Traveller's diarrhoea

What it is, and what causes it

Traveler's diarrhea is caused predominantly by bacterial pathogens, up to 80%-90%, and is associated with hygiene practices.

Among those bacterial pathogens, which are the common cause at up to 80%-90%, the one whose own listed clue is the name itself is Escherichia coli of the ETEC type: its unique clinical clue is traveler's diarrhea, watery, and the note beside it is that it is self-limiting, with ciprofloxacin if severe. In the bacterial table enterotoxigenic E. coli has an incubation period of 1-3 days, a duration of 2-3 days, and diarrhea as its only listed sign, with no fever and no blood. Cholera and enterotoxigenic E. coli are also grouped together as the ones associated with profuse, rapidly dehydrating diarrhea.

The advice that carries evidence before the trip

Handwashing has been shown to reduce the risk of traveler's diarrhea by 30%, and the use of alcohol-based hand sanitizer is also effective. That is the answer when a traveler asks what to do before he goes.

Three things that sound right are not:

• Although it is considered traditional advice, avoiding street vendor foods, tap water, ice and raw foods has not been shown to reduce the risk of traveler's diarrhea
• There is not sufficient evidence to recommend taking a probiotic to reduce the risk
• Due to concerns about antimicrobial resistance and altering protective bowel flora, taking prophylactic antibiotics is generally not recommended for healthy travelers

The antibiotic is not ruled out, only moved: using an antibiotic for as-needed treatment is appropriate.