Epidemiology of travellers' diarrhea

Background: Travellers' diarrhea (TD) continues to be the most frequent health problem in travellers with destinations in lower income parts of the world as compared with where they reside, even if that risk has slightly decreased. Methods: A systematic review was published 18 months ago; now PubMed was searched for more recent publications relating to travel, diarrhea, epidemiology, incidence, risk. Results: A trend to decreasing incidence rates have been noted in this as compared with the last century, but TD remains frequent. The clinical picture varies from a trivial ailment to severe with subsequent hospitalization. Of great concern are long-term sequelae, particularly post-infectious irritable bowel syndrome. The most important risk factors are the destination and duration of exposure among the environmental factors, whereas the age is the most relevant host factor. Conclusions: Even if improved hygienic conditions in low-income countries often visited by travellers have resulted in slightly diminished incidence rates of TD, this remains a frequent health problem. Visitors to such destinations must be informed about that health risk and it is beneficial to equip them with instructions and a travel kit to enable them to some extent self-manage TD occurring abroad.