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MAP 1. High-risk regions for contracting travelers’ diarrhea


Map 1 created by authors using Microsoft Excel.


WHAT IS TRAVELERS’ DIARRHEA?

Travelers’ diarrhea is a condition related to the ingestion of contaminated food or water, which commonly occurs after
traveling to another country. It is the most common travel-related illness and is commonly caused by a bacteria called ETEC (enterotoxigenic Escherichia coli) that contaminates local food and water sources. Travelers’ diarrhea occurs in approximately 20% to 60% of travelers to low-income regions of the world, as there is a larger risk of eating and/or drinking contaminated items. The symptoms of travelers’ diarrhea typically begin within the first week of arrival; however, symptoms can occur any time during travel, even after returning home. The symptoms typically subside

within 5 days without treatment.

WHO IS AT RISK?

Anyone traveling to another country could be at increased risk of contracting travelers’ diarrhea. High-risk locations are

indicated in blue on Map 1 (above) and include Asia, the Middle East, Africa, Mexico, Central America, and South America.

WHAT ARE THE SYMPTOMS?

Symptoms can include large amounts of loose-to-watery diarrhea occurring at least 3 times within a 24-hour period. Symptoms can also include nausea, vomiting, abdominal pain, abdominal cramping, or fever (>100.4°F).

PREVENTION

One of the best ways to prevent travelers’ diarrhea is to avoid tap water while in high-risk areas. It is recommended to drink beverages from sealed containers and to avoid ice as well. You should not eat raw fruits and vegetables that have not been washed in clean water. If you are unable to find a clean water source, you should boil water before using it. It is important to frequently wash your hands before and after meals. If you have had travelers’ diarrhea before or are traveling to a high-risk area, you can discuss medication prevention options with your doctor prior to your trip.

TREATMENT OPTIONS

Travelers’ diarrhea will usually resolve within 3 to 7 days without any treatment. You should drink lots of water and electrolytes (bottled water, bottled Gatorade, or some other electrolyte replacement) to replace lost fluids. Antibiotics are not usually used for prevention or treatment. You should seek medical attention if you have a fever over 102°F, bloody stools, signs of severe dehydration (feeling unusually tired, confused, dizzy or lightheaded, not urinating for over 8 hours, passing out), or vomiting that does not stop.

INTERESTED IN LEARNING MORE?

You can find additional information on the CDC (Centers for  Disease Control and Prevention) website as well as the StatPearls reference sheet. Both links are included below.

SOURCES

  1. Centers for Disease Control and Prevention. Connor B. Chapter 2: Preparing international travelers: travelers’ diarrhea.
  2. CDC Yellow Book. https://wwwnc.cdc.gov/travel/yellowbook/2020/preparing-international-travelers/travelers-diarrhea. Accessed March 30, 2023.
  3. Dunn N, Okafor CN. Travelers’ diarrhea. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK459348/?report=reader. Accessed March 30, 2023.
  4. Travelers’ diarrhea. Centers for Disease Control and Prevention. https://wwwnc.cdc.gov/travel/page/travelers-diarrhea. Accessed March 30, 2023.