Traveler's diarrhea (TD) is the most common health problem a traveler encounters. It is almost always caused by ingesting certain organisms in contaminated food or water. Diarrhea can also be caused -- particularly in children -- by anxiety, stress, allergies, fatigue, and dietary changes.
Symptoms and Course
Diarrhea frequently occurs within the first week of travel, but may develop at any point, even after returning home. Traveler's diarrhea 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, the diarrhea lasts more than 3 months. When TD lasts a long time, it can cause post-infectious irritable bowel syndrome. Traveler's diarrhea is rarely life threatening, although it can be severely debilitating, especially in children. Weakness, reduced urine output, lightheadedness, and mental changes require immediate medical attention, especially in children. Life-threatening symptoms include reduced levels of consciousness, seizures, and coma.
Risk by Country
Traveler's diarrhea typically affects 40 - 60% of people from industrialized nations who visit 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.
- Intermediate-risk destinations include most Southern European countries and a few Caribbean islands.
- Low-risk destinations include Canada, Northern Europe, Australia, New Zealand, the United States, and some Caribbean islands.
Review Date: 01/30/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.