Abdominal cramps and diarrhea; Fever, vomiting, severe abdominal pain, and bloody diarrhea are present in some cases. [CDC Travel, p. 49]
About 80-90% of cases are caused by bacteria and 5-8% by viruses. Protozoa cause about 10% of cases in longer-term travelers. Enterotoxigenic Escherichia coli (ETEC) are the most common cause. "Because of the competing concerns of effective treatment of TD episodes and a desire to avoid the potential negative consequences of antibiotic use, consensus guidelines have been developed by the International Society of Travel Medicine to address this (Box 2-2 and Table 2-6)." [CDC Travel, p. 48-56] Most patients have noninflammatory diarrhea. Low-grade fever is present in about 1/3. In a 2 week visit, about 50% of tourists to a tropical country develop traveler's diarrhea. Preventive measures (hand washing, water purification, and eating hot foods) may reduce the attack rate to 15%. [PPID, p. 1259-60]
For updated text and symptoms of infectious diseases, see iddx.com.
Often diagnosed clinically; Fecal leukocytes; Stool culture (E. coli, Shigella, Salmonella, Campylobacter, Aeromonas, Plesiomonas, Y. enterocolitica); Shiga toxin assay; Giardia Ag detection by ELISA; Stool for O&P; [ABX Guide]