Traveller s diarrhoea

Traveller s diarrhoea may be eaused by one of many gastrointestinal pathogens (Table 6.4). However, enterotoxigenic Escherichia coli is the most common pathogen. Whilst it is generally short-lived, traveller s diarrhoea can seriously mar a brief period abroad, be it for holiday or business purposes. Although not universally accepted, the use of short-course co-trimoxazole or quinolone such as norfloxacin can abbreviate an attack in patients with severe disease. 

Lima AA Tropical diarrhoea New developments in traveller s diarrhoea. Curr Opin Infect Dis 2001 14 547-552. 

Q3 Which organisms are most frequently associated with traveller s diarrhoea ... 

Q4 Mrs Kaye may be at risk because this was her first visit abroad and possibly she was particularly affected by a change in diet or did not take the usual precaution of drinking bottled water and avoiding salads and unwashed fruit. Mrs Kaye also takes ranitidine for indigestion and there is some evidence that patients with reduced gastric acid, including those who take H2 antagonists such as ranitidine, are at increased risk of traveller s diarrhoea. 

Traveller s diarrhoea, which affects people travelling outside their own countries, usually lasts two to five days. It involves three or four unformed stools in 24 hours and at least one other symptom, such as faecal urgency, fever, nausea, vomiting, abdominal pain or cramps. 

The most frequent cause of traveller s diarrhoea is E. coli but other bacterial causes include C. jejuni and Salmonella species. A minority of cases appear to involve viral infection, such as rotavirus. 

Up to 15% of patients with traveller s diarrhoea have dysentery (bloody diarrhoea). 

Frequency and nature of stools Rapid onset. Watery stools, passed frequently Acute diarrhoea Traveller s diarrhoea... 

Blood and/or mucus in stool Traveller s diarrhoea Inflammatory bowel disease... 

Begins during or soon after return from visit to tropical or subtropical country Traveller s diarrhoea... 

TNA, FD23/1431, Research Work on Traveller s Diarrhoea Report by Lt Col J. Barnes and Wg Cdr RJ. Moylan-Jones ,June 1966. 

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