Traveler's Diarrhea

Traveler's diarrhea (TD) is the most common health problem that a traveler encounters. It is almost always caused from ingesting certain organisms in contaminated food. (Diarrhea can also be caused--particularly in children--by anxiety, stress, allergies, fatigue and diet changes.)

Symptoms and Course

Diarrhea frequently occurs within the first week of travel but may develop at any point, including after returning home. TD causes four or five loose or watery stools per day. Vomiting may also occur. It usually lasts 3 or 4 days, but about 14% of cases last longer. In rare cases, TD lasts more than 3 months. When TD does last a long time, it can cause postinfectious irritable bowel syndrome. TD is rarely life threatening, although it can be severely debilitating, especially in children. Any of the following symptoms require immediate medical attention, especially in children: Weakness, reduced urine output, lightheadedness, and mental changes. Life-threatening symptoms are reduced levels of consciousness, seizures, and coma.

Risk by Country

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Traveler's diarrhea typically affects between 20 -  50% of all international tourists, with the highest risk occurring in travelers to developing countries:

• High-risk destinations include most of the developing countries of Latin America, Africa, the Middle East, and Asia. The risk varies widely, however, in these countries. For example, in one study, 73% of children who traveled to Africa and 61% who went to India experience diarrhea. Only 40% who were in Southeast Asia, Latin American and other African countries had diarrhea.
• Intermediate risk destinations include most of the Southern European countries and a few Caribbean islands.
• Low-risk destinations include Canada, Northern Europe, Australia, New Zealand, the United States, and a number of the Caribbean islands.

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