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Traveller's diarrhoea produces a number of symptoms (the main one being diarrhoea) that occur throughout a trip or immediately after returning from one.
The cause is infectious, caused by bacteria, a virus or parasites contracted during a trip.
Half of the cases are bacterial and caused by E.coli. Among the viruses the most frequent is the norovirus, and the parasites Giardia and Campylobacter.
In most cases, natural recovery happens within a few days, without treatment with a specific antibiotic.
Patients with traveller’s diarrhoea present with frequent and abundant liquid stools, which may contain blood and mucus.
Additionally, patients almost always experience abdominal pain, nausea, vomiting and often a high fever.
Traveller's diarrhoea can affect anyone, especially those travelling to lesser developed countries.
It is most common in young travellers (20-35 years) and during long trips, usually occurring within the first few weeks.
In most cases, since traveller's diarrhoea is self-limiting, no specific diagnostic measures are taken, but the symptoms are treated, especially with oral rehydration solutions to avoid dehydration.
Diagnosis by stool cultures that look for parasites, viruses or causative bacteria, is reserved for cases in which symptoms last more than a week.
Cases of traveller's diarrhoea usually occur on trips where healthcare is poor and oral rehydration should be started as soon as possible.
The treatment of traveller's diarrhoea involves maintaining an adequate degree of hydration in order to maintain the amount of water, mineral salts and glucose that the body needs, and which are altered by the presence of diarrhoea and vomiting.
Oral rehydration solutions, either in liquid form or sachets for dissolving in clean water, are ideal in these cases. Degassed carbonated drinks may be a temporary solution if oral rehydration is not available.
If symptoms persist for more than four days, or are severe, medical advice should be sought, even in an area with poor healthcare.
The use of antibiotics in these cases has not been proven advantageous and is not advised.
The use of anti-diuretics is also debatable, as they may impede the expulsion of diarrhoea necessary to start the recovery process.
They are not always recommended.
Specific testing is not initially indicated.
Early treatment for diarrhoea with an oral rehydration solution is fundamental as previously indicated.
Prevention is fundamental in order to avoid traveller’s diarrhoea though complete prevention is never possible.
Drinking water and water used for tooth-brushing must be bottled or sterilised with a sterilisation tablet for such use.
Only cooked foods should be consumed, never raw.
Salads must be avoided, above all.
Fruit should be eaten only after having been washed with clean water and peeled with a clean knife.
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