Susceptible Travelers' Diarrhea caused by Enterotoxigenic E. Coli (ETEC) Infection

Travelers' diarrhea, the most common health problem of international travelers, typically is caused by bacteria known as enterotoxigenic Escherichia coli (ETEC). ETEC is a bacterial species that is a major cause of the most common type of travelers’ diarrhea, and is common in many areas of the world. ETEC can cause severe diarrhea and other gastrointestinal symptoms such as nausea, gas, bloating, and abdominal cramps.

ETEC infection usually occurs in people travelling to Mexico, Central America, North Africa, India, Southeast Asia, and parts of South America. Symptoms typically begin 1 to 3 days after a person consumes contaminated food or water. Most infections with ETEC cause self-limiting diarrhea, but in some cases, severe symptoms can lead to hospitalization.

Prevention

To help reduce the risk of travelers’ diarrhea, travelers should:

Drink only bottled water or water that has been boiled; avoid tap water and ice cubes
Wash hands with soap and water frequently
Avoid uncooked fruits and vegetables unless they can be peeled
Avoid unpasteurized dairy products
Avoid raw or undercooked meats and seafood
Avoid buffets and food vendors

Treatment

In most cases, travelers’ diarrhea caused by ETEC can be managed with the following treatments:

Over-the-counter medications, such as loperamide (Imodium), to help control diarrhea
Fluids to prevent dehydration
Antibiotics, such as azithromycin or ciprofloxacin, if symptoms are severe and become uncontrolled

It is important to seek immediate medical attention if any of the following occur:

Severe abdominal pain
Signs of dehydration, such as decreased urine output, dry mouth, confusion, light-headedness, or irritability
High fever
Blood in the stool

By preventing exposure to contaminated food or water and taking preventive measures, travelers can reduce their risk of becoming infected with ETEC. It is important that travelers take these steps to protect their health and prevent illness due to contaminated food or water.