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Travelers' Diarrhea Alert.

Posted by Stuart Rose on

traveler's diarrhea, E. coli

Q: What is Travelers' Diarrhea?

A: It's the most common disease that travelers get. You have a 50% chance of illness if staying in a lesser-developed country for more than one month.

  • The diarrhea is typically non-bloody diarrhea. You may have a slight (or no) fever, stomach cramps and mild nausea. 
  • The diarrhea can range from mild (a few episodes daily) to frequent and explosive.
  • Bacteria cause 80—85% of travelers’ diarrhea, parasites about 10%, and viruses 5%. Toxin-producing E. coli is the most common bacterial culprit.
  • Food and water precautions may help prevent travelers’ diarrhea. 
  • You can pick up these germs from hard surface,e.g., doorknobs; Hand washing and hand sanitizer gels will reduce the incidence of diarrhea by 30%.

 What to do:

Step #1 If you suddenly get loose/watery stools: Take 2 Imodium (loperamide) tablets immediately, and then 1 capsule or tablet after each unformed stool, but no more than 8 in any 24-hour period, per package instructions. Overuse of loperamide may cause constipation.

 

Step #2 At the same time, take the antibiotic you were prescribed—either azithromycin or ciprofloxacin.

 

Azithromycin (Zithromax)

  • Adults: Take 2- tablets immediately with food. A single 2-tablet dose is often sufficient and symptoms may be resolved by the next day. Azithromycin has a long duration of action. Persistent diarrhea (>3 days) despite an antibiotic, may be due to a virus or parasite, and treatment with metronidazole may be needed.

           

  • Children: Azithromycin suspension, 1–2 tsp daily, for 1–3 days.

 

Ciprofloxacin (Cipro) This is an alternative choice

  • Take 3 tablets as a single dose, once a day, as needed. A single 3-tablet dose may be sufficient, but you can take it for up to 3 days, if necessary.

 

Preventing TD with Pepto-Bismol

*1-2 tablets with meals and at bedtime will reduce the incidence of TD by about 60%. Pepto-Bismol has antibacterial properties.

 

 

When to Seek Medical Help

If you have fever, abdominal pain, vomiting, bloody stools, seek medical help. These symptoms are termed dysentery.

Dysentery is caused by infections from bacteria, parasites or viruses that primarily affect the colon. The most important bacterial form of dysentery is called shigellosis. Typhoid fever can be a cause, but may be associated with constipation.

Protozoa cause amoebic dysentery.

If you have the symptoms of dysentery, seek medical help ASAP.

 

Travelers’ diarrhea in children can cause dehydration in a short period of time, especially if the child is also vomiting. Seek medical help ASAP if your child exhibits any of the following signs or symptoms:

  1. Persistent vomiting
  2. Bloody stools or severe diarrhea
  3. A fever of 102 F (39 C) or more
  4. Dry mouth or crying without tears
  5. Signs of being unusually sleepy, drowsy or unresponsive

Decreased volume of urine, including fewer wet diapers in infants


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