Traveler's diarrhea causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
There are many causes of diarrhea and it is important to recognize which ones are serious and which are not. Infectious agents are the primary cause of TD. Bacterial enteropathogens cause approximately 80% of TD cases. The most common causative agent isolated in countries surveyed has been enterotoxigenic Escherichia coli (ETEC). In infants and children it is estimated that nearly 70% of diarrhea is due to viruses
Causes
Pathogens implicated in travellers' diarrhea are:
| E. coli, enterotoxigenic | 20-75% |
| E. coli, enteroaggregative | 0-20% |
| E. coli, enteroinvasive | 0-6% |
| Shigella spp | 2-30% |
| Salmonella spp | 0-33% |
| Campylobacter jejuni | 3-17% |
| Vibrio parahemolyticus | 0-31% |
| Aeromonas hydrophila | 0-30% |
| Giardia lamblia | 0 to less than 20% |
| Entamoeba histolytica | 0-5% |
| Cryptosporidium sp | 0 to less than 20% |
| Rotavirus | 0-36% |
| Norwalk virus | 0-10% |
The most common causative agent isolated in countries surveyed has been enterotoxigenic Escherichia coli (ETEC). Enteroaggregative E. coli is increasingly recognized and many studies do not look for this important bacterium. Some bacteria release toxins which bind to the intestines and cause diarrhea; others damage the intestines themselves by their direct presence. In infants and children it is estimated that nearly 70% of diarrhea is due to viruses; for adult travelers, this drops to around 30%. Diarrhea caused by viral agents is usually self-limited.