Traveler's Diarrhea (cont.)
What causes travelers' diarrhea?
Travelers' diarrhea usually is contracted by the ingestion of contaminated food or water. Contrary to common belief, food - not water - is primarily at fault. Most cases of travelers' diarrhea are caused by bacteria. The most important bacterium is
enterotoxigenic E. coli which is estimated to account for up to 70% of all cases.
Most E. Coli are harmless. However, there are five unique classes of E. coli that can cause inflammation of the stomach and bowels (gastroenteritis) and are termed enterovirulent. They are virulent (extremely noxious) for the intestine (or, in Greek, the enteron).
Collectively, these five classes of enterovirulent E. coli are referred to as the EEC group (enterovirulent E. coli). Each class of EEC is distinct and different from the others.
- Enteroinvasive E. coli (EIEC) invades (passes into) the intestinal wall to produce severe diarrhea.
- Enterohemorrhagic E. coli (EHEC): A type of EHEC, E.coli 0157:H7, can cause bloody diarrhea and the hemolytic uremic syndrome (anemia and kidney failure).
- Enterotoxigenic E. coli (ETEC), the one that causes most of travelers' diarrhea, produces a toxin that acts on the intestinal lining.
- Enteropathogenic E. coli (EPEC) can causes diarrhea outbreaks in newborn nurseries.
- Enteroaggregative E. coli (EAggEC) can cause acute and chronic (long
lasting) diarrhea in children.
Other bacterial species implicated in travelers' diarrhea include
Campylobacter jejuni, Shigella, and Salmonella. Viruses (including
Rotavirus,
Norwalk virus and other enteric viruses) less commonly are
causes of travelers' diarrhea. Parasitic infections are an uncommon
cause with the exception of Giardia lamblia, which
should be suspected in individuals traveling to Russia or to mountainous regions
of the Northern Hemisphere. Cryptosporidia, another parasite, also has been
implicated as a common cause of diarrhea in visitors to St. Petersburg,
Russia.
What are the symptoms of travelers' diarrhea?
The symptoms of travelers' diarrhea vary. Generally, diarrhea occurs within the first week of travel and lasts up to
three to four days. Affected individuals on average pass up to five loose or watery bowel movements per day which may be associated with cramps. On occasion, individuals may experience fever or bloody stools.
Next: How is travelers' diarrhea diagnosed? »
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