Travelers diarrhea Cipro dose

Key Points:

  • Travelers' diarrhea is the most frequent cause of illness among travelers.
  • Bacteria cause 80—85% of travelers' diarrhea, parasites about 10%, and viruses 5%.
  • Most cases of diarrhea in which no pathogen is identified respond to antibiotics, suggesting that most of these are bacterial in origin.
  • Travelers to lesser-developed countries should carry stand-by antibiotics for self-treatment of diarrhea.
  • There are very few indications for taking prophylactic antibiotics to prevent travelers' diarrhea.
  • Food and water precautions may help prevent travelers' diarrhea but are often ineffective because of lack of compliance on the part of the traveler.
  • Hand washing and hand sanitizer gels reduce the incidence of diarrhea (as well as respiratory illness).
  • The oral cholera vaccine (Dukoral) provides up to 30% crossover protection against ETEC-caused diarrhea.

What's New

  • Backpacking in wilderness areas in the U.S. What is the risk of acquiring infectious diarrhea? A recent study showed that alpine wilderness water below cattle areas used by pack animals is at risk for containing coliform organisms. Water from wild, day hike, or backpack areas showed far less risk for coliforms (diarreha-causing bacteria). Hikers to areas where water can be fecally contaminated by cattle should filter all drinking water.

Overview of Travelers' Diarrhea

Diarrhea is by far the most common medical problem among people traveling to less developed tropical and subtropical countries. Travelers' diarrhea, however, is not a specific disease. The term describes the symptoms of an intestinal infection caused by certain bacteria, parasites, or viruses that are transmitted by the consumption of contaminated food or water, get ingested after touching contaminated surfaces, or through intimate contact with people carrying the microorganism. The severity and duration of symptoms depend on which microorganism is causing the illness.

Your Risk of Getting Travelers' Diarrhea

Your risk is related to which countries you visit, the month or season of your visit, the duration of your visit, how often you eat in restaurants, and whether or not you eat in local homes or from food vendors. Some studies show that poor restaurant hygiene may be the source of most cases of travelers' diarrhea.

There is little risk (attack rate of about 4%) when visiting North America, northern and central Europe, Australia, and New Zealand. Intermediate attack rates (8% to 20%) are found in travelers to most destinations in the Caribbean, southern Europe, Israel, Japan, and South Africa. High-risk destinations (attack rates of up to 60% during the first 2 weeks) include Mexico, the Dominican Republic and Haiti, and the developing countries of Africa, South and Central America, the Middle East, and Asia. One attack of travelers' diarrhea won't “immunize” you against further episodes. In fact, the attack rate in long-term travelers and expatriates remains unchanged for several years after arrival.

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