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Traveler’s Diarrhea - Coggle Diagram
Traveler’s Diarrhea
Introduccion
The incidence of traveler’s diarrhea has decreased in countries with increasing economies and in some previously high-risk destinations with improved tourism infrastructure
It was documented that acute and chronic diarrhea accounted for 335 of every 1000 medical visits of returned travelers
The disease is present if travelers develop at your destination 3 or more unformed stools every 24 hours or so and presentation of 1 additional symptom, like abdominal cramps, tenesmus, nausea, vomiting, fever, or fecal urgency.
Risk Groups
Environmental Factors
The risk of traveler’s diarrhea depends not only on the destination and duration of exposure but also on the travel style, particularly the available budget, that often determines where a traveler purchasesmeals.
Seasonal variations exist for the risk of traveler’s diarrhea, with lower rates occurring in Winter:
• In Mexico, traveler’s diarrhea risk increases with warmer temperatures and greater rainfall.
• Exposure to recreational waters has been associated with acquisition of several infections
Host Factors
Younger travelers tend to have a greater risk of acquiring traveler’s diarrhea, with infants and toddlers often having more severe disease and a greater propensity to require hospitalization.
Several genetic factors are associated with increased risk of traveler’s diarrhea(mostly polymorphism associations):
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Preventive Medication
Bismuth subsalicylate providesmodest protection against traveler’s diarrea, because it contains salicylate, it should be avoided in patients taking anticoagulants or long-term salicylate therapy
Systemic antibiotics taken prophylactically can reduce the incidence of traveler’s diarrhea by more than 90%
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Clinical Manifestations
The average duration of untreated traveler’s diarrhea is 4 to 5 days. Long-term complications of traveler’s diarrhea can occur: postinfectious irritable bowel syndrome (PI-IBS) can occur in travelers who did notexperience traveler’s diarrhea
Chronic gastrointestinal symptoms other than IBS (eg, persistent or chronic diarrhea) can also be seen at a higher rate
Reactive arthritis, often associated with HLA-B27, and Guillain-Barré syndrome have been associated with traveler’s diarrea.
Etiology/Microbiology
Most cases of traveler’s diarrhea are caused by bacterial enteropathogens, whereas bacterial pathogens cause less than 15% of endemic diarrhea cases in adults living in their home country:
• Enterotoxigenic Escherichia coli
• Enteroaggregative E coli
• Campylobacter
• Salmonella
• Shigella
• Norovirus
• Rotavirus
• Giardia
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