's diarrhea or traveler's diarrhea (RD ) an infectious disease of the intestine is called, which is caused by toxins of different bacteria and usually occurs in the first few days of a trip to the tropics or subtropics. For travelers coming from temperate zones, it is the most common sickness at all.

Pathogen

Normally, the ( regionally different compositions ) gut flora in balance, which is different greatly disturbed by the sudden presence of other bacteria. Their enterotoxins ( detected in ETEC, Campylobacter species, Shigella and Salmonella ) lead to an active secretion of chloride ions from the intestinal cell into the intestinal lumen. These are followed by sodium ions and water passively. In addition to the impaired bone resorption, it is therefore of a so-called secretory diarrhea, in the latter pathogens by direct infection of the intestinal mucosa also an inflammatory dysentery.

ETEC are to be made in Latin America to 50 %, in Asia only 15% responsible for the diarrhea. Campylobacter, Shigella and Salmonella are responsible for 1-15 % of cases. Clinically, it can be caused by different pathogens diarrhea hardly differ. A pathogen is not necessary in most cases, since this specifically in the milder forms of the disease no effect on any therapy has.

Incidence

The mean frequency varies by destination:

  • A high risk, with an incidence up to 50 % is when traveling to Latin America, Asia and Africa - on some Nile cruises are up to 80 % of the passengers affected, leading to synonyms such as Pharaoh's Revenge, Curse of the Pharaoh or pyramid SideStep. When traveling to Central and South America vengeance is accordingly spoken of Montezuma.
  • A medium risk with an incidence 10-20 % is for Southern Europe, Israel, Caribbean
  • A low risk, with an incidence of less than 8 % is when traveling to Northern Europe, North America, Australia, New Zealand and Japan.

Course

The traveler's diarrhea is divided into two different forms:

Acute Diarrhea

A traveler's diarrhea manifests itself in 90 to 95% as acute traveler's diarrhea. The incubation period is from a few hours to a few days, which means that the majority of travelers get their diarrhea within the first four days of the trip. Thus, it is (along with nausea and vomiting)

In about one percent of these patients the diarrhea is so severe that hospitalization is necessary, about 20 percent are bedridden, and the remaining 80 percent feel their freedom of movement more or less limited, and are only slightly ill. The mean disease duration is three to five days. The diarrhea is usually self- terminating.

Chronic Diarrhea

In 8 to 15 per cent, it takes over a week, 2-3 % ( to 10 %) develop chronic diarrhea, which is more than four weeks, and is therefore often clarified only after the return to the home country. The most frequently detected pathogen here is Giardia lamblia.

Prophylaxis

Although traveler's diarrhea is self-limiting in most cases, it is advisable to prevent the disease by adequate prophylaxis. This can consist of:

  • Immunization ( vaccination ) is available this against cholera, typhoid and ETEC.
  • Avoidance of infected food Only original sealed drinks
  • Boil and / or filter water
  • Food peel or cook before consumption either
  • Take only freshly cooked and hot food to be
Enterotoxigenic Escherichia coli
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